Primary Trauma Nurse (PTN) and

Core Trauma Nurse (CTN)Role Development

Ashley Fidler, BSN, RN, CENMary Kay Stauffer, RN

Objectives

Create awareness of PTN and CTN selection process

Demonstrate the process for PTN selection and training as well as advancement to the CTN role

Differentiate between the PTN and CTN roles

Primary Trauma Nurse (PTN)

Prospective candidates are identified by the nurse educator or nurse manager

Must be in the ED for a minimum of one year with a PTN completion goal by the 3rd year in the ED

A discussion is held at the Core Trauma Nurse meeting (monthly) for peer input regarding potential PTN candidates

PTN (cont.)

Candidates are given prep workMust review the trauma manual and

trauma protocolsMust complete a skills check list

Skills Check List

Check list is to be filled out as much as possible prior to PTN day

LANCASTER GENERAL HOSPITAL Trauma Nurse Skills Checklist

You must be the nurse performing the procedure and be cosigned by the charge nurse. The following skills must have date, co-signature and MRN#

Rapid Sequence Intubation Procedure:

Chest Tube Insertion Procedure:

Central Line Insertion Procedure:

NGT/OGT insertion:

Level One Infuser: Demonstration of one error-free set-up and

running of the Level One for Validator OR

Use of the Level One on a patient

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Date: ________ MRN____________ Charge Nurse Co-signature: ______________

Date: ________ MRN____________ Charge Nurse Co-signature: ______________

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Date: ________ MRN____________ Charge Nurse Co-signature: ______________

Date: ________ MRN____________ Charge Nurse Co-signature: ______________

Date: ________ MRN____________ Charge Nurse Co-signature: ______________

Date: ________ MRN____________ Charge Nurse Co-signature: ______________

Date: ________ MRN____________ Charge Nurse Co-signature: ______________

Date: ________ MRN____________ Charge Nurse Co-signature: ______________

Date: ________ MRN____________ Charge Nurse Co-signature: ______________

Date: ________ MRN____________ Charge Nurse Co-signature: ______________

Date: ________ MRN____________ Charge Nurse Co-signature: ______________

Date: ________ MRN____________ Charge Nurse Co-signature: ______________

Critical Thinking Stations

Candidates sign up for an individual, 30 minute session to sit before a panel of CTN’s

Presented with real trauma scenarios and must follow ABCDE guidelines as if it were a real trauma patient

Candidates are then scored based on performance If a passing score is obtained, they are given a

trauma binder and invited to PTN day

PTN Day

One, 8 hour day Presentation of a trauma video (made by fellow CTN’s) that

includes a poorly-run trauma scenario as well as an efficiently-run scenario demonstrating crew resource management

Half day of lecture-based material including special circumstances and population-specific concerns

Half day of hands-on, real-time trauma scenarios with opportunities to practice documentation and bed side resuscitation

PTN Day (Cont.)

Candidates are evaluated on an individual basis If a passing score is obtained, PTN’s are placed

on orientation and must pass 6 real traumas with CTN’s as mentors (2nd nurse)

3 traumas must be graded on documentation and three must be graded on bedside resuscitation

Evaluation Tool

Primary Trauma Nurse (PTN) Post Trauma Evaluation Communication Tool

PTN:__________________________________ Date:_______

This form is to be completed after each trauma (total of 6) during the PTN orientation phase. Form to be completed and turned into the ED Nurse Manager after completion.

For the following categories, rate the orientee; 2= Meets Standards (requires some oversight and supervision) 1= Does Not Meet Standards (requires significant oversight and supervision) 0= No Opportunity Communication 2 1 0 Comments

Demonstrates respect for the confidentiality of patient information (PHI).

Is assertive during the resuscitation ensuring closed loop communication is occurring.

Communicates effectively with other team members.

Demonstrates positive team dynamics with staff, manager, physicians, patients, families, and members of the interdisciplinary team.

Accepts and applies constructive criticism in a positive and professional manner to improve future performance.

Accurately reports test results according to policy and procedure.

Coordinates patient care by working with the interdisciplinary team.

Time Management 2 1 0 Comments

Anticipates and independently initiates tasks to be completed

Always anticipates needs of patient by preparing for procedures based on presentation and findings i.e. Level I, OR.

Communicates to Charge Nurse the need for upgrade of care/need to transfer.

Effectively manages rapidly changing situations.

PTN candidate has successfully completed the requirements of the primary trauma nurse Yes ___ No ___ If no, plan established for orientee to meet standards:________________________________________________ ____________________________________________________________________________________________

Comments:_________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________ CTN/PTN: _________________________________ Date: _____ (Please Sign Name) PTN Candidate: ___________________________ Date: _____ (Please Sign Name)

Core Trauma Nurse (CTN)

Selection processCandidates complete a declaration of intent which

includes: Qualifications, contributions to the trauma program, and individual strengths

Submit a resumeComplete a readiness checklist/self assessmentMeet required points (similar to Clinical Ladder)

CTN (Cont.)

A peer review is conducted by current CTN’s and candidates must have exceptional trauma documentation

Candidates must have a score of 20 with at least 50% earned in mentoring/coaching

Must be approved by current CTN’s

CTN Role

Must attend 50% of monthly meetings Act as a resource and mentor for trauma care

throughout the ED Serves as the primary preceptor for new PTN’s Collect trauma PI data and make suggestions for

improvement Demonstrate advanced/expert knowledge in practice

relevant to policies, procedures and standards

CTN Role

Teach and guide new PTN’s about the trauma nurse role on PTN day

Participate in trauma researchDisseminate important trauma

information/changes through the CTN communication list

Questions?