Data entry system update The Trauma Audit & Research Network (TARN)

Data entry system updateThe Trauma Audit & ResearchNetwork (TARN)

Recent system changes As agreed by TARN Audit Committee

Recent system changes-CORE dataset: As agreed by TARN Audit Committee • Incident location added: Segregated Cycle Route • Used for pedal cyclists injured on a fully segregated cycle route, this does not include cycle lanes • Was the patient involved in a Major Incident: added to Incident location. • Help text guidance updated >>>

Recent system changes & guidance-CORE dataset As agreed by TARN Audit Committee • Injury Intent • Suspected domestic (intimate partner) violence added. Protection in vehicle Forward facing and Rear facing child seats (for under two years old) have been added. Help text guidance has been updated to advise the use of the generic ‘Child seat’ option if the type of child seat is not known &/or the child is 2+years old.

Recent system changes & guidance-CORE dataset As agreed by TARN Audit Committee • Anticoagulant reversal added to interventions, Pre Hospital, ED & CC • Pre-injury Anticoagulant added to At Discharge screen See Help Text for advice The options for anticoagulants are the same as for antiplatelets. If you are unsure of the reason these products were administered please record them as anticoagulants.

Recent system changes & guidance-CORE dataset As agreed by TARN Audit Committee • Nurse Competency • To support recent guidance from the National Major Trauma Nursing Group and NHS-England, we are giving you the opportunity to document the competency of the first nurse to treat a patient in ED. • This has been added as a new question to the Attendants section and is conditional on ‘Nurse’ being selected as the Attendant type. • More information about this guidance will be added to News and Activity section over the coming weeks. • Options for Nursing Grades and Training will also be updated. • Current Guidance: standard practice is to record only Doctors and Nurse Consultants as attendants

Nurse Competency: Further guidance Guidance from NMTNG added to Resources section Oct 18

Recent system changes-CORE dataset: Added January 2019 As agreed by TARN Audit Committee • Nurse training revision- Trauma Immediate Life Support (TILS) has been added. • Nurse speciality revision- Specialist Pain Management has been added as an option for Nurses (already applied for Doctors).

Recent system changes-CORE dataset: Added June 2018 As agreed by TARN Audit Committee Attendant grades:Local anaesthetic (theatre only) has been added to the list of Attendee grades. This option can be used if the patient has an operative procedure in theatre but this is performed under Local rather than General Anaesthetic, so no anaesthetist was present.

Recent system changes-CORE dataset: Added June 2018 As agreed by TARN Audit Committee Complications:Post-operative haemorrhage, Anastomotic haemorrhage and Vascular complications have been combined into one generic category of: Haemorrhage.Delirium and Abdominal compartment syndrome have both be added to the dropdown list. Pre-existing conditions:Previous injury (non-healed) has been added and should be used if the patient suffers 2 incidents, the first of which is ineligible (closed radius for example) and the second eligible. In this scenario the ineligible injury (radius) should be listed as a Pre-existing condition.

Recent system changes-CORE dataset: Added June 2018 • As agreed by TARN Audit Committee • Performance Review Indicators report changes: • A PROMS available (Patient Reported Outcome Measures) field has been added to this report. • Yes: Indicates that a PROMS questionnaire has been completed and the PROMs data linked to a TARN submission. • The Shocked field has been renamed to SBP <110 (systolic Blood pressure).

Recent system changes & guidance-CORE dataset • Notification of Transfers: • Algorithm in place to identify potential matching transfers. • Uses criteria such as: Incident date, Age, Gender, Receiving hospital, Surname. • True matching submissions are then linked during the standard data processing procedure. • Therefore, it is not necessary to routinely email TARN with details of matching submissions, as most will be picked up automatically • Exception: If submissions remain unmatched for more than one month, at which point they will then appear on your Unmatched Transfers report(Audit tab). • At this point, please email support@tarn.ac.uk with the matching submission number (where known) and we shall investigate why the submissions weren’t picked up by the transfer algorithm. • Usual reasons for this are that different genders, incident details, transferring hospital or ages have been entered by the hospitals, which we can then correct and link the two submissions.

Rehabilitation prescription 2019 • Launched April 2019- mandatory from that point • Prescription matches TARN system exactly • Fields are live on TARN system now, data can be entered now so that trusts can familiarise themselves with the changes. • Existing BPT rehabilitation questions will remain until April 19, and continue to determine BPT payment until this time. Must be answered to ensure BPT payment • Guidance document in Resources section of TARN website. • BPT flowchart document to follow from NHS E & Professor Chris Moran

Rehabilitation prescription 2019 questions: Added October 2018 Agreed by NHS-E Task & Finish group

Rehabilitation prescription 2019 questions: Added October 2018

Planned system changes As agreed by TARN Audit Committee

Planned system changes-CORE dataset: From February 2019 • As agreed by TARN Audit Committee • Nursing Grades revision: • The dropdown list will be revised to only show the following: Band 5, 6, 7, 8, 9 and Not Known. Help text guidance will be updated & any previous records mapped accordingly. • Nurse Consultant will remain on the Doctors & Senior Nursing Grades list as now. • Performance Review Indicators report revision: • Admitted to ED will be added. • Admission to the 3rd Ward the patient was admitted to, will be removed. • Chest Wall Trauma Screen report added: • To accompany the Chest Wall Trauma specialist screen. This report will pull information both from this specialist screen & the CORE dataset and focus on patients with 3+ rib fractures. • It will be available for users to produce anytime – from the Audit tab (as with the BOAST4 report

Planned system changes-CORE dataset: From April 2019 • As agreed by TARN Audit Committee • Data Accreditation will be amended in the following ways: • Time of Intubation: Will be added due to inclusion in new NICE Quality standards. • People with major trauma who cannot maintain their airway and/or ventilation have drug-assisted rapid sequence induction (RSI) of anaesthesia and intubation within 45 minutes of the initial call to the emergency services (NICE Quality Statement) • Incident date/time will be reviewed separately to 999 call date/time: Due to importance of ambulance call times in new NICE Quality standards. • Time of provisional and final CT report: Will be added due to inclusion in new NICE Quality standards. • People who have had urgent 3D imaging for major trauma have a provisional written radiology report within 60 minutes of the scan (NICE Quality Statement) • Time of TXA: will be added. • Name of Previous/next hospital patient is transferred to/from: Will be removed. • More information will be provided in forthcoming Newsletters.

Data entry system update The Trauma Audit & Research Network (TARN)