The magnitude of trauma as a national and international problem is documented by data that identifies injury as being the primary cause of death in persons under age 45. The optimal care of the trauma patient is best accomplished within a framework in which all members of the trauma team use a systematic, standardized approach to the care of the injured patient. Emergency nurses are essential members of the trauma team. Morbidity and mortality of trauma patients can be significantly reduced by educating nurses to provide competent trauma care. The Emergency Nurses Association (ENA) and its constituents have the responsibility to facilitate trauma-related, continuing education opportunities for nurses who provide care to trauma patients.
Trauma nursing as a discipline refers to the process and content of all the different roles nurses have in the care of the trauma patient. Knowledge is the core of any discipline. The purpose of TNCC is to present core-level knowledge, refine skills, and build a firm foundation in trauma nursing.
Trauma Nursing Core Course (TNCC)
ENA developed and implemented the TNCC for national and international dissemination as a means of identifying a standardized body of trauma nursing knowledge. The TNCC (Provider) is a 16 or 20-hour course designed to provide the learner with cognitive knowledge and psychomotor skills. Nurses with limited emergency nursing clinical experience, who work in a hospital with limited access to trauma patients, or who need greater time at the psychomotor skill stations are encouraged to attend courses scheduled for the 20-hour format. The TNCC (Instructor) course is an 8-hour course designed to prepare nurses to become TNCC (Provider) Instructors. The nurse must have successfully completed the provider course prior to attending the Instructor course. The Instructor course emphasizes appropriate teaching strategies as well as correct evaluation methods.
Provider Course Participants
The TNCC may be officially attended by registered nurses (RN's). Other health care providers may attend the course as observers. In order to maximize success in the TNCC (Provider), it is recommended that the participant have at least six months of clinical nursing experience in an emergency care setting. It is assumed that the course participant possesses generic nursing knowledge, has an understanding of emergency care terminology, and has familiarity with standard emergency equipment.
ENA's Department of Course Operations at the National ENA office is responsible for approving, in advance, all TNCC courses and instructors and also monitoring the quality of the TNCC program. The Course Operations Department and TNCC International Faculty will serve as a resource as needed.
A standardized nationwide fee for TNCC (Provider) or TNCC (Instructor) is not set, because costs associated with conducting these courses varies from location to location. An indirect fee is submitted to National ENA for each participant and a portion of this indirect fee is returned to the ENA State Council to support their trauma program and other council functions (e.g., nursing practice functions).
Organization of the TNCC Provider Course Manual
The TNCC (Provider) manual is designed to reinforce and supplement lectures and psychomotor skills content. The interactive psychomotor skill stations facilitate initial integration of psychomotor abilities in a risk-free setting which simulate trauma patient situations. The following psychomotor skill stations are included in the TNCC (Provider): Trauma Nursing Process (scenario-driven, interactive trauma assessment), Airway and Ventilation Interventions, Spinal Immobilization, Selected Interventions: Chest Trauma and Traction Splinting. A ratio of one faculty per four learners is required. Each participant is provided the opportunity to practice the identified skills during rotation through the skill stations.
TNCC (Provider) Course Content
- The Trauma Nursing Core Course and Trauma Nursing
- Epidemiology, Biomechanics and Mechanisms of Injury
- Initial Assessment
- Airway and Ventilation
- Brain and Cranial Trauma
- Ocular, Maxillofacial, and Neck Trauma
- Thoracic Trauma
- Abdominal Trauma
- Spinal Cord and Vertebral Column Trauma
- Musculoskeletal Trauma
- Surface and Burn Trauma
- Special Populations: Pregnant, Pediatric, and Older Adult Trauma Patients
- Disaster Management
- Psychosocial Aspects of Trauma Care
- Transition of Care for the Trauma Patient
- Demonstration of the Trauma Nursing Process Station
- Trauma Nursing Process Teaching Stations
- Airway and Ventilation Interventions Teaching Stations
- Spinal Protection, Helmet Removal, and Splinting
- Physical Assessment Station (International; optional for U.S.)
Successful completion of the course includes scoring 80% or greater on the multiple choice examination and demonstrating all critical steps and 70% of the total points in the evaluated skill station – the Trauma Nursing Process.
Verification will be issued from ENA upon successful completion of the evaluated psychomotor skill station and the multiple choice examination. Expiration of verification will occur four years from the last day of the month in which the card was issued. ENA does not offer certification on any level as related to completion of this course.
Continuing Nursing Education Contact Hours
Contact hours are awarded based on hours attended, regardless of performance during evaluation.