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Emergency department nursing

Mitchell Hayes, David Schlundt, Kemberlee Bonnet, Timothy J Vogus, Sunil Kripalani, Michael T Froehler, Michael J Ward
BACKGROUND AND OBJECTIVES: Acute Ischemic stroke (AIS) is a time-sensitive emergency and patients frequently present to, and are transferred from emergency departments (EDs). We sought to evaluate potential factors, particularly organizational, that may influence the timeliness of interfacility transfer for ED patients with AIS. METHODS: We conducted semistructured interviews at 3 EDs that routinely transfer AIS patients. A structured interview guide was developed and piloted prior to use...
February 7, 2019: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
Elizabeth Brigham, Jodi Brady, Robert P Olympia
Illness and injury associated with sport and physical activities may occur in the school setting. Although most sport-related illness and injury in students are considered minor emergencies, life- and limb-threatening illnesses or injuries may occur, such as sudden cardiac arrest, heat stroke, status asthmaticus, catastrophic brain or cervical spine injuries, hypoglycemia, blunt chest/abdominal injuries, or extremity fractures requiring surgery. It is important for the school nurse to recognize potential life- and limb-threatening emergencies associated with sport and physical activity, to initiate stabilization of the student with life- and limb-threatening symptoms, and to triage these students to an appropriate level of care (back to the classroom, home with their guardian with follow up at their primary healthcare provider's office, or directly to the closest emergency department via emergency medical services)...
February 9, 2019: NASN School Nurse
Riitta Mikkola, Heini Huhtala, Eija Paavilainen
The emergency department is a workplace where the staff regularly encounter new challenges and factors that can cause fear. The aim of this study was to describe coping with work-related fear among emergency department staff. The study explains the current coping methods of emergency department staff and the requirement for support as well as the availability of support. A coping model for work-related fear was also developed and will be presented. The study was conducted using a survey developed specifically for this study, which included the Brief COPE Inventory...
February 8, 2019: Scandinavian Journal of Caring Sciences
Mariza Elsi, Iswenti Novera
OBJECTIVE: Triage is basically a categorization process to prioritize various treatments for patients based on the types of disease, severity, prognosis and resource availability. However, the term triage is more appropriate to be used in the context of natural disaster or mass casualties. Within the context of emergency situation in emergency department, the term triage refers to a method used to assess the severity of patients' condition, determine the level of priority, and mobilize the patients to the suitable care unit...
February 4, 2019: Enfermería Clínica
Ge Bai, Gabor D Kelen, Kevin D Frick, Gerard F Anderson
OBJECTIVE: As nurse practitioners (NPs) and physician assistants (PAs) become an integral part of delivering emergency medical services, we examined the involvement of NPs and PAs who billed independently in emergency departments (EDs). METHODS: We used Medicare provider utilization and payment data from 2012 to 2016 to conduct a retrospective analysis. We examined the changes in the number of each clinician type who billed independently for four common emergency services (CPT codes: 99282-5), the change in their service volume, and the change in their average number of services billed...
January 31, 2019: American Journal of Emergency Medicine
A Harley, A N B Johnston, K J Denny, G Keijzers, J Crilly, D Massey
AIM: Sepsis is a significant and time-sensitive clinical concern for patients who present to Emergency Departments (EDs). Existing guidelines do not define nurses' roles in managing sepsis. This study explored ED nurses' experiences and perceptions around recognising and responding to patients with sepsis, and their awareness of sepsis screening and prognostic tools. The knowledge and insights gained from this study may be used to inform local and international ED policies, and enrich nursing educational packages that may be used to improve quality of patient care and patient outcomes...
February 4, 2019: International Emergency Nursing
Elaine Zibrowski, Lisa Shepherd, Richard Booth, Kamran Sedig, Candace Gibson
BACKGROUND: Many emergency departments (EDs) have used the Lean methodology to guide the restructuring of their practice environments and patient care processes. Despite research cautioning that the layout and design of treatment areas can increase patients' vulnerability to privacy breaches, evaluations of Lean interventions have ignored the potential impact of these on patients' informational and physical privacy. If professional regulatory organizations are going to require that nurses and physicians interact with their patients privately and confidentially, we need to examine the degrees to which their practice environment supports them to do so...
February 6, 2019: JMIR Human Factors
Josephine Zachodnik, Jakob Hessel Andersen, Anja Geisler
INTRODUCTION: Post-operative pain is associated with poor patient satisfaction and severe complications. It is often underreported and poorly managed. The aim of this study was to investigate which factors influence and prevent optimal pain treatment according to healthcare providers. METHODS: We conducted an electronic questionnaire survey, which was distributed by e-mail to 364 doctors, nurses, dentists and social and healthcare assistants employed at the emergency and surgical departments of Zealand University Hospital, Koege, Denmark...
February 2019: Danish Medical Journal
Mayer B Davidson, S Joshua Davidson
INTRODUCTION: Primary care physicians are often challenged to adjust insulin doses. To facilitate this process, we evaluated in a safety net clinic the work flow and glycemic effects of remote glucose monitoring utilizing Federal Drug Administration (FDA) cleared, Conformité Européenne (CE) registered software that contained computerized algorithms for insulin dose adjustments to help clinicians make dosing decisions for insulin-requiring patients. METHODS: Patients taking insulin for at least 6 months with HbA1c levels of at least 8...
February 5, 2019: Diabetes Therapy: Research, Treatment and Education of Diabetes and related Disorders
Haleh Mousavi Isfahani, Sogand Tourani, Hesam Seyedin
Objective: To perform a systematic review of the properties and results of the studies that their approaches are lean management in emergency departments and the factors which influence on their performance. Method: The necessary information in the first stage was collected by searching these keywords: "Lean principles" "Lean Six Sigma", "Lean Process", "Lean thinking", "Lean Methodology", "Toyota Production System lean processing", "lean techniques", "emergency department", "emergency medicine", "emergency room" and "emergency care " ...
January 2019: Bulletin of Emergency and Trauma
Rasmus Bo Hasselbalch, Mia Pries-Heje, Martin Schultz, Louis Lind Plesner, Lisbet Ravn, Morten Lind, Rasmus Greibe, Birgitte Nybo Jensen, Thomas Høi-Hansen, Nicholas Carlson, Christian Torp-Pedersen, Lars S Rasmussen, Kasper Iversen
INTRODUCTION: Triage systems with limited room for clinical judgment are used by emergency departments (EDs) worldwide. The Copenhagen Triage Algorithm (CTA) is a simplified triage system with a clinical assessment. METHODS: The trial was a non-inferiority, two-center cluster-randomized crossover study where CTA was compared to a local adaptation of Adaptive Process Triage (ADAPT). CTA involves initial categorization based on vital signs with a final modification based on clinical assessment by an ED nurse...
2019: PloS One
Elsie Rizk, Joshua T Swan, Ohbet Cheon, A Carmine Colavecchia, Lan N Bui, Bita A Kash, Sagar P Chokshi, Hua Chen, Michael L Johnson, Michael G Liebl, Ezekiel Fink
Purpose: The purpose of this project was to develop a set of valid and feasible quality indicators used to track opioid stewardship efforts in hospital and emergency department settings. Methods: Candidate quality indicators were extracted from published literature. Feasibility screening excluded quality indicators that cannot be reliably extracted from the electronic health record or that are irrelevant to pain management in the hospital and emergency department settings...
February 1, 2019: American Journal of Health-system Pharmacy: AJHP
Gülten S Dağ, Songül Bişkin, Meral Gözkaya
The aim of this study was to determine the nursing procedures carried out by emergency department nurses. This descriptive study was carried out between April and September 2015 in the emergency departments of two state hospitals and one university hospital in Turkey. The study population comprised 139 emergency nurses working for at least 1 year in the emergency department of one of the three hospitals. Data were gathered by using the Emergency Nursing Procedures Questionnaire, which is composed of three sections to reveal nursing procedures performed in emergency departments...
February 4, 2019: Nursing & Health Sciences
Vivienne Chong, TimothyJ Schultz, Frank Donnelly
RATIONALE, AIMS AND OBJECTIVES: Patients with acute abdominal pain are a common presentation in hospital emergency departments; however, international studies have demonstrated that hospitals often lack clinical protocols to guide care. This study aimed to investigate whether Australian hospital emergency departments have acute abdominal pain clinical protocols, identify hospital-level predictors of the presence of these clinical protocols, and assess the quality of protocols. METHODS: A survey was sent to all Australian hospitals with emergency departments, collecting data on hospital characteristics and the presence of acute abdominal pain clinical protocols...
February 4, 2019: Journal of Evaluation in Clinical Practice
Kristyn C Huffman
Fast tracks are widely used in emergency departments to increase patient throughput as annual visits continue to rise in the United States. A modified triage process known as QuickLook, which omits patients' past medical history, is used in some hospitals to further increase throughput. This article discusses the effects of QuickLook on patient placement, reviews the role of past medical history in triage, and discusses the impact of integrating a targeted history question into the QuickLook process of an emergency department in Arizona...
March 2019: Nursing Clinics of North America
Margaret Fry, Kirsten Abrahamse, Steve Kay, Rosalind M Elliott
INTRODUCTION: Suicide in older people is a public health concern. Emergency nurses are ideally placed to identify suicide risk. Therefore, the aim of this research was to explore emergency nurses' knowledge, confidence and attitudes about suicide in older people. METHODS: This descriptive exploratory study was conducted in four emergency departments in Sydney, Australia. Data were collected using a 28-item survey from a convenience sample of emergency nurses. Descriptive quantitative statistics and conventional content analysis were performed...
January 30, 2019: International Emergency Nursing
Gunjan Tiyyagura, Paula Schaeffer, Marcie Gawel, John M Leventhal, Marc Auerbach, Andrea G Asnes
OBJECTIVES: Emergency Department (ED) providers may fail to recognize or report child abuse and/or neglect (CAN). To improve recognition and reporting, we designed the Community ED CAN Program in which teams of local clinicians (nurses, physicians, physician assistants) received training in CAN and 1) disseminated evidence-based education, 2) provided consultation, case follow-up and access to specialists, and 3) facilitated multi-disciplinary case review. The aims of this study were to understand the Program's strengths and challenges and to explore factors that influenced implementation...
January 29, 2019: Academic Pediatrics
Bor-An Chen, Hui-Hui Chien, Chun-Chung Chen, Hui-Tsai Chen, Chii Jeng
BACKGROUND AND OBJECTIVES: Nurses serve as gatekeepers of the health of long-term care facility (LTCF) residents and are key members deciding whether residents should visit an emergency department (ED). Inappropriate decisions as to ED visits may result in ED overcrowding, excessive medical expenses, and nosocomial infections. Currently, there is a lack of effective tools for assessing the barriers and level of difficulty experienced by LTCF nurses. The purposes of this study were to develop a Patient Transfer Decision Difficulty Scale (PTDDS) and test its effectiveness...
2019: PloS One
Claus Vogelmeier, Jürgen Floege, Thomas Gamstätter
Celebrating the 200th anniversary of its founder, Friedrich Theodor von Frerichs, the German Society of Internal Medicine (DGIM) publishes perspectives for its work in the coming years, which will be shaped by challenges for medicine and science. Based on ten critically analyzed topics - namely physicians as researchers, "choosing wisely", digital medicine, the economization of medicine, medical education, demographic changes and multimorbidity, systems medicine, infectious diseases and hygiene, intensive care and emergency departments, and nursing and medical assistance jobs - this paper outlines the fundamental positions of the society...
February 2019: Deutsche Medizinische Wochenschrift
Kerry Caperell, Justen Pettigrew, Andrew Gerughty, Michelle Stevenson
OBJECTIVE: The aim of this study was to evaluate the accuracy of the initial impression of emergency department providers on the disposition of children with asthma exacerbation. METHODS: We conducted a prospective survey of physicians and other providers in the emergency department of a children's hospital and parents of children presenting with asthma exacerbation. The treating provider completed a survey after finishing the examination and immediately upon exiting the patient's room...
February 2019: Pediatric Emergency Care
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