Karen M. Rohr

Date of Award

5-1-2006

Document Type

Dissertation

Degree Name

Doctor of Philosophy (PhD)

Department

Nursing

Abstract

People age 65 years and older are the fastest growing segment of the United States population. As the older population increases, the risk for injury also increases. Use of alcohol is a major contributing risk factor for unintentional injury and death. The problem is that despite the fact that alcohol use is one of the major causes of unintentional injury and death in trauma centers, most trauma centers do not routinely screen patients for alcohol problems and provide intervention when needed. A descriptive correlational methodology was used to identify and compare the characteristics and hospital outcomes of older trauma patients who tested positive at the time of admission with those who did not. The convenience sample included 883 patients age 65 years and over who presented to the emergency department of multiple health care facilities. The theoretical base used was the Neuman Systems Model. Data analysis consisted of existing trauma registry data for the 2004 calendar year from six level II trauma centers located in a rural Upper Great Plains state. Variables investigated were alcohol status, age, gender, ethnicity, type of insurance, mechanism of injury, injury severity, hospital and intensive care unit length of stay, and discharge disposition. The findings identified 4.2% were tested for alcohol; 45.9% were alcohol positive (AP) and 54.1% were alcohol negative (AN). Alcohol prevalence was 1.9%. Blood alcohol levels ranged from 10 to 400 mg/dl; 76.5% were greater than 80 mg/dl. Statistical analysis demonstrated no sociodemographic differences between the alcohol groups and alcohol use had no effect on the injury-related outcomes of AP older trauma patients. However, a significant correlation was found between injury severity and discharge disposition in the AN group. It is apparent from the results of this study that health care providers do not routinely screen older trauma patients. This study provides compelling evidence that routine alcohol screening needs to be done on all older trauma patients at the time of admission. Further study with a larger sample size is recommended to investigate whether or not alcohol use has an effect on the injury-related outcomes of older trauma patients admitted to level II trauma centers.

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