The relationship of burnout (BO), compassion fatigue (CF), compassion satisfaction (CS), and secondary traumatic stress (STS) to personal/environmental characteristics, coping mechanisms, and exposure to traumatic events was explored in 128 trauma nurses. Of this sample, 35.9% had scores consistent with BO, 27.3% reported CF, 7% reported STS, and 78.9% had high CS scores. High BO and high CF scores predicted STS. Common characteristics correlating with BO, CF, and STS were negative coworker relationships, use of medicinals, and higher number of hours worked per shift. High CS correlated with greater strength of supports, higher participation in exercise, use of meditation, and positive coworker relationships. Caring for trauma patients may lead to BO, CF, and STS; identifying predictors of these can inform the development of interventions to mitigate or minimize BO, CF, and STS in trauma nurses.

The purpose of this study is to determine the incidence of secondary traumatic stress (STS) in nurses who primarily care for trauma patients. A demographic/behavioral survey and Penn Inventory to measure the presence of STS were distributed to 262 nurses in a level I trauma center. Relationships between STS and years of experience, coping strategies, and personal and environmental characteristics were examined. Response rate was 49%. The median Penn Inventory score was 17.5. Nine nurses (7%) scored 35 or more, reflecting STS. Those with STS had fewer years of nursing experience and in trauma nursing, were more likely to use medicinals, and had fewer and weaker support systems.

The ABCDE bundle is an evidence-based, multidisciplinary approach to optimizing patient outcomes in the adult intensive care unit (ICU). The ABCDE bundle incorporates awakening, breathing, coordination, delirium monitoring and management, and early mobility to minimize potentially deleterious effects of prolonged hospitalization, including the development of delirium. Health care organizations that implement the ABCDE bundle have improved patient outcomes such as decreased ICU and hospital lengths of stay, decreased duration of mechanical ventilation, decreased prevalence and duration of delirium, and decreased health care costs. The purpose of this evidence-based practice project was to implement the ABCDE bundle in a six-bed general adult ICU of a rural community hospital. Implementation of the bundle decreased average patient hospital length of stay by 1.8 days, reduced length of mechanical ventilation by an average of 1 day, and established a baseline delirium prevalence of 19% over a 3-month time period. The results of this project indicate that the ABCDE bundle can be implemented in rural, community-based hospitals and provides a safe, cost-effective method for enhancing ICU patient outcomes.

Ethnic minority groups are less engaged than Caucasian American adults in advance care planning (ACP). Knowledge deficits, language, and culture are barriers to ACP. Limited research exists on ACP and advance directives in the Chinese American adult population. Using a pre–posttest, repeated measures design, the current study explored the effectiveness of a nurseled, culturally sensitive ACP seminar for Chinese American adults on (a) knowledge, completion, and discussion of advance directives; and (b) the relationship between demographic variables, advance directive completion, and ACP discussions. A convenience sample of 72 urban, community-dwelling Chinese American adults (mean age = 61 years) was included. Knowledge, advance directive completion, and ACP discussions increased significantly after attending the nurse-led seminar ( p < 0.01). Increased age correlated with advance directive completion and ACP discussions; female gender correlated with ACP discussions. Nursing education in a community setting increased advance directive knowledge and ACP engagement in Chinese American adults. [ Journal of Gerontological Nursing, 41 (8), 17–21.]