Improving Trauma Care in Low-Resource Settings: A Quasi-Experimental Study on the Competencies of Intensive Care and Emergency nurses

Abstract

Background: Trauma is a significant global health issue, particularly in low and middle-incomecountries (LMICs) with limited resources. Annually, trauma causes approximately 6 million deathsand countless disabilities, burdening healthcare systems, especially in LMICs. Yet, structuredtrauma-training for nurses remains scarce in countries like Burundi. Aim: This study aimed toevaluate the outcomes of implementing the Life & Limb Primary Trauma Care (PTC) approach onintensive care and emergency nurses’ competencies in Bujumbura, Burundi. Methods: A beforeand-after quasi-experimental design was used, involving 50 intensive care and emergency nurses.Training was implemented over a period of 12 months. A pretest and posttest assessment were doneto measure nurses' knowledge, skills, and attitudes about Primary Trauma Care. Before,immediately after and one month after PTC training program implementation. Data collectionphases comprised assessment, implementation, and evaluation. Statistical analyses includedrepeated measures ANOVA, Spearman’s rank-order correlation coefficients and Chi squared test,and a second posttest was conducted one month after completing the training to reassess nurses’retention of competencies. Results: Findings demonstrated significant improvement in nurses'competencies following PTC training implementation. Knowledge scores increased from a mean of11.24 pretest to 15.30 at the second posttest. Skills assessments showed substantial gains, withprimary survey skills rising from 25.32 to 34.78 and secondary survey skills from 42.28 to 61.72.Attitude scores also improved markedly, with confidence levels increasing from 22.72 pretest to33.68 at the second posttest. Demographic variables also influenced outcomes, with male nursesshowing greater knowledge gains. Conclusion: The PTC approach proved effective in enhancingintensive and emergency nurses' competencies in Burundi. Recommendations include integratingPTC approach into bachelor of nursing curricula. Further research should include conductinglongitudinal studies to assess long-term retention and training sustainability