Date of Graduation

Spring 2026

Document Type

Culminating Project

Degree Name

Doctor of Nursing Practice (DNP)

Department

Nursing

Committee Chairperson

Jacquelyn Owens DNP, CRNP, FNP-BC

Committee Member

Jasmine Garces-King DNP, MHA, LSSGB, ACNP-BC,CCRN, TCRN

Abstract

Trauma care for older adults, ages 65 and older, poses challenges for trauma centers and emergency departments. This age group accounts for nearly 20% of the population and is expected to continue growing, underscoring the need for rapid, efficient management after injury. Complex medical conditions and medications, such as anticoagulants, can worsen injuries even from low-energy mechanisms like a ground-level fall (GLF). As a result, trauma centers develop protocols to identify patients at the highest risk of serious injury and to allocate resources for assessment and treatment. Across the country, trauma centers have updated protocols to include anticoagulant use as a trigger for trauma activation. Trauma activation mobilizes resources, including staff and diagnostic imaging, to quickly detect potentially life-threatening injuries and to facilitate surgery or hospital admission. A literature review was conducted to identify which older adults are most at risk of significant injury after a GLF. Anticoagulant medications were not found to be an independent risk factor for serious injuries, contrary to previous assumptions. A retrospective cohort review of trauma registry data was conducted to determine whether full trauma activation is necessary. The study included 534 elderly patients, 217 of whom underwent trauma activation, and 171 of those were taking anticoagulants. Of those, 50% were discharged home, and 5% experienced a TBI, consistent with existing literature. This review also highlights inefficiencies in resource use and proposes improvements to the initial management of geriatric trauma after a GLF.

Final Version Confirmation

1

Download

Share

COinS