Addressing the Burden of Burn Injury Utilizing a Comprehensive Holistic Innovative Approach

Background: “I woke up and all I could see was smoke. I could hardly breathe. Then it dawned on me- the house was on fire. All I could think about is…..Lord, please get my wife and kids out of this house alive….” Most of us will thankfully never experience the life-changing events of a burn survivor, their families, and loved ones. In a matter of seconds, lives are tragically lost or irrevocably changed. Burn injuries are quoted as one of the worst traumatic injuries. They are painful, costly, disfiguring, may worsen over time, require extensive rehabilitation, and may be associated with long term disability (Heffernan & Comeau, 2014).

The global burden of burn injuries is significant. According to the World Health Organization (WHO), 265,000 deaths occur each year from burn injuries with the majority occurring in low and middle income countries. Additionally, these preventable injuries are a leading cause of morbidity worldwide. The millions who survive are often disabled for the rest of their lives and the resulting disfigurements may result in social stigmas and rejection (WHO, 2014).

Introduction: Dr. Richard Gamelli, the president of the International Society for Burn Injuries (ISBI), has challenged the global community to meet goals to improve outcomes of burn patients, with emphasis on the importance of partnerships, education, training and advocacy. One important goal is to consider the unique needs of each local community (ISBI, 2014).

In an effort to transcend above and beyond the routine care of hospitalized burn patients, one burn center in Southeast Texas has successfully implemented a bundled program to address the complex, holistic needs of adult burn patients beyond the walls of the burn center itself. Elements of the bundle include 1.) prevention and education, 2.) the Phoenix Society’s Survivors Offering Assistance in Recovery (SOAR) program, 3.) Blocker Burn Champions (BBC), and 4.) The Dr. Sally Abston Memorial Fund for Burn Survivors.

Description: The first element of the bundle is education on burn prevention and early treatment of an acute burn injury. Numerous community outreach prevention activities have been conducted at area schools, local industrial and chemical plants, and other venues. Examples of topics presented include smoke detector use and maintenance, avoiding scald burns, and protective wear for industries. In addition to burn prevention, many professional development opportunities on early treatment have been provided to local community hospitals, fire fighters, regional emergency medical services, and first responders at industrial plants. Educating prehospital providers and referring hospitals is paramount to optimizing outcomes. The literature supports the need for collaborative relationships between the prehospital setting, emergency departments and burn centers for the promotion of positive outcomes for burn patients (Zaletel, 2009).

The second element of the bundle is the enrollment in the Phoenix Society’s Survivors Offering Assistance in Recovery (SOAR) program. SOAR is an established evidence based hospital program that many hospitals elect to offer locally. The program trains burn survivors and their families to provide emotional support to burn patients and their loved ones. The value of SOAR is the provision of support for the overwhelming psychosocial recovery needs of burn survivors and the opportunity for former burn patients to inform and inspire others.

The third element of the bundle is the formation of a charitable organization (BBC) to provide financial support, free of charge, for burn patients who meet specified criteria. Examples of this support include funding for pharmacy bills, transportation costs, medical equipment, and various personal needs. The organization’s board consists of nurses and other interdisciplinary members of the burn team who volunteer their time. Monies generated for this organization are from various fundraisers that are held throughout the year.

The fourth element of the bundle is financial assistance for burn survivors to attend the annual international conference sponsored by the Phoenix Society. This popular multiday conference is geared for burn survivors, their support systems, fire fighters, prehospital providers, and burn professionals. Its popularity includes the opportunity for burn patients and caregivers to network and support each other. This assistance for sponsorship was initially made possible by a generous donation from a grateful former patient with the stipulation that the funds would be used to send future burn survivors to this conference.

Outcomes and Impact: Forty nine community outreach and education events were provided over the most recent 3 year period. Numerous patients and their families have been financially and emotionally supported by SOAR, the charitable organization (BBC), and the funds for the annual burn survivor conference. The true return on investment is priceless- a local community focused on burn prevention, regional area providers engaged in evidence-based care to improve early treatment, and the provision of psychosocial support for burn survivors and their loved ones.

Implications: The theme for the 26^th International Nursing Research Congress is question locally, engage regionally, apply globally. According to Dr. Richard Gamelli, the president of the International Society for Burn Injuries (ISBI), “if we work together as a worldwide burn team we can elevate the level of burn care and lessen the global burden of burn injury” (ISBI, 2014, para 4). As a global community of energetic and committed nurses, we can rise to this challenge utilizing creative and innovative strategies. Through community partnerships, education, and patient advocacy we can all make an impact….one patient and local community at a time.