Fatal Attractions
Mary Edge, Christopher Maliani, Jessica Rodriguez, & Lindsey Santoro
Christine E. Lynn College of Nursing
Abstract
Advanced directives are often viewed as being limited to the elderly and terminally ill. However, adults in the U.S. ages 18 years and older need to be aware that tragedy does not discriminate against age. A large proportion of falls, car accidents and blunt object injuries are related to traumatic brain injury that may result in a coma in which patients may be placed on life support and unable to express their end of life decisions. Due to the magnitude of patients suffering unexpected traumatic brain injuries and the scarcity of advanced directives among hospital admissions, having an advanced directive will benefit the health of the population by providing reassurance that their health will be protected and their autonomy will be preserved. To spread awareness of advanced directives and the reality of the occurrence of tragic accidents affecting people of all ages, we have developed the Fatal Attraction theme park.
This theme park is located in California, where mortality from car accidents has increased significantly. Admission into the park is a completed advanced directive that is adjustable. Advanced directive awareness and safety are promoted by the following attractions: The Test Track promotes vehicle safety, the Tower of Terror brings awareness to falls, and the Laser Battlefield teaches head protection in the event of flying objects. Throughout the park we have life support simulation models and supportive personnel in our advanced directives booths to answer any questions regarding end of life decisions. Advantages and disadvantages have been weighed for each intervention. One recommendation is to choose a receptive, sparsely populated city in California to prevent further accidents due to an increase in visitors. Also, to create a website to allow visitors to fill out the advanced directives before coming to the park to allow adequate time for contemplation. The theme park will be evaluated by the number of recorded advanced directives in one year and a decrease in the amount of traumatic brain injuries reported by the CDC in 5 years.
Fatal Attractions
The lack of awareness of the importance of creating an advanced directive for adults over the age of 18 is a problem in the United States. Advanced directives are often viewed as being limited to the elderly and terminally ill. However, the general population may not take into consideration the need for an advanced directive until a tragic accident occurs. The Centers for Disease Control and Prevention (CDC) reported that one-third of injury related deaths are due to traumatic brain injury in the United States (“Injury Prevention,”2016). Emphasizing the importance of an advanced directive may benefit patients and families when making decisions about end of life care in unexpected situations in which the patients cannot speak for themselves.
In 2010, an estimated 2.5 million emergency room visits, hospitalizations and deaths were related to traumatic brain injury (“Injury Prevention”, 2016). This estimate was gathered by the CDC’s National Center for Health Statistics for the year 2010 (“Injury Prevention”, 2016).Upon admission to the hospital, the recorded presence of advanced directives ranged from 3% to 14% in the general population (Gordy & Klein, 2011). Due to the magnitude of patients suffering unexpected traumatic brain injuries (TBIs) and the scarcity of advanced directives among hospital admissions, the security of an advanced directive will benefit the health of the population by providing reassurance of health protection and preservation of their autonomy.
A traumatic brain injury is the most serious form of head injury in which brain damage may result from forceful impact or evolve after the injury due to lack of nutrients and oxygen to the brain. (Hinkle & Cheever, 2013). Toddlers up to four years old, teenagers, and the elderly over 65 years old are at the highest risk for TBI, with a higher occurrence for males. Falls,accidents involving motor vehicles, blunt objects to the head, and assaults are the most common causes of TBIs (Hinkle & Cheever, 2013).
The Fatal Attraction theme park was chosen to be built in the state of California as this state has had an increase in motor vehicle accidents resulting in mortalities in the last decade and new approaches are needed to improve these outcomes (Waxman, Izfar, & Grotts, 2012). An advantage to placing the park in an area with poor motor vehicle safety is that it will increase awareness of the problem and may promote change. A disadvantage is that increasing the amount of people in the area may actually increase accidents.
One of the featured rides, Test Track, will educate riders on safety precautions to prevent TBI as well as defensive driving techniques. This intervention is not only useful for newly licensed adolescents, but the older population as well. A study of the fatality and injury of older adult drivers in California emphasizes the need to for further motor vehicle safety among older adults (Loftipour, et al, 2013). An advantage of the test track is that drivers may be more cautious on the road when they are driving. A disadvantage is that the elderly may have health conditions that do not allow them to participate in the ride and experience the intervention.
Immersion into our Laser Battlefield mimics explosions and our Tower of Terror to bring awareness of falls will stimulate learning through simulation. The availability of personnel to answer questions at advanced directive booths and life support simulation models throughout the park will provide further education regarding end of life care. Immersion through symbolic and sensory factors has shown to enhance learning by facilitating multiple perspectives, providing position learning with guidance, and transferring of knowledge to be applied in real world situations ( Dunleavy & Dede, in press). An advantage to simulation emersion is that the interaction creates a high probability of being remembered and applied. The disadvantage is that the simulation may still not be taken seriously since it is not real and there are no harmful consequences.
Admission to the theme park requires completed advanced directive for each adult over 18 years of age. Requiring an advanced directive for people of all ages, with or without a chronic disease or terminal illness, may increase awareness that trauma does not discriminate against age (Gordy & Klein, 2011). An advantage of requiring the advanced directive for admission is that the person will have knowledge of the different aspects of the advanced directives and they can keep them in mind while touring the park and make any adjustments before leaving the park. A disadvantage is that people may not put careful thought into their advanced directive due to eagerness to enter the park.
Based on the advantages and disadvantages of each intervention, the first recommendation is to build the theme park in a sparsely populated area of California. This will allow space for people from all over the U.S.to visit and learn, while still bringing awareness to the people in California that an intervention was needed due to their increase in motor vehicle mortalities. The second recommendation is to provide a comprehensive advanced directive website and advertise for people to fill out the advanced directives on this website before they get to the park to allow adequate time for contemplation of end of life decisions and communication with their families.
The plan for Fatal Attraction theme park will be implemented by assessing the communities’ views of having a theme park in the area and choosing the community that is the most receptive to the idea. We will meet with the city counsle to discuss economic potential, restrictions, and overall benefit to the community. At the end of one year, we will evaluate our work by the increase in the number of advanced directives recorded in the area and in the U.S. We will also follow the CDC databases to evaluate if there are significantly less cases of traumatic brain injury in the U.S. over the course of five years.
References
Dunleavy, M., & Dede, C. (in press). Augmented reality teaching and learning. In J.M. Spector, M.D Merrill, J. Elen, & M.J. Bishop (Eds.), The Handbook of Research for Educational Communications and Technology (4th ed.). NewYork: Springer.
Gordy, S., & Klein, E. (2011). Advance directives in the trauma intensive care unit: Do they really matter? International Journal of Critical Illness and Injury Science, 1(2), 132–137.
doi.org/10.4103/2229-5151.84800
Hinkle, J. L., Cheever, K. H. (2013). Management of patients with neurologic trauma. Hinkle & Cheever: Brunner & Suddarth's Textbook of Medical-Surgical Nursing, 13th Edition. (1996). Philadelphia, PA : Lippincott Williams & Wilkins. Retrieved from
https://coursepoint.vitalsource.com/#/books/9781469863801/cfi/6/850!/4/2/2/2/2@0:0
Injury prevention and control: Traumatic brain injury and concussion. (2016). Centers for Disease Control and Prevention. Retrieved from http://www.cdc.gov/TraumaticBrainInjury/severe.html
Lotfipour, S., Sayegh, R., Chakravarthy, B., Hoonpongsimanont, W., Anderson, C. L., & Fox, J.C. (2013). Fatality and injury severity of older adult motor vehicle collisions in Orange County, California, 1998-2007. Western Journal Of Emergency Medicine: Integrating Emergency Care With Population Health, 14(1), 63-68. doi:10.5811/westjem.2011.8.6610
Waxman, K., Izfar S., & Grotts, J. (2012). The mortality risk from motor vehicle injuries in California has increased during the last decade [Abstract]. Journal of Trauma & Acute Care Surgery, 73 (3), 716-720. doi:10.1097/TA.0b013e31825c14e2
Mary Edge, Christopher Maliani, Jessica Rodriguez, & Lindsey Santoro
Christine E. Lynn College of Nursing
Abstract
Advanced directives are often viewed as being limited to the elderly and terminally ill. However, adults in the U.S. ages 18 years and older need to be aware that tragedy does not discriminate against age. A large proportion of falls, car accidents and blunt object injuries are related to traumatic brain injury that may result in a coma in which patients may be placed on life support and unable to express their end of life decisions. Due to the magnitude of patients suffering unexpected traumatic brain injuries and the scarcity of advanced directives among hospital admissions, having an advanced directive will benefit the health of the population by providing reassurance that their health will be protected and their autonomy will be preserved. To spread awareness of advanced directives and the reality of the occurrence of tragic accidents affecting people of all ages, we have developed the Fatal Attraction theme park.
This theme park is located in California, where mortality from car accidents has increased significantly. Admission into the park is a completed advanced directive that is adjustable. Advanced directive awareness and safety are promoted by the following attractions: The Test Track promotes vehicle safety, the Tower of Terror brings awareness to falls, and the Laser Battlefield teaches head protection in the event of flying objects. Throughout the park we have life support simulation models and supportive personnel in our advanced directives booths to answer any questions regarding end of life decisions. Advantages and disadvantages have been weighed for each intervention. One recommendation is to choose a receptive, sparsely populated city in California to prevent further accidents due to an increase in visitors. Also, to create a website to allow visitors to fill out the advanced directives before coming to the park to allow adequate time for contemplation. The theme park will be evaluated by the number of recorded advanced directives in one year and a decrease in the amount of traumatic brain injuries reported by the CDC in 5 years.
Fatal Attractions
The lack of awareness of the importance of creating an advanced directive for adults over the age of 18 is a problem in the United States. Advanced directives are often viewed as being limited to the elderly and terminally ill. However, the general population may not take into consideration the need for an advanced directive until a tragic accident occurs. The Centers for Disease Control and Prevention (CDC) reported that one-third of injury related deaths are due to traumatic brain injury in the United States (“Injury Prevention,”2016). Emphasizing the importance of an advanced directive may benefit patients and families when making decisions about end of life care in unexpected situations in which the patients cannot speak for themselves.
In 2010, an estimated 2.5 million emergency room visits, hospitalizations and deaths were related to traumatic brain injury (“Injury Prevention”, 2016). This estimate was gathered by the CDC’s National Center for Health Statistics for the year 2010 (“Injury Prevention”, 2016).Upon admission to the hospital, the recorded presence of advanced directives ranged from 3% to 14% in the general population (Gordy & Klein, 2011). Due to the magnitude of patients suffering unexpected traumatic brain injuries (TBIs) and the scarcity of advanced directives among hospital admissions, the security of an advanced directive will benefit the health of the population by providing reassurance of health protection and preservation of their autonomy.
A traumatic brain injury is the most serious form of head injury in which brain damage may result from forceful impact or evolve after the injury due to lack of nutrients and oxygen to the brain. (Hinkle & Cheever, 2013). Toddlers up to four years old, teenagers, and the elderly over 65 years old are at the highest risk for TBI, with a higher occurrence for males. Falls,accidents involving motor vehicles, blunt objects to the head, and assaults are the most common causes of TBIs (Hinkle & Cheever, 2013).
The Fatal Attraction theme park was chosen to be built in the state of California as this state has had an increase in motor vehicle accidents resulting in mortalities in the last decade and new approaches are needed to improve these outcomes (Waxman, Izfar, & Grotts, 2012). An advantage to placing the park in an area with poor motor vehicle safety is that it will increase awareness of the problem and may promote change. A disadvantage is that increasing the amount of people in the area may actually increase accidents.
One of the featured rides, Test Track, will educate riders on safety precautions to prevent TBI as well as defensive driving techniques. This intervention is not only useful for newly licensed adolescents, but the older population as well. A study of the fatality and injury of older adult drivers in California emphasizes the need to for further motor vehicle safety among older adults (Loftipour, et al, 2013). An advantage of the test track is that drivers may be more cautious on the road when they are driving. A disadvantage is that the elderly may have health conditions that do not allow them to participate in the ride and experience the intervention.
Immersion into our Laser Battlefield mimics explosions and our Tower of Terror to bring awareness of falls will stimulate learning through simulation. The availability of personnel to answer questions at advanced directive booths and life support simulation models throughout the park will provide further education regarding end of life care. Immersion through symbolic and sensory factors has shown to enhance learning by facilitating multiple perspectives, providing position learning with guidance, and transferring of knowledge to be applied in real world situations ( Dunleavy & Dede, in press). An advantage to simulation emersion is that the interaction creates a high probability of being remembered and applied. The disadvantage is that the simulation may still not be taken seriously since it is not real and there are no harmful consequences.
Admission to the theme park requires completed advanced directive for each adult over 18 years of age. Requiring an advanced directive for people of all ages, with or without a chronic disease or terminal illness, may increase awareness that trauma does not discriminate against age (Gordy & Klein, 2011). An advantage of requiring the advanced directive for admission is that the person will have knowledge of the different aspects of the advanced directives and they can keep them in mind while touring the park and make any adjustments before leaving the park. A disadvantage is that people may not put careful thought into their advanced directive due to eagerness to enter the park.
Based on the advantages and disadvantages of each intervention, the first recommendation is to build the theme park in a sparsely populated area of California. This will allow space for people from all over the U.S.to visit and learn, while still bringing awareness to the people in California that an intervention was needed due to their increase in motor vehicle mortalities. The second recommendation is to provide a comprehensive advanced directive website and advertise for people to fill out the advanced directives on this website before they get to the park to allow adequate time for contemplation of end of life decisions and communication with their families.
The plan for Fatal Attraction theme park will be implemented by assessing the communities’ views of having a theme park in the area and choosing the community that is the most receptive to the idea. We will meet with the city counsle to discuss economic potential, restrictions, and overall benefit to the community. At the end of one year, we will evaluate our work by the increase in the number of advanced directives recorded in the area and in the U.S. We will also follow the CDC databases to evaluate if there are significantly less cases of traumatic brain injury in the U.S. over the course of five years.
References
Dunleavy, M., & Dede, C. (in press). Augmented reality teaching and learning. In J.M. Spector, M.D Merrill, J. Elen, & M.J. Bishop (Eds.), The Handbook of Research for Educational Communications and Technology (4th ed.). NewYork: Springer.
Gordy, S., & Klein, E. (2011). Advance directives in the trauma intensive care unit: Do they really matter? International Journal of Critical Illness and Injury Science, 1(2), 132–137.
doi.org/10.4103/2229-5151.84800
Hinkle, J. L., Cheever, K. H. (2013). Management of patients with neurologic trauma. Hinkle & Cheever: Brunner & Suddarth's Textbook of Medical-Surgical Nursing, 13th Edition. (1996). Philadelphia, PA : Lippincott Williams & Wilkins. Retrieved from
https://coursepoint.vitalsource.com/#/books/9781469863801/cfi/6/850!/4/2/2/2/2@0:0
Injury prevention and control: Traumatic brain injury and concussion. (2016). Centers for Disease Control and Prevention. Retrieved from http://www.cdc.gov/TraumaticBrainInjury/severe.html
Lotfipour, S., Sayegh, R., Chakravarthy, B., Hoonpongsimanont, W., Anderson, C. L., & Fox, J.C. (2013). Fatality and injury severity of older adult motor vehicle collisions in Orange County, California, 1998-2007. Western Journal Of Emergency Medicine: Integrating Emergency Care With Population Health, 14(1), 63-68. doi:10.5811/westjem.2011.8.6610
Waxman, K., Izfar S., & Grotts, J. (2012). The mortality risk from motor vehicle injuries in California has increased during the last decade [Abstract]. Journal of Trauma & Acute Care Surgery, 73 (3), 716-720. doi:10.1097/TA.0b013e31825c14e2