The Role of Advanced Practice Providers in the West Virginia Trauma System

Abstract

BACKGROUND Injured patients in rural states like West Virginia (WV) rely on advanced practice providers (APPs) to provide initial care in Level Ill an IV trauma centers prior to transfer to medical centers with additional resources. This is a first attempt to survey trauma centers in WV and report on the roles that APPs perform in trauma care. METHODS Trauma directors and program managers at all 21 accredited trauma centers in WV were queried via an online survey. The number of APPs~-physicians' assistants (PAs) and nurse practitioners (NPs) participating in trauma care were queried from each center. Information was obtained on the location where APPs participated in trauma care, such as: trauma bay, operating room, and intensive care unit. Follow-up surveys inquired about trauma educational opportunities provided to APPs, including: Advanced Trauma Life Support (ATLS), Rural Trauma Team Development Course (RTTDC), and Stop the Bleed (STB). RESULTS Responses were received from 81% of WV's trauma centers. The total number of APPs participating in trauma care were 81 (PAS =48; NPS = 33). The majority of APPs performed patient care roles in the trauma bay (84%). The results of the follow-up survey demonstrated that 100% of trauma centers provide the ALS course for their APPs, 83% provide RTTDC, and 50% provide STB training. CONCLUSIONS The WV trauma system relies on APPs to deliver care from patient arrival through definitive treatment and disposition. Opportunities exist for education and training of the APP community within a rural trauma system.