Aim: To compare and assess the quality of nursing care provided to acute trauma patients that have been admitted to trauma wards and non-trauma outlying wards.

Design: Multi-centre comparison, questionnaire study undertaken in three large hospitals in South Wales. The study compares the knowledge of qualified trauma nurses, based on trauma wards and non-trauma nurses, based on outlying wards.

Method: 100 qualified trauma nurses and 170 qualified non-trauma nurses were asked to independently complete a questionnaire. The questions included the nursing management of common fractures and post operative conditions. The completed questionnaires were marked and the results analysed.

Results: 100% of the questionnaires were completed and returned. The trauma nurses conveyed the importance of ice (85%) and elevation (97%) in the initial management of limb fractures. This compares with ice (10%) and elevation (50%) on the outlying wards. Trauma nurses correctly monitor for potentially devastating post operative complications and compartment syndrome 87% of the time compared with 42% on outlying wards. Spinal injuries are managed appropriately 88% of the time on trauma wards compared with 36% on outlying wards.

Conclusion: Trauma patients receive optimum nursing care when admitted to a trauma ward and are nursed by trauma nurses. They probably have a shorter hospital stay. Many of the out-lying wards provide sub-optimal trauma nursing care and a few are positively dangerous.

Recommendations: We believe that hospital trusts should train nurses to confidently and competently be able to nurse outlying patients. Until that time, we recommend that trauma patients should not be nursed by non-trauma nurses.