Evaluating implementation of WHO Trauma Care Checklist vs. modified WHO checklist in improving trauma patient clinical outcomes and satisfaction

KEY WORDS WHO Trauma -Care Checklist Pain Management Patient Satisfaction Trauma Care -Management WHOModified-Trauma Care-Checklist Received: 2020-08-04 Accepted: 2020-08-15 Introduction Trauma is any wound or penetrating or nonpenetrating injury caused intentionally or unintentionally by external factors in the human body.1 Trauma injury is one of the leading causes of death and disability, responsible for more deaths than deaths due to HIV, malaria, and tuberculosis combined.2 Globally, trauma injury burdens countries at all levels of development mentally, socially, and economically.3 In Iran, trauma is the second leading cause of premature death in the young population, regardless of gender.35 In patients with severe trauma, the primary goal is patient survival, and the secondary goals are avoiding organ failure, other complications, speeding up recovery, and ultimately achieving the desired quality of life.6 Therefore, early systematic evaluation of trauma patients is a critical component of improving the care process, reducing medical errors, and increasing patients' quality of life.7 The efficacy of checklist implementation to improve patient safety, optimize care, and reduce medical errors has been reported airway management, fluid resuscitation, and diagnosis of life-threatening injuries.8-13 WHO checklist The WHO Trauma Care checklist (TCC) is a simple tool that is designed to ensure the safety of trauma patients in life-threatening conditions.14 TCC identifies minimum sets of steps taken in care of all trauma patients admitted in emergency units, regardless of resource availability.15 It is designed to standardize and reinforce aspects of early assessment of patients with trauma, thereby reducing the likelihood of diagnostic, therapeutic, and care errors during initial resuscitation.15 TCC validity has been tested by global collaboration across different emergency units.14 The WHO TCC consists of two main sections. Results of recent studies show that WHO's checklist for trauma care reduces mortality,16 delivers favorable treatment results,17 and improves patient self-report of the treatment outcome.18 Although the WHO checklist has been useful in coordinating and harmonizing trauma care and services, the checklist is short of providing the critical steps for the management of pain in trauma care. [...]due to the vital role of pain management in patients, in the current study, we added 'pain management' as an additional step to the first part of t