Nursing Management Strategies and Clinical Outcomes in Patients with Severe Trauma: A Comprehensive Review

Background Severe trauma remains a leading cause of morbidity and mortality worldwide and imposes a substantial burden on healthcare systems. Patients with high-grade trauma require rapid, coordinated, and evidence-based nursing care to prevent secondary injuries, reduce complications, and improve survival. Effective nursing management plays a critical role in trauma teams, particularly in emergency departments and intensive care units, where timely assessment, prioritization, and intervention are essential. Objective This review aimed to examine contemporary nursing management strategies for patients with severe trauma and evaluate their impact on clinical outcomes, patient safety, and quality of care. Methods An integrative literature review was conducted using PubMed, Scopus, CINAHL, and Web of Science databases, covering studies published from ۲۰۱۴ to ۲۰۲۵. Search terms included severe trauma, high-grade trauma, trauma nursing, nursing management, critical care, and patient outcomes. Original quantitative and qualitative studies addressing nursing-led or nurse-involved management strategies in severe trauma care were included. Data were analyzed through thematic synthesis. Results The review included ۳۶ studies encompassing emergency, prehospital, and intensive care trauma settings. Key nursing management strategies identified were early trauma assessment using standardized protocols (e.g., ATLS-based nursing frameworks), continuous hemodynamic monitoring, early hemorrhage control, pain and sedation management, prevention of secondary brain injury, and interprofessional communication and coordination. Studies consistently demonstrated that structured nursing protocols and advanced trauma training were associated with reduced mortality, shorter ICU length of stay, lower incidence of complications, and improved functional outcomes. Leadership skills, clinical decision-making ability, and situational awareness of nurses were highlighted as critical determinants of trauma care quality.