Factors Affecting Interprofessional Teamwork in Emergency Care of Poly-Trauma Patients

This article discusses the factors that affect interprofessional teamwork in emergency care of poly-trauma patients at the emergency department. It explores individual, relational, processual, and organizational factors that influence teamwork. The article also highlights the significance of collaboration for providing a quality service to patients.

The Factors Affecting Inter
Professional Teamwork In
Emergency Care Of Poly-Trauma
Patients At The Emergency
Department
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Table of Contents
INTRODUCTION...........................................................................................................................3
MAIN BODY ..................................................................................................................................3
Discuss the factors affecting inter professional team work in emergency care of poly-trauma
patients at the emergency department.........................................................................................3
Significance of the collaboration for a quality service................................................................8
CONCLUSION................................................................................................................................9
REFERENCES..............................................................................................................................10
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INTRODUCTION
Poly-trauma usually takes place when an individual is suffering from injuries to various
parts of body or at different organs. Traumatic brain injury occurs in poly-trauma with
combination of several disabling states like burns, visual damage, amputation, visual damage,
post traumatic stress disorder or any further medical issues (Lapierre, Lefebvre and Gauvin-
Lepage, 2019). Due to such complexity and severity because of such injuries, the health care
providers require high level of coordination as well as strong integration of medical services and
support during emergency of poly-trauma. The approach which may be utilised during
emergency should be patient centred and interdisciplinary based on inter professional team work.
The report will focus on discussing various factors which are affecting inter professional
teamwork with respect to emergency care of poly-trauma patients at the department of
emergency. The report will further outline the value of collaboration in quality services.
MAIN BODY
Discuss the factors affecting inter professional team work in emergency care of poly-trauma
patients at the emergency department
Poly-trauma or multiple trauma has been refereed to as a medical term which describes
the status of an individual who are subjected to various traumatic injuries. The major cause of
mortality as well as morbidity is due to poly-trauma in countries who are developing or
developed. The trauma is one of the leading cause of death in adults or in children, even if it does
not cause death it may result in severe disability. The occurrence and prevalence of such
condition may ranges from one region to another region. The most common cause of such
traumas are bullet injuries, road accidents, fall from height, blast injuries and many more. In
civilian life, road accidents are the most general and usual cause of poly-trauma. Such condition
are usually encountered in emergency cases, due to which it is highly essential that the
emergency department are fully equipped with all resources and machines for treating such
accidents (Seamon and et.al., 2015). The poly-trauma patients represents supreme challenge
which involves in taking care of trauma and at the same time optimising their care approach with
high focus on quality care and good clinical research. A large number of patients facing such
condition land in the emergency division of hospitals. The mission of the team members who are
working in these departments enrol the issues, establishing some basic priorities, stabilises the
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patients condition and transfer them to speciality ward or operation theatre depending upon their
condition and requirements. The team which are formed in such department has to be comprising
of various people specialising in their own expertise. Such inter professional team work is very
essential to be maintained in such division for providing quality care and support at the time of
emergency to poly-trauma patients.
The hospitals should have a designed and separated as well as integrated emergency
department which have the capability to provide surgical services and medical facilities during
urgency to treat patient under a same roof. There are some procedures which are being conducted
for treating the patients suffering from poly-trauma, initially they gets assessed which further
assist in making treatment plans. As soon as the victims enters the emergency department, they
gets attended by a general surgeon (Scholten and et.al., 2015). All essential data and information
are sent to other specialities which maintains the record of every patient by general department.
In case of major emergency, all specialist which are required as per the accident are called for
operating the victim. At this state, all doctors specialising at different domains asses the patient
carefully along with stabilising them. The patients once get treated gets clearance form the
doctors who decided whether they need to keep them for further observation or discharge the
victim. In case of poly-trauma consultation has to be taken from various specialists for ultimately
getting a clearance for procedures like discharge or admit. The patients with poly-trauma are
treated in emergency department by several specialists like orthopaedic surgeon, general
surgeon, anaesthetist, ENT surgeon, neurosurgeon, cardiothoracic surgeon and other paramedical
personnels that together make up inter professional team work. There are some factors which
influences the inter professional team work in the case of poly-trauma patients at emergency
department. Some of these factors are discussed below.
Individual factors
The individual factors play a very crucial role in determining the quality of inter
professional team work who are dealing with poly-trauma patients. The individual factors are
described below.
Exposure – The team members in such department who are found to get exposed to poly-
trauma care in their earlier life stages are observed to be more calmer than those who did not face
such related situation (Dale and Bjørnsen, 2015). It has been found that people who have priorly
exposed to poly-trauma are more comfortable in delivering their appropriate roles, they remain
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calm while giving medication and doing specific treatment which require extreme precision and
experience. They become so acquainted with the current situation that they tends to become
more effective while interacting with the patients and their family members. Such role make the
victims as well as their family members normal and calm. The nurses who do not have such prior
experience tends to become nervous and make small mistakes while handling patients. Due to
such issue they are required to attend trauma room training which make them understand how
they can cope up with such issues effectively and can behave optimally when such situations are
exposed.
Physical and emotional state – The physical and emotional state is one of the most
important factors which can affects the way people deal with the situation. When team members
are tired and less patient it has been observed that they tend to become more stressed and anxious
after getting exposed to any poly-traumatic condition (Ritwik, Massey and Hagan, 2015). The
emotional state, that is there mood and stress level demonstrates who positively and negatively it
will affects the inter professional team work while dealing poly-trauma patients. The physical
state, that is if some members are tired due to which they could not focus on their work and feel
to collaborate with other team members. Such situation may be amended by building more
focussed group who are experienced enough to neglect such issue while dealing with emergency
cases.
Knowledge updating – The knowledge updating is a powerful factor which seems to
highly influence the team work. When an individual has solid and concrete knowledge, they have
confidence in dealing with post-traumatic patient in more effective and productive way. When
people who do not make any update to their current knowledge, they some how lag behind in
providing updated treatments and not able to deal with recent technologies which require high
amount of expertise and knowledge. The poly-traumatized person can be dealt more efficiently
when they get to handle by such health professionals who are determined and knowledgeable
enough to render innovative care and support at emergency situations (Mlcak, Buffalo and
Jimenez, 2018).
Relational factors
The relational factors are some vital elements which help in keeping the inter
professional team work better in context of interpersonal relation and communication. Some
relational factors are mentioned below.
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Communication – The key element of collaborative team work is communication. Real
time and active interaction in poly-trauma care have been determined by many professionals
when laying concern on good communication. The interaction which are associated with closed
loop are suggested more to facilitate team work. The chief purpose of effective communication is
to avoid misunderstanding and ensuring that all the details and important instruction regarding
the patients are clear (Nikathil and et.al., 2017). The nurses who are responsible in providing
medications and daily diagnosis are needed to communicate to other team members on daily
basis for eliminating the chance of getting misunderstanding and to avoid such case which result
from misleading data. The conversation among team members should be in quite and decent
manner, loud noises consequence in distracting the doctors and making the other patients
uncomfortable. Debriefing is a strategy which can be utilised when health professionals are
required to review poly-trauma care.
Roles – The distribution of roles is another element which influences the collaboration of
team work while supporting the poly-traumatic victims. This factors includes in identifying each
individual's role prior to the arrival of such patients. As per many health professionals,
determination of their roles are considered as facilitating element. The people who are engaged
in such team work should know their roles and duties at initial stages only, this factors will
further smooths the situation and leads in effective care. The team members who do not
understand or know about their roles, fails to provide care at the time of emergency. Such factor
may be a leading cause of resulting premature deaths due to poly-trauma in some people.
Identification of leader is highly required in setting the steps in trauma by assigning various roles
to different team member in respect to manage the functions for dealing poly-trauma.
Team composition – The role of leader is highly involved in handling the patients
through good inter professional team work. The team which are composed should have all type
of knowledge either basic or professional which are highly required while taking care and in
treatment of emergency patients of post-traumatic (Smitht and et.al., 2015). The stability of team
is another factor which comes under team composition. The health providers defines stable team
as a one which are composed of people who understands each other and can work in
collaboration in emergency department. Introduction of new team members at the time of
urgency may outcome in less coordination in trauma room.
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Processual factors
Processual factors like environment, urgency, protocol, working shifts and many more
have the capacity to affect the inter professional collaboration while treating the poly-traumatic
patients. Some of these factors are given below.
Environment – The physical environment of hospitals and equipments have a major
impact on team work on poly-trauma support. The equipments which are obsolete or having
trouble to get access appears to impede inter professional team work. The presence of updates
equipments who are well maintained shows that such patients can be easily assessed and it
prevents in lowering mortality and rate of morbidity. The presence of non trauma patients in the
same room where poly-traumatic victims are admitted affects the environmental factor which
have a negative impact in quality care and team work (Montoya and et.al., 2015). The presence
of family members also influences the team work, but if they are calm and do not bother patient
then such situation may be avoided. In most cases, family members are not involve in patient
emergency care ward due to issue of contamination.
Work shifts – It has been observed that, trauma practice range depending upon the period
of shift and urgency. The experience which are faced at the time of day, evening and night are all
different. The resource availability also changes when the team focus on three shifts due to
which the experience changes. The day shift are considered to be more easier because it has all
resource accessibility and more help could be taken from new staff which will not be available at
night and evening shifts.
Organisational factors
The support which an organisation provide to the team members of emergency
department may be differing in depending upon their priorities and support, some of these factors
are described below.
Organisational support and priorities – The material as well as human resources which
are rendered by organisation seems to have a large impact on team work. It has been seen that
when health professionals are supported in terms of resources and staff then they feel grounded
and become more enthusiastic to work in such department (Newgard and et.al., 2017). The
constant clinical support and equipments which are provided for giving good medical support to
poly-traumatic victims acts as a facilitating factor. Deficiency of clinical support and appropriate
staff during evening or at night shift have adverse impact in delivering quality care to such
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individuals. The priorities which organisation defines must have positive role in bringing good to
emergency department as well as to inter professional team work. If an organisation only lay
emphasis on growing their business by enhancing marketing area and do not focus on proving
proper support then it has a negative impact on dealing with poly-trauma patient which leads into
premature death.
Significance of the collaboration for a quality service
It has been observed that multiple health workers from various professional backgrounds
come together in order to support the patients who needs to be facilitated and supported. In the
case of poly-trauma patients, the emergency department has to be occupied with high
experiencing inter professionals in context to supply highest quality of care. The collaboration
among inter professional team work is vital in sharing data and for conducting effective
communication which not only make the condition of patient better but also strengthens the
health care system at the time of emergency as well (Kehoe and et.al., 2015). It is needed that all
team members has to engage for supporting the patients for making their health condition better
as soon as possible. Effective inter professional collaboration practices have been observed to
promote better and active participation of each aspect of health care with respect to the patient
care. The significance of the collaboration have been seen to be high for a quality service, such
value are discussed below.
Improve outcome of patient and care – The people who are brought or visit emergency
department complaining about a certain issue or regarding any health issue. The services which
are provided in this department are quick and focus on treating the patients as soon a they get
assessed. The department has been made to improve the outcome of victims, they get quick
evaluation and resources for making the condition of patient better. Depending upon there
recovery and severity of health issue, they are either admitted or discharged. During their stay,
they are assessed by any therapist and worker who deals in rendering quality services to people.
Such inter professional team have a holistic and comprehensive perceptive of the patients. Along
with care team meetings, large number of hospitals motivates on patient centred and team based
round check ups which assist to foster inter professional collaboration in health care (van Zuiden
and et.al., 2017).
Lower medical error – In health care, the gaps which are produced due to less or
misleading communication may have high cost not only in terms of money but also related to
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health status of people. The medical errors which are caused by less communication or
information gap is a leading cause of deaths. The role of inter professional comes here, who have
the capacity to deal poly-trauma conditions with either high experience and effective
communication. The group conversations, closed loop interactions are some of the tactics which
are utilised by such professionals in order to give high quality services and facilities. The
collaboration in health care system can lower the preventable reactions due to drugs, reduces the
mortality rate and optimises the medication dosage.
Start treatment faster – The medical services which are provided to non emergency
ward or some other department includes slow processing operations (Jennings and et.al., 2017).
The patients have to wait in long queue for doctors consultation and the reports of lab also take a
while to get in the victims hand. In inter professional collaboration, the gaps are filled more
effectively by taking help of better clinical communication technology. The members are
constantly in touch which reflects automated alerts for dealing with people having health issues.
The entire team of collaboration has all type of experts who deals with varying health conditions
via quick services like video, chats or by any other way.
Lowers health care cost – The collaboration of inter professionals can lowers the
medical error, improving the outcome of patients and treatment efficiency gets better and fast, all
of these factors collectively reduces the health care cost (Duffy, Avalos and Dowling, 2015). By
assorting the work flow redundancies and inefficiencies in functioning are also managed by such
team members which aids in rendering high quality health care.
CONCLUSION
From the above report it can be concluded that, poly-trauma normally occurs when a
person is suffering from injuries to assorted parts of body or at various organs. The affecting
inter professional team work in emergency care of poly-trauma patients at the emergency
department are individual factors, relational factors, processual factors and organisational
factors. The significance of collaboration of quality services assist in improving the outcome of
patients, lowers the medical error, treatment efficiency gets fast and accurate and the cost of
health care are reduced.
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REFERENCES
Books and Journals
Dale, J., & Bjørnsen, L. P. (2015). Assessment of pain in a Norwegian Emergency
Department. Scandinavian journal of trauma, resuscitation and emergency
medicine, 23(1), 86.
Duffy, E., Avalos, G., & Dowling, M. (2015). Secondary traumatic stress among emergency
nurses: a cross-sectional study. International emergency nursing, 23(2), 53-58.
Jennings, R. M. & et.al., (2017). Reducing head CT use for children with head injuries in a
community emergency department. Pediatrics, 139(4), e20161349.
Kehoe, A. & et.al., (2015). The changing face of major trauma in the UK. Emerg Med J, 32(12),
911-915.
Lapierre, A., Lefebvre, H., & Gauvin-Lepage, J. (2019). Factors affecting interprofessional
teamwork in emergency department care of polytrauma patients: Results of an
exploratory study. Journal of Trauma Nursing, 26(6), 312-322.
Mlcak, R. P., Buffalo, M. C., & Jimenez, C. J. (2018). Prehospital management, transportation,
and emergency care. In Total burn care (pp. 58-65). Elsevier.
Montoya, K. F. & et.al., (2015). Shock index as a mortality predictor in patients with acute
polytrauma. Journal of Acute Disease, 4(3), 202-204.
Newgard, C. D. & et.al., (2017). Evaluation of rural vs urban trauma patients served by 9-1-1
emergency medical services. JAMA surgery, 152(1), 11-18.
Nikathil, S. & et.al., (2017). Workplace violence in the emergency department: A systematic
review and meta analysis. Emergency Medicine Australasia, 29(3), 265-275.
Ritwik, P., Massey, C., & Hagan, J. (2015). Epidemiology and outcomes of dental trauma cases
from an urban pediatric emergency department. Dental traumatology, 31(2), 97-102.
Scholten, A. C. & et.al., (2015). Pain management in trauma patients in (pre) hospital based
emergency care: current practice versus new guideline. Injury, 46(5), 798-806.
Seamon, M. J. & et.al., (2015). An evidence-based approach to patient selection for emergency
department thoracotomy: a practice management guideline from the Eastern Association
for the Surgery of Trauma. Journal of Trauma and Acute Care Surgery, 79(1), 159-173.
Smith, K. A. & et.al., (2015). A preprocedural checklist improves the safety of emergency
department intubation of trauma patients. Academic Emergency Medicine, 22(8), 989-
992.
van Zuiden, M. & et.al., (2017). Intranasal oxytocin to prevent posttraumatic stress disorder
symptoms: a randomized controlled trial in emergency department patients. Biological
Psychiatry, 81(12), 1030-1040.
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