Trauma Response Nurse Impact on Trauma Bay Efficiency and Time to Definitive Care

Timely transition from the emergency department (ED) to definitive care is critical in severely injured patients. Deploying surgical trauma intensive care nurses (ICU) as trauma response nurses (TRNs) during highest (alpha-level) trauma activations may improve care coordination and expedite transitions; however, evidence supporting this practice remains limited.

To evaluate the effect of the TRN on ED length of stay (LOS) and time to definitive care for alpha trauma activation patients.

This single-center, retrospective cohort study analyzed all alpha trauma activations involving patients aged 16 years and older admitted to a Level I trauma center in the southeastern US between July 1, 2022, and June 30, 2024. Clinical outcomes were compared between patients managed with and without a TRN during trauma bay resuscitation.

Among 353 patients, 193 (55%) were in the TRN group and 160 (45%) in the non-TRN group. The median ED LOS was 77 minutes (IQR, 59-105.5) for the TRN group versus 81.5 minutes (IQR, 61.5-127.3) for the non-TRN group ( p = .20, r = 0.07). The median time to the operating room (OR) was 63 (IQR, 32-94.5) minutes versus 80 (IQR, 24.8-120.5) minutes ( p = .88, r = 0.03). The median time to ICU was 77 (IQR, 62.5-105) minutes with a TRN, compared to 81 (IQR, 65-129.3) minutes ( p = .21, r = 0.07). We did not observe statistically significant differences between groups.

ED LOS, time to OR, and time to ICU were similar between groups, with slightly lower values in patients with TRN involvement. Further evaluation is needed to determine clinical relevance and impact on trauma protocol adherence.