The State Major Trauma Unit a new service

1. The State Major Trauma Unita new service Susanne Jenner 28th August 2008

2. Index • The State Major Trauma Unit (SMTU) • Goals and Objectives • Multidisciplinary Team • Social Work Service • Conclusion • References

3. The State Major Trauma Unit • Is part of a 40 bed unit completed 2008 • Located level 3 north block RPH • To accommodate: • State Major Trauma Unit – 25 beds • State Adult Burns Unit – 10 beds • with 5 either/or beds usually SMTU. • In a disaster situation can be become one high acuity 40 bed unit.

4. Official Opening

5. Reception

6. Corridor (east view)

7. Single adjoining room

8. SMTU Goals and Objectives • Provision of expert care of trauma patients • To expedite patients from ED • To improve flow of major trauma patients in all related clinical areas • To expedite patients from ICU, HDA and Theatres/Recovery by providing “step down” facility. • To provide an ongoing Education and Research environment for improved trauma management and patient outcomes.

9. Complex Trauma Patients • All Multi-system trauma patients requiring input from more than one admitting specialty • Single system injuries with complex co-morbidities. • Exclusions • Patients who require advanced organ system support eg renal, ventilator or cardiac • Isolated spinal and neurosurgical injuries

10. Multidisciplinary Team • Medical • Trauma Fellows 1.6 fte • RMO’s 5 fte • Nursing 42.78 fte • Case Manager 1 fte • Clinical Psychologist 2 fte • Social Work 1.6 fte level 7 • Physiotherapy 3 fte • 1 level 8 and 2 level 4/6 for 7 day service

11. Multidisciplinary team cont’d • Occupational Therapy 2.5 fte • 3 level 7s for 7 day service • Speech 1fte • Dietician 0.6 fte • Pharmacy 1 fte • Chaplaincy ? 0.4fte • Administration personnel • Researchers

12. Social Work Service • Expectation • Provide Trauma specific SW service • 72 hour turnaround • See every patient incl ICU and HDU • Action taken to develop the role • Literature search • Identify role • Develop Psychosocial assessment specific to trauma

13. Social Work role • Prioritise (using traffic light system) • Complete psychosocial assessment • Documentation • Headings are used for assessment details • Action required • Plan including early discharge destination • Handover • The medical notes are used as a social work handover.

14. Social Work role cont’d • Sources of information contained in your assessment must be documented. • The comprehensive psychosocial assessment is intended as a guide only and contains the information required by the SMTU and assist in efficient discharge planning. • Intended outcome • Continuity of Social Work Service to the Unit

15. Psychosocial Assessment (headings) • Family • Cultural • Employment • Education • Financial • Residence • History • Trauma

16. Psychosocial Assessment cont’d • Preliminary discharge plan • Legal • Pre-existing function • Leisure interests • Risk Factors • Protective Factors • Conclusion/Impression

17. In closing • Research programs underway • Lots of QI’s • Some expected and unexpected outcomes • Statistical spot light • Important factor to remember The environment dictates service delivery ie how we work.

18. References • State Major Trauma Unit, Operational Policy, January 2008 • Brewin, Andres & Valentine, 2000 in Bonanno George A; Loss, Trauma, and Human Resilience; 2004; American Psychological Association Inc Vol.59, No 1, 20-28. • Bonanno George A; Loss, Trauma, and Human Resilience; 2004; American Psychological Association Inc Vol.59, No 1, 20-28. • Australian Centre for Posttraumatic Mental Health; Australian Guidelines for the treatment of Adults with Acute Stress Disorder and Posttraumatic Stress Disorder; February 2007.