None listed
Conditions
Brief summary
Blunt chest injury can cause significant morbidity and mortality if not treated appropriately. An evidence-based, multidisciplinary early notification mechanism and care bundle for patients with isolated blunt chest wall injury was implemented as the standard of care at two NSW sites in 2017. This was named the Chest Injury bundle of care Protocol (ChIP) This is a retrospective multi-site observational evaluation of ChIP, specifically a comparison of hospitals that currently use ChIP with hospitals that do not use ChIP, and also pre- and post-comparison at hospitals with ChIP. This study is a real-world evaluation of the effect of the protocol (ChIP) on patients, health service outcomes and costing. The implementation processes will also be evaluated. The primary outcome measure is non-invasive ventilation to investigate if the implementation of ChIP will result in a reduced incidence of patients with isolated blunt chest injury requiring NIV. NIV is considered an indication of respiratory deterioration. Evaluation will be using retrospectively collected data linked to NSW Admitted Patient Data Collection (APDC) data and NSW Activity Based Funding data.
Interventions
The intervention is the Chest Injury bundle of care Protocol (ChIP) - which includes a set of evidence-informed interventions for patients presenting with blunt chest injury. ChIP provides a flowchart for the identification of patients with blunt chest injury in the emergency department who are at risk of deterioration. Once identified a pager system is activated that alerts the surgical team, physiotherapist, intensive care registrar and liaison nurse, pain and aged care teams to review the pat
The intervention is the Chest Injury bundle of care Protocol (ChIP) - which includes a set of evidence-informed interventions for patients presenting with blunt chest injury. ChIP provides a flowchart for the identification of patients with blunt chest injury in the emergency department who are at risk of deterioration. Once identified a pager system is activated that alerts the surgical team, physiotherapist, intensive care registrar and liaison nurse, pain and aged care teams to review the patient within 60 minutes. The flowchart than provides guidelines for evidence-informed management of the patient. This includes oxygenation such as high flow nasal prongs, analgesia and supportive interventions such as deep breathing exercises. ChIP has already been implemented at three hospitals using behaviour change theories in November 2017. ChIP will be observed from 22 November 2017 to June 2019.
Sponsors
University of Sydney
Eligibility
Sex/Gender
All
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
Blunt thoracic trauma mechanism Adult greater or equal to 18 years Admitted to hospital Rib/sternum fracture (clinical or radiological diagnosis)
Exclusion criteria
Injury occurred while in hospital for other reason (activation system not possible) Major cognitive impairment (patients are unable to participate in the care bundle) Intubated Prehospital or in the emergency department
Outcome results
None listed