data entry: system structure the trauma audit & research network (tarn) data collection session...

Data Entry: System structure

The Trauma Audit & Research Network (TARN)

Data Collection session

Log into: https://www.tarn.ac.uk/Training

Electronic Data Collecting & Reporting system(EDCR) overview

Process of care & outcome data relating to eligible Trauma patients

Secure on-line system (www.tarn.ac.uk):

Username & password required

Patient confidentiality paramount:

Names, Hospital Numbers, Full Postcodes not seen by TARN

Location based system, following patient pathway: From scene to Discharge

Choice of datasets: Core or Extended

Submission Contains all the data relating to a Patient’s incident:

Patient

Incident

Location

Outcome

Injuries

Submission Summary screen

Screen showing current STATUS of all your Hospitals’ submissions

You can access any submission by clicking on number adjacent to Status

You can see all submissions created by any User linked to your Hospital

Submission Status CREATED

DISPATCHED

APPROVED

REJECTED*

RETURNED*

REDISPATCHED*

DISPATCHED & FLAGGED

AWAITING POST

MORTEM**

Incomplete submission, data being entered

Complete submission, TARN to check

Checked & coded by TARN (part of Hospital dataset)

Does not fulfil inclusion criteria

Additional information requested by TARN

Additional information supplied by User

Flagged awaiting matching Transfer or PM PM to be sent to TARN at later date

(reminder email sent regularly)

Only Approved cases are used in Reports

Searching for submissions

Use any fields on SEARCH screen. FIND Results appear at bottom of screen Access relevant submission by clicking on (12 digit) Submission ID Click REPORT to convert to Excel

Example: Hospital: St Elsewhere3 Admission Dates: 01/05/15-02/05/15 Status: All

Transfer notification system TRANSFER NOTIFICATION: Submission Summary screen

Shows Missing transfers into/from your Hospital

Hover over Hospital name to show corresponding site coordinator details

The submission processUser:Create New Submission: Example: Hospital HolbyaNHS Number: 9999999999Date of Arrival: 10/01/2015 Time of Arrival: 10.00

Check for duplicationUnique Submission ID generated Choose Dataset: Core or ExtendedEnter & Save dataValidate dataDispatch

Standard Screens

Core dataset Extended dataset

Core Dataset For standard cases

Most fields Mandatory

Contains: ALL Fields used in routine analysis and reporting

Generic screens: Pre Hospital, ED, Critical Care

Limited Observations & Interventions

Generic Questions

Dates Times Observations (Patient’s observed status on arrival in location)

Requested: Pre Hospital, ED and Critical Care

Generic QuestionsRequested: Pre Hospital, ED and Critical Care

Interventions (non surgical procedures given to patient in that location)

Attendants (Doctors who treated patient in that location)

Core Dataset: Observations & InterventionsPre-hospital, ED and Critical Care locations

•Respiratory rate•Oxygen saturation•Blood pressure•Capillary refill

•Pulse rate•Glasgow Coma Score*•Pupil reactivity**

•Pupil size•Airway status•Breathing status

•Airway support•Breathing support•Blood products in 24hrs•Tranexamic Acid

•Chest drain•Spinal protection•Fluid

•Extubation•Spinal Protection Removal •Embolisation

Observations: 1st taken

Interventions:

*GCS: Glasgow Coma Score: GCS

Measure of a patient’s level of consciousness, taken by assessing: Eye, Verbal and Motor responses.

Ranges from 15 (normal functioning) to 3 (no responses).

Reduced GCS is an indication of a possible brain injury.

Used in the Probability of Survival model

Record: Pre Hospital, ED & at 1st hospital (Transfers in)

One of most important fields in EDCR: Part of the Data Accreditation %

Rapid Sequence Intubation (RSI) sometimes performed Pre Hospital

RSI: sedation & paralysis of a pt prior to Intubation

GCS3 often documented in ED: THIS SHOULD NOT BE RECORDED

Users should record in ED: Airway Status: Intubated Breathing Status: Ventilated GCS: No Resp Rate: No

Documentation of GCS & Intubation

**Pupil Reactivity Record: Pre Hospital, ED & Critical Care

Particularly important: When GCS is <15 or Head injury

Included in future Probability of Survival model

One of most important fields in EDCR: Part of the Data Accreditation %

Note: PEARL (Pupils Equal & Reacting to light) Record as BRISK

Specialist screens

BOAST4Rehabilitation prescriptions

BOAST 4Guideline derived from BOA & BAPRAS

Severe Open fractures of Tibia

TARN specialist screen used to collect data

Guideline requires: 1. Early identification of severe open fractures of the tibia 2. Joint care from orthopaedic & plastic surgeons 3. Surgical wound debridement & operative fracture stabilisation within 24

hours 4. Definitive soft-tissue cover within 72 hours of injury

Gustilo Anderson Open fracture Classification

Severe Open Tibial fracture: Gustilo Anderson grade IIIB or IIIC

Specialist screen – BOAST 4BOAST4 screen appears if User answers “Yes” to question on the Opening section:

“Does this patient have severe open lower limb fractures”?

BOAST4

“Did the fracture have surgical stabilisation” &

“Was definitive soft tissue cover of injury achieved”

Only answer YES if procedures performed at your Hospital.

Rehabilitation Prescription

Core Dataset: Outcome Measures screen

Note: This screen auto-populates post Injury Coding by TARNUsers do not enter data into this screen

Validating VALIDATE Missing Mandatory (red) & Preferred fields (green) Mandatory fields must be corrected Click here to Dispatch to TARN

View Diary* Rejected submissions: Reason for rejection noted by TARN in Diary Returned submissions: Additional information requested by TARN in Diary Re-dispatched submissions: User should respond to TARN request in Diary &

then Re-dispatch the submission

Awaiting Post Mortem** Where selected: User should send Post Mortem to TARN when available Particularly important: Deaths in ED

When sending PMs: Annonymise Include 12 digit submission ID Email to: tarn.supportstaff@nhs.net or support@tarn.ac.uk Post Mortems shredded by TARN after coding

Extended Dataset1. Complex cases

a. Multiple ICU visits

b. Transfers in: bypass ED

2. Or ADDITIONAL data points e.g. Haematology, Blood Gases, Pelvic binder

All Observations, Interventions & Investigations shown

Core fields remain Mandatory

Extended dataset only fields: Not routinely analysed