The holiday season and family time, social gatherings, garish decorations, and vacationing are almost all synonymous this time of year. Although everyone spends this time of year differently and perhaps is not part of the typical mainstream holiday mayhem, we all are exposed to busier roads, crowded shopping malls, higher stress, and an even more distracted society. It is unfortunate that in the midst of what should be a delightful time of year, traumatic injuries still occur; trauma does not stop for these 2 months. So, as we head into the holiday season, what better time to take inventory of our injury prevention efforts.
Those of us in the trauma business are fully aware that traumatic injury remains the most underrecognized public health problem facing the nation today and that the medical costs of injury to society are enormous. Efforts to prevent or decrease this burden in communities fall into the hands of trauma centers and trauma systems. The creation and organization of trauma injury prevention efforts clearly exist within trauma networks nationally. However, despite the various efforts, "injury remains the leading cause of years of potential lives lost and leaves millions of Americans chronically disabled every year" (Committee on Trauma American College of Surgeons, 2014). It is clear that we all need to continue with injury prevention efforts that are based on registry data, monitor the effectiveness of the efforts, and work as a team within our organizations and communities in sharing the safety messages. It is the responsibility of all trauma team members to enforce preventive measures.
Let's take injury prevention briefly back to the basics. There are three levels of injury prevention: primary prevention, secondary prevention, and tertiary prevention (Fowler, 2009). Primary prevention involves a process to stop the actual traumatic event such as a fall or car crash. Secondary prevention involves the prevention or minimization of the injury during the event such as airbag deployment. Tertiary prevention is providing optimal care to the injured patient in order to return him or her to a functional lifestyle. Primary prevention is the focus for this holiday team exercise.
Primary prevention is not as simplistic as it sounds. We know that educating on safe behaviors does not necessarily lead to safe performance. If the audience is not motivated or ready to change the risk-taking behavior, the behavior will most likely continue. In the Resources for Optimal Care of the Injured Patient, the American College of Surgeons defined key elements that are necessary for an effective injury prevention program that are listed below (Committee on Trauma American College of Surgeons, 2014):
1. Target the community: Review your data and identify the primary causes of injury and death. Drill further into your data and analyze the seasonality of these injuries as well.
2. Work upstream: Identify the root causes of injury and the contributing factors.
3. Choose preexisting proved or promising programs: Understand that new program development, assessment, and implementation are complex and time-consuming. It is not always necessary to reinvent the wheel.
4. Always partner with other organizations: Make use of the fact that other trauma centers and other organizations are interested and involved in community injury prevention efforts.
5. Embrace the media: Learn to speak effectively and allow trauma center leaders to become a reliable source of injury prevention information for local print and broadcast media.
6. Be politically savvy: Realize that elected and appointed leaders can help if the trauma center understands their goals and the ways to work with them to create effective laws promoting prevention.
7. Do not forget the data: Develop surveillance and monitoring tools to assess not only the available performance indicators of the trauma center's prevention efforts but also the prevention effectiveness.
Take the opportunity now and analyze your injury prevention efforts. Confirm that your injury prevention programs meet the outlined elements above and implement a plan for the holiday season. Let's work to keep our families, friends, and coworkers safe for the holidays by enforcing the following:
* No texting and driving: Stay focused on the road.
* Sober driving: Share mocktail recipes for the designated driver.
* Decking the halls safely: Keep trees away from fireplaces and radiators. Place candles and menorahs away from curtains and other flammable decorations. Ensure that the tree light wires or extension cords are intact. Some live plants are poisonous, so place cautiously if children are in the home. Be cautious in where you place decorations that may have sharp edges, are breakable, or are small enough for children to grab or swallow. Make sure that extension cords and other floor decorations are out of the walking path especially in the homes of our elderly to prevent tripping hazards.
* Ladder climbing with a spotter: Use a ladder that safely reaches higher levels and have someone steady the ladder.
The most important message would be to slow down, take a deep breath, and enjoy the holidays. This is the most challenging for our society this time of year and throughout, but we still need to enforce safety measures. Trauma nurses know all too well that a few seconds of inattentiveness or risky behavior can derail the course of a healthy life forever. Together, continue to create, promote, and evaluate your primary prevention efforts now and year round. Remember, if you impact one life with a preventive message, you are a winner. However, we all know that we accomplish much more than that when we act to prevent traumatic injury. On behalf of the Society of Trauma Nurses' Board of Directors, I would like to wish everyone a wonderful, safe, and healthy holiday season.
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