TY - JOUR
T1 - Burn and Trauma Burden and Screening for Interpersonal Violence During the COVID-19 Pandemic
AU - Loza-Avalos, Sandra E.
AU - DeAtkine, Elizabeth
AU - Ochoa, Manuela
AU - Treviño, Robert
AU - Diercks, Kiersten
AU - Edwards, Courtney
AU - George, Jessica
AU - Lunardi, Nicole
AU - Paquette, Shannon
AU - Bisgaard, Erika
AU - Kuhlenschmidt, Kali
AU - Cripps, Michael
AU - Park, Caroline
N1 - Publisher Copyright:
© 2023 Elsevier Inc.
PY - 2023
Y1 - 2023
N2 - Introduction: Nationwide shelter-in-place (SIP) orders during the pandemic have had long-lasting effects, including increased rates of domestic violence and interpersonal violence. Screening for violence varies by institution, which tool is used, and when. Given increases in burn and trauma admissions over the course of the pandemic, we sought to examine trends at our institution during this time period to better guide care and anticipate system-level effects. Methods: We performed a retrospective cohort study of pediatric burn and adult burn and trauma patients at our level 1 trauma/burn center between March-May 2019 and March-May 2020. Home safety screening was performed by nursing staff using a 1-part screening questionnaire. Patients presenting before March 15, 2020, were defined as “pre-SIP; ” between March 16-May 19, 2020, were “during SIP; ” and those after May 19, 2020, were designated as “post-SIP.” Descriptive and chi-square statistics were used. Demographic, injury patterns, and screening information were collected. Results: Blunt trauma comprised 60% of injuries, followed by burns (30%) then penetrating injury (7%). Over the entire time period analyzed, 1822 patients had documented home safety screening; ∼2% of patients screened reported a safety concern pre-SIP, compared to 3% of patients during SIP. There were higher rates of burns and penetrating injury during SIP compared to other periods (P ≤ 0.0001). Home safety screening rates were 94%-95% pre- and during SIP, but dropped to 85% post-SIP (P < 0.0001). Home safety concerns were reported almost 2% of the time pre-SIP and 3% during SIP (P = 0.016). Conclusions: We noted an increase in trauma and burns during and after SIP orders, consistent with the experiences of other institutions. Implementation of a nurse-driven screening process demonstrated high compliance with appropriate referrals. The burden of burn and traumatic injury remains significant, highlighting a need for continued psychosocial screening and the provision of psychosocial support resources in the acute trauma setting.
AB - Introduction: Nationwide shelter-in-place (SIP) orders during the pandemic have had long-lasting effects, including increased rates of domestic violence and interpersonal violence. Screening for violence varies by institution, which tool is used, and when. Given increases in burn and trauma admissions over the course of the pandemic, we sought to examine trends at our institution during this time period to better guide care and anticipate system-level effects. Methods: We performed a retrospective cohort study of pediatric burn and adult burn and trauma patients at our level 1 trauma/burn center between March-May 2019 and March-May 2020. Home safety screening was performed by nursing staff using a 1-part screening questionnaire. Patients presenting before March 15, 2020, were defined as “pre-SIP; ” between March 16-May 19, 2020, were “during SIP; ” and those after May 19, 2020, were designated as “post-SIP.” Descriptive and chi-square statistics were used. Demographic, injury patterns, and screening information were collected. Results: Blunt trauma comprised 60% of injuries, followed by burns (30%) then penetrating injury (7%). Over the entire time period analyzed, 1822 patients had documented home safety screening; ∼2% of patients screened reported a safety concern pre-SIP, compared to 3% of patients during SIP. There were higher rates of burns and penetrating injury during SIP compared to other periods (P ≤ 0.0001). Home safety screening rates were 94%-95% pre- and during SIP, but dropped to 85% post-SIP (P < 0.0001). Home safety concerns were reported almost 2% of the time pre-SIP and 3% during SIP (P = 0.016). Conclusions: We noted an increase in trauma and burns during and after SIP orders, consistent with the experiences of other institutions. Implementation of a nurse-driven screening process demonstrated high compliance with appropriate referrals. The burden of burn and traumatic injury remains significant, highlighting a need for continued psychosocial screening and the provision of psychosocial support resources in the acute trauma setting.
KW - Burns
KW - Interpersonal violence
KW - Pandemic
KW - Trauma
UR - http://www.scopus.com/inward/record.url?scp=85176417588&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85176417588&partnerID=8YFLogxK
U2 - 10.1016/j.jss.2023.09.062
DO - 10.1016/j.jss.2023.09.062
M3 - Article
C2 - 37957086
AN - SCOPUS:85176417588
SN - 0022-4804
JO - Journal of Surgical Research
JF - Journal of Surgical Research
ER -