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Emergency Nurse: the Journal of the RCN Accident and Emergency Nursing Association

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https://www.readbyqxmd.com/read/29521080/concussion-in-sport-the-importance-of-accurate-and-reliable-discharge-advice
#1
Cormac Norton
Concussion in sport is a common presentation in urgent and emergency care settings, so it is essential that nurses have a full understanding of the condition. Most patients who attend an emergency department with concussion are discharged and discharge advice must be well-informed and evidence based. This article outlines the normal anatomy of the brain and the pathophysiology of concussion, and discusses the guidelines on returning to sport following this injury.
March 9, 2018: Emergency Nurse: the Journal of the RCN Accident and Emergency Nursing Association
https://www.readbyqxmd.com/read/29521079/advanced-nurse-practitioner-scheduled-return-clinic-a-clinical-audit-of-a-quality-initiative
#2
Louise Canty, Anthony Kearney
Emergency care settings in Ireland have struggled with a high volume of service users in recent years. This nationwide crisis led to the establishment of the National Emergency Medicine Programme Strategy in 2012, which identified two key performance indicators for efficiency in emergency care: the patient experience time, which should not exceed six hours from the time of registration to the time of discharge; and patients who do not wait for treatment (DNW) should make up less than 5% of those attending emergency care services...
March 9, 2018: Emergency Nurse: the Journal of the RCN Accident and Emergency Nursing Association
https://www.readbyqxmd.com/read/29521078/recognition-and-nursing-management-of-children-with-non-traumatic-limp
#3
Elizabeth Wilson, Peter Cox, Karen Greaves, Siba Prosad Paul
Children with acute onset non-traumatic limp often present to emergency departments (EDs). The limp can occasionally be associated with medical emergencies such as septic arthritis and slipped upper femoral epiphysis but is often due to less severe conditions. This article discusses the common and self-limiting causes of acute onset of non-traumatic limp in children, such as transient synovitis, reactive arthritis, and benign acute childhood myositis. It also discusses more severe conditions, including septic arthritis, osteomyelitis, slipped upper femoral epiphysis, Perthes disease, malignancies and non-accidental injury...
March 9, 2018: Emergency Nurse: the Journal of the RCN Accident and Emergency Nursing Association
https://www.readbyqxmd.com/read/29521077/prudent-healthcare-in-emergency-departments-a-case-study-in-wales
#4
Louise Condon, Sharon Burford, Robin Ghosal, Brett Denning, Gail Rees
To deliver a patient-centred service, emergency departments (EDs) must be efficient, effective and meet the needs of the local population. This article describes a service redesign of unscheduled care in a hospital in Wales, which followed the principles of prudent healthcare to improve patient experiences. Extending the roles of nurse specialist practitioners was a major component of the redesign. Six working groups were established to guide the process, one of which was responsible for working cooperatively with the local community, which was concerned about perceived 'downgrading' of the ED...
March 9, 2018: Emergency Nurse: the Journal of the RCN Accident and Emergency Nursing Association
https://www.readbyqxmd.com/read/29424494/accidents-and-ethics-a-visual-narrative-approach
#5
Catherine Gadd, Colin Jones
Emergency department (ED) attendances are continuing to rise, and medical and nursing teams are working under considerable strain. ED clinicians are used to thinking on their feet and possess the skills to multitask, and juggle ever-changing and competing priorities against the clock. This article reports the findings of a study that enabled ED clinicians to take time out to reflect on some of the difficult decisions they make daily, and to ask whether they consider ethical principles in depth, and if they are of any practical help...
February 9, 2018: Emergency Nurse: the Journal of the RCN Accident and Emergency Nursing Association
https://www.readbyqxmd.com/read/29424493/is-it-safe-to-inject-local-anaesthetic-with-adrenaline-into-the-pinna-and-external-nose
#6
Emma Millar, Arthur Henderson, Angus Waddell
Adrenaline containing lidocaine preparations such as lignospan are routinely used in ear, nose and throat (ENT) care. Despite this, textbooks and internet resources warn against their use in peripheries, including the nose and ear. As a result, they are commonly avoided by other specialties, such as emergency medicine. This article reports on the findings of a review undertaken to assess the evidence of harm associated with using lignospan in the pinna and external nose. A literature search was carried out, and retrospective data were collected on all elective facial skin lesion surgery in the ENT department at the Great Western Hospital in Swindon between 2005 and 2015...
February 9, 2018: Emergency Nurse: the Journal of the RCN Accident and Emergency Nursing Association
https://www.readbyqxmd.com/read/29424492/urgent-care-centre-redirection-evaluation-of-a-nurse-led-intervention
#7
Nicola Groom, Tara Kidd, Nicola Carey
AIM: Patient redirection can help reduce service demand by providing information about more appropriate services. There is, however, no evidence about the effect of nurse-led patient redirection in urgent care centre settings. The aim of this project was to develop and evaluate a nurse-led patient 'self-care and redirection first' intervention in an urgent care centre (UCC). METHOD: Adopting a prospective observational design, the intervention was delivered to an opportunity sample of patients who attended a south London hospital UCC, between June and July 2014, and evaluated through patient interviews five to ten days after initial attendance...
February 9, 2018: Emergency Nurse: the Journal of the RCN Accident and Emergency Nursing Association
https://www.readbyqxmd.com/read/29219259/nursing-management-of-childhood-chickenpox-infection
#8
Grace Boyd, Paul Anthony Heaton, Rachel Wilkinson, Siba Prosad Paul
Chickenpox is an extremely contagious infectious disease caused by varicella zoster virus (VZV). It is a common childhood illness characterised by an itchy vesicular rash and fever, which usually resolves spontaneously without medical intervention. Serious, and rarely fatal, complications can occur, including pneumonia, central nervous system infection, overwhelming secondary bacterial infections, especially with Group A streptococcus, and necrotising fasciitis. Therefore it is crucial that emergency department (ED) nurses can recognise the signs and symptoms that indicate deterioration...
December 8, 2017: Emergency Nurse: the Journal of the RCN Accident and Emergency Nursing Association
https://www.readbyqxmd.com/read/29219258/military-preceptees-journey-in-the-emergency-department
#9
Marta Fullstone, Olivia Hall
This article is an account of the experiences of two newly qualified military graduates who became preceptees in an emergency department (ED). It considers the emotions felt, the benefits of previous nursing experience, and the importance of reflection and support from colleagues. The article also suggests that ED experience can shape nurses' ability to undertake operational and non-operational military nursing roles.
December 8, 2017: Emergency Nurse: the Journal of the RCN Accident and Emergency Nursing Association
https://www.readbyqxmd.com/read/29219257/evaluation-of-a-mental-health-liaison-team-part-2-the-themes-and-their-effect-on-practice
#10
Alex McClimens, Shona Kelly, Mubarak Ismail, Jeff Breckon
Hospitals and emergency departments (EDs) are caring for increasing numbers of patients who present with underlying mental health issues. Managing these patients can be challenging for clinical staff who often lack the specialist knowledge and skills required to provide appropriate care. This article, part two of two on the evaluation of a newly formed mental health liaison team (MHLT) working in a general hospital, focuses on the perceptions and experiences of the MHLT participants, and explores three sub-themes derived from the interview data...
December 8, 2017: Emergency Nurse: the Journal of the RCN Accident and Emergency Nursing Association
https://www.readbyqxmd.com/read/29125259/implementation-of-a-model-of-emergency-care-in-an-australian-hospital
#11
Tracey Millichamp, Shannon Bakon, Martin Christensen, Kate Stock, Sarah Howarth
AIM: Emergency departments are characterised by a fast-paced, quick turnover and high acuity workload, therefore appropriate staffing is vital to ensure positive patient outcomes. Models of care are frameworks in which safe and effective patient-to-nurse ratios can be ensured. The aim of this study was to implement a supportive and transparent model of emergency nursing care that provides structure - regardless of nursing staff profile, business or other demands; improvement to nursing workloads; and promotes individual responsibility and accountability for patient care...
November 10, 2017: Emergency Nurse: the Journal of the RCN Accident and Emergency Nursing Association
https://www.readbyqxmd.com/read/29125258/evaluation-of-a-mental-health-liaison-team-part-1-background-and-literature-review
#12
Alex McClimens, Shona Kelly, Mubarak Ismail, Jeff Breckon
Hospitals and emergency departments (EDs) are caring for increasing numbers of patients who present with underlying mental health issues. Management of these patients can be challenging for clinical staff who often lack the specialist knowledge and skills required to provide appropriate care. In April 2015, a mental health liaison service was introduced in Rotherham Hospital as part of a two-year pilot scheme. The aim was to provide assessment and treatment of adults with mental health problems admitted to the hospital...
November 10, 2017: Emergency Nurse: the Journal of the RCN Accident and Emergency Nursing Association
https://www.readbyqxmd.com/read/29125257/improving-door-to-needle-times-for-patients-with-suspected-neutropenic-sepsis
#13
Tracy Wild
Neutropenic sepsis is a potentially life-threatening complication of chemotherapy and has an associated mortality of 2% to 21%. Patients can deteriorate rapidly and are usually advised to attend their local emergency department (ED) for urgent assessment and antibiotic therapy within one hour of arrival. Delivery of this emergency care is, however, inconsistent, and at times suboptimal, due to a lack of awareness of the condition and of clinical expertise. This article discusses a collaborative project between an acute oncology service and an ED, which has improved and sustained compliance with this standard through a range of initiatives, including revised and integrated sepsis guidelines, education, sepsis champions and a fast-track patient pathway...
November 10, 2017: Emergency Nurse: the Journal of the RCN Accident and Emergency Nursing Association
https://www.readbyqxmd.com/read/29115768/lean-thinking-in-emergency-departments-concepts-and-tools-for-quality-improvement
#14
Frances Bruno
The lean approach is a viable framework for reducing costs and enhancing the quality of patient care in emergency departments (EDs). Reports on lean-inspired quality improvement initiatives are rapidly growing but there is little emphasis on the philosophy behind the processes, which is the essential ingredient in sustaining transformation. This article describes lean philosophy, also referred to as lean, lean thinking and lean healthcare, and its main concepts, to enrich the knowledge and vocabulary of nurses involved or interested in quality improvement in EDs...
October 12, 2017: Emergency Nurse: the Journal of the RCN Accident and Emergency Nursing Association
https://www.readbyqxmd.com/read/29115767/care-delays-in-patients-with-signs-and-symptoms-of-acute-myocardial-infarction
#15
Susan Sanders
AIM: More than six million patients with signs and symptoms suggestive of a heart attack present to emergency departments (EDs) in the US each year. Of those diagnosed with acute myocardial infarction (AMI), one third die in the acute phase. Rapid ED triage can reduce the mortality rate, yet there are still delays in patient care. The aim of this study is to explore the relationship between patient and nurse characteristics, patient presentations, delays in triage, and delays in obtaining electrocardiograms (ECGs) of patients with signs and symptoms of AMI...
October 12, 2017: Emergency Nurse: the Journal of the RCN Accident and Emergency Nursing Association
https://www.readbyqxmd.com/read/29115766/recognition-and-nursing-management-of-sepsis-in-early-infancy
#16
Mary Fenton-Jones, Anna Cannon, Siba Prosad Paul
Neonatal sepsis describes serious bacterial or viral infections that manifest in the first 28 days of life, causing significant morbidity and mortality. Although most babies with early-onset neonatal sepsis are born and managed in hospital, some are born in the community, or discharged early from postnatal wards. Consequently, emergency department (ED) nurses and other healthcare professionals need to be able to identify and treat these infants effectively to improve long-term outcomes. This article discusses neonatal sepsis, including causative organisms, types of neonatal sepsis and why neonates are vulnerable to infection...
October 12, 2017: Emergency Nurse: the Journal of the RCN Accident and Emergency Nursing Association
https://www.readbyqxmd.com/read/29115757/parkinson-s-disease-nursing-care-in-emergency-settings
#17
Vicky Queen
In the UK 127,000 people are diagnosed with Parkinson's disease, many of whom are frequently admited to hospital. However, Parkinson's disease is not usually the primary cause of admission. Emergency department (ED) nurses must be aware of the medication needs of people with Parkinson's disease and how these can be met in emergency setings to ensure the stability of their condition and to prevent the development of neuroleptic malignant syndrome, a potentially fatal condition caused by abrupt omission of Parkinson's medication...
September 14, 2017: Emergency Nurse: the Journal of the RCN Accident and Emergency Nursing Association
https://www.readbyqxmd.com/read/29115756/assessing-for-head-injury-in-alcohol-intoxicated-patients
#18
Ciara Hoban
Each year, 1.4 million people with recent head injuries attend emergency departments in England and Wales. The incidence of head injury in acutely intoxicated patients is estimated to be as high as 65%. One of the challenges of assessing and managing patients who have consumed drugs or alcohol is that the signs and symptoms of this type of intoxication are also risk factors for intracranial complications and head injury, which makes differentiation between the two diagnoses difficult. This article examines the literature on assessment and management of intoxicated patients with head injuries to identify the challenges faced by healthcare professionals undertaking neurological assessments...
September 14, 2017: Emergency Nurse: the Journal of the RCN Accident and Emergency Nursing Association
https://www.readbyqxmd.com/read/28703072/-it-s-up-to-nurses-to-tell-politicians-how-it-is
#19
Layla Haidrani
What is your job? I am a practising advanced nurse practitioner in urgent first contact care and visiting professor of prescribing and medicines at Birmingham City University. I also have roles with the Resuscitation Council UK and the British National Formulary. As an independent consultant, I work with organisations to investigate errors, as well as chairing and presenting conferences.
July 13, 2017: Emergency Nurse: the Journal of the RCN Accident and Emergency Nursing Association
https://www.readbyqxmd.com/read/28703071/reporting-occupational-violence-in-emergency-departments
#20
(no author information available yet)
A study has revealed that emergency department (ED) staff across all roles receive verbal abuse from patients, but that nurses are more likely to be physically assaulted and are less likely to feel safe.
July 13, 2017: Emergency Nurse: the Journal of the RCN Accident and Emergency Nursing Association
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