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https://www.readbyqxmd.com/read/27860022/shared-decision-making-with-vulnerable-populations-in-the-emergency-department
#1
Ana Castaneda-Guarderas, Jeffrey Glassberg, Corita R Grudzen, Ka Ming Ngai, Margaret E Samuels-Kalow, Erica Shelton, Stephen P Wall, Lynne D Richardson
The emergency department occupies a unique position within the health care system, serving as a safety net for vulnerable patients, regardless of their race, ethnicity, religion, country of origin, sexual orientation, socioeconomic status or medical diagnosis. Shared decision making (SDM) presents special challenges when used with vulnerable population groups. The differing circumstances, needs and perspectives of vulnerable groups invoke issues of provider bias, disrespect, judgmental attitudes and lack of cultural competence; as well as patient mistrust, and the consequences of their social and economic disenfranchisement...
November 17, 2016: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
https://www.readbyqxmd.com/read/27836139/on-the-threshold-of-safety-a-qualitative-exploration-of-nurses-perceptions-of-factors-involved-in-safe-staffing-levels-in-emergency-departments
#2
Lisa A Wolf, Cydne Perhats, Altair M Delao, Paul R Clark, Michael D Moon
: The emergency department is a unique practice environment in that the Emergency Medical Treatment and Active Labor Act (EMTALA), which mandates a medical screening examination for all presenting patients, effectively precludes any sort of patient volume control; staffing needs are therefore fluid and unpredictable. The purpose of this study is to explore emergency nurses' perceptions of factors involved in safe staffing levels and to identify factors that negatively and positively influence staffing levels and might lend themselves to more effective interventions and evaluations...
November 8, 2016: Journal of Emergency Nursing: JEN: Official Publication of the Emergency Department Nurses Association
https://www.readbyqxmd.com/read/27803503/evaluation-of-pharmacist-impact-on-culture-review-process-for-patients-discharged-from-the-emergency-department
#3
Ruben D Santiago, Jose A Bazan, Nicole V Brown, Eric J Adkins, Mary Beth Shirk
Background: Accurate and timely review of microbiological test results is a core component of antimicrobial stewardship. There is documented success of these programs in the inpatient setting; however, emergency department (ED) patients are typically not included in these initiatives. Objectives: To assess the impact of an emergency medicine pharmacist (EMP)-facilitated review process of positive microbiological test results from patients discharged from the ED as measured by time to positive result review and number of indicated interventions completed...
October 2016: Hospital Pharmacy
https://www.readbyqxmd.com/read/27798810/emergence-delirium-in-pediatric-anesthesia
#4
REVIEW
Arthura D Moore, Doralina L Anghelescu
Emergence delirium (ED) is a complex of perceptual disturbances and psychomotor agitation that occurs most commonly in preschool-aged children in the early postanesthetic period. The incidence of ED varies between 10 and 80% in children and is perceived as a troublesome clinical situation by 42% of pediatric anesthesiologists. Although these events are often short lived, they increase the risk of self-injury and delayed discharge, require additional nursing staff and can increase medical care costs, all of which are causes for concern...
October 31, 2016: Paediatric Drugs
https://www.readbyqxmd.com/read/27756354/use-of-point-of-care-testing-and-early-assessment-model-reduces-length-of-stay-for-ambulatory-patients-in-an-emergency-department
#5
Meri Kankaanpää, Maria Raitakari, Leila Muukkonen, Siv Gustafsson, Merja Heitto, Ari Palomäki, Kimmo Suojanen, Veli-Pekka Harjola
BACKGROUND: To assess whether the use of point-of-care testing (POCT) and early assessment team (EAT) model shortens emergency department (ED) length of stay (LOS). METHODS: This prospective, observational study with comparison between three study periods was performed in three phases in a metropolitan ED with 57,000 annual visits. Data were collected from adult ambulatory patients who were discharged home. Phase 1 served as a control (n = 1559 in one month)...
October 18, 2016: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
https://www.readbyqxmd.com/read/27748221/impact-of-process-improvements-on-measures-of-emergency-department-efficiency
#6
Alexander K Leung, Shawn D Whatley, Dechang Gao, Marko Duic
OBJECTIVE: To study the operational impact of process improvements on emergency department (ED) patient flow. The changes did not require any increase in resources or expenditures. METHODS: This was a 36-month pre- and post-intervention study to evaluate the effect of implementing process improvements at a community ED from January 2010 to December 2012. The intervention comprised streamlining triage by having patients accepted into internal waiting areas immediately after triage...
October 17, 2016: CJEM
https://www.readbyqxmd.com/read/27686172/significant-reduction-in-preanalytical-errors-for-nonphlebotomy-blood-draws-after-implementation-of-a-novel-integrated-specimen-collection-module
#7
Rachel D Le, Stacy E F Melanson, Athena K Petrides, Ellen M Goonan, Ida Bixho, Adam B Landman, Anne Marie Brogan, David W Bates, Milenko J Tanasijevic
OBJECTIVES: Most preanalytical errors at our institution occur during nonphlebotomy blood draws. We implemented an electronic health record (EHR), interfaced the EHR to the laboratory information system, and designed a new specimen collection module. We studied the effects of the new system on nonphlebotomy preanalytical errors. METHODS: We used an electronic database of preanalytical errors and calculated the number and type of the most common errors in the emergency department (ED) and inpatient nursing for 3-month periods before (August-October 2014) and after (August-October 2015) implementation...
October 2016: American Journal of Clinical Pathology
https://www.readbyqxmd.com/read/27681511/a-qualitative-study-of-factors-facilitating-clinical-nurse-engagement-in-emergency-department-catheter-associated-urinary-tract-infection-prevention
#8
Eileen J Carter, Daniel J Pallin, Leslie Mandel, Corine Sinnette, Jeremiah D Schuur
OBJECTIVE: The aim of this study was to explore the actions of nurse leaders that facilitated clinical nurses' active involvement in emergency department (ED) catheter-associated urinary tract infection (CAUTI) prevention programs. BACKGROUND: Hospitals face increasing financial pressures to reduce CAUTI. Urinary catheters, often inserted in the ED, expose patients to CAUTI risk. Nurses are the principal champions of ED CAUTI prevention programs. METHODS: This was a qualitative analysis from a multisite, comparative case study project...
October 2016: Journal of Nursing Administration
https://www.readbyqxmd.com/read/27678381/identification-of-at-risk-youth-by-suicide-screening-in-a-pediatric-emergency-department
#9
Elizabeth D Ballard, Mary Cwik, Kathryn Van Eck, Mitchell Goldstein, Clarissa Alfes, Mary Ellen Wilson, Jane M Virden, Lisa M Horowitz, Holly C Wilcox
The pediatric emergency department (ED) is a critical location for the identification of children and adolescents at risk for suicide. Screening instruments that can be easily incorporated into clinical practice in EDs to identify and intervene with patients at increased suicide risk is a promising suicide prevention strategy and patient safety objective. This study is a retrospective review of the implementation of a brief suicide screen for pediatric psychiatric ED patients as standard of care. The Ask Suicide Screening Questions (ASQ) was implemented in an urban pediatric ED for patients with psychiatric presenting complaints...
September 27, 2016: Prevention Science: the Official Journal of the Society for Prevention Research
https://www.readbyqxmd.com/read/27665031/impact-and-feasibility-of-an-emergency-department-based-ventilator-associated-pneumonia-bundle-for-patients-intubated-in-an-academic-emergency-department
#10
Lawrence A DeLuca, Paul Walsh, Donald D Davidson, Lisa R Stoneking, Laurel M Yang, Kristi J H Grall, M Jessica Gonzaga, Wanda J Larson, Uwe Stolz, Dylan M Sabb, Kurt R Denninghoff
BACKGROUND: Ventilator-associated pneumonia (VAP) has been linked to emergency department (ED) intubation and length of stay (LOS). We assessed VAP prevalence in ED intubated patients, feasibility of ED VAP prevention, and effect on VAP rates. METHODS: This was a quality improvement initiative using a pre/post design. Phase 1 (PRE1) comprised patients before intensive care unit (ICU) bundle deployment. Phase 2 (PRE2) occurred after ICU but before ED deployment. Phase 3 (POST) included patients received VAP prevention starting at ED intubation...
September 21, 2016: American Journal of Infection Control
https://www.readbyqxmd.com/read/27641288/book-review-philosophy-of-science-for-nursing-practice-concepts-and-applications-michael-d-dahnke-h-michael-dreher-2nd-ed-2016-new-york-springer
#11
REVIEW
https://www.readbyqxmd.com/read/27641287/book-review-philosophy-of-science-for-nursing-practice-concepts-and-applications-michael-d-dahnke-h-michael-dreher-2nd-ed-2016-new-york-springer
#12
REVIEW
https://www.readbyqxmd.com/read/27617108/recruitment-of-minority-adolescents-and-young-adults-into-randomised-clinical-trials-testing-the-design-of-the-technology-enhanced-community-health-nursing-tech-n-pelvic-inflammatory-disease-trial
#13
Maria Trent, Shang-En Chung, Charlotte Gaydos, Kevin D Frick, Jennifer Anders, Steven Huettner, Richard Rothman, Arlene Butz
PURPOSE: Pelvic inflammatory disease (PID) disproportionately affects adolescent and young adult (AYA) women and can negatively influence reproductive health trajectories. Few randomized controlled trials (RCTs) have focused on strategies to improve outpatient adherence or to reduce reproductive morbidity in this population. This paper describes the research methods and preliminary effectiveness of recruitment, retention, and intervention strategies employed in a novel RCT designed to test a technology-enhanced community-health nursing (TECH-N) intervention among urban AYA with PID...
August 2016: European Medical Journal. Reproductive Health
https://www.readbyqxmd.com/read/27596110/screening-for-suicidal-thoughts-and-behaviors-in-older-adults-in-the-emergency-department
#14
Marian E Betz, Sarah A Arias, Daniel L Segal, Ivan Miller, Carlos A Camargo, Edwin D Boudreaux
OBJECTIVES: To estimate the prevalence of self-harm, suicidal ideation (SI), and suicide attempts (SA) in older adults in the emergency department (ED), including differences according to age, sex, and race and ethnicity. DESIGN: Quasi-experimental, multiphase, eight-center study with prospective review of consecutive charts during enrollment shifts (November 2011-December 2014). SETTING: Eight EDs in seven states, all with protocols for nurses to screen every patient for suicide risk (universal screening)...
October 2016: Journal of the American Geriatrics Society
https://www.readbyqxmd.com/read/27581952/the-costs-of-fall-related-injuries-among-older-adults-annual-per-faller-service-component-and-patient-out-of-pocket-costs
#15
Geoffrey J Hoffman, Ron D Hays, Martin F Shapiro, Steven P Wallace, Susan L Ettner
OBJECTIVE: To estimate expenditures for fall-related injuries (FRIs) among older Medicare beneficiaries. DATA SOURCES: The 2007-2009 Medicare claims and 2008 Health and Retirement Study (HRS) data for 5,497 (228 FRI and 5,269 non-FRI) beneficiaries. STUDY DESIGN: FRIs were indicated by inpatient/outpatient ICD-9 diagnostic codes for fractures, trauma, dislocations, and by e-codes. A pre-post comparison group design was used to estimate the differential change in pre-post expenditures for the FRI relative to the non-FRI cohort (FRI expenditures)...
September 1, 2016: Health Services Research
https://www.readbyqxmd.com/read/27496899/the-transition-to-clinical-expert-enhanced-decision-making-for-children-aged-less-than-5%C3%A2-years-attending-the-paediatric-ed-with-acute-respiratory-conditions
#16
Leah Bowen, Alison Shaw, Mark D Lyttle, Sarah Purdy
BACKGROUND: Rates of unplanned paediatric admissions are persistently high. Many admissions are short-stay events, lasting less than 48 hours. OBJECTIVE: This qualitative research explores factors that influence clinical decision making in the paediatric ED (PED) for children under 5 attending with acute respiratory conditions, focusing on how management decisions adapt with increasing experience. METHOD: Semi-structured interviews were conducted with 15 PED clinicians (doctors, emergency nurse practitioners and registered nurses) with varying levels of experience in paediatric emergency medicine (PEM), emergency medicine or paediatrics...
August 5, 2016: Emergency Medicine Journal: EMJ
https://www.readbyqxmd.com/read/27485431/interprofessional-and-interdisciplinary-simulation-based-training-leads-to-safe-sedation-procedures-in-the-emergency-department
#17
Thomas C Sauter, Wolf E Hautz, Simone Hostettler, Monika Brodmann-Maeder, Luca Martinolli, Beat Lehmann, Aristomenis K Exadaktylos, Dominik G Haider
BACKGROUND: Sedation is a procedure required for many interventions in the Emergency department (ED) such as reductions, surgical procedures or cardioversions. However, especially under emergency conditions with high risk patients and rapidly changing interdisciplinary and interprofessional teams, the procedure caries important risks. It is thus vital but difficult to implement a standard operating procedure for sedation procedures in any ED. Reports on both, implementation strategies as well as their success are currently lacking...
2016: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
https://www.readbyqxmd.com/read/27193065/comparison-of-different-approaches-to-the-surgical-treatment-of-penile-fractures-quicker-return-to-sexual-function-with-longitudinal-incisions
#18
M X Xu, Z Zhou, H J Yao, K Zhang, J Da, M Zhang, Z Wang, M J Lu
The objective of this study was to compare the long-term clinical outcomes from longitudinal incisions and subcoronal circumferential degloving incisions in the surgical treatment of penile fractures. From July 2001 to July 2014, 23 patients were identified with penile fractures. Fourteen patients underwent longitudinal incisions after ultrasound localization; nine patients underwent subcoronal circumferential degloving incisions. Sexual function was evaluated preoperatively and postoperatively using an abridged International Index of Erectile Function (IIEF) questionnaire...
July 2016: International Journal of Impotence Research
https://www.readbyqxmd.com/read/26792683/nursing-care-as-a-predictor-of-phlebitis-related-to-insertion-of-a-peripheral-venous-cannula-in-emergency-departments-findings-from-a-prospective-study
#19
A Palese, E Ambrosi, F Fabris, A Guarnier, P Barelli, P Zambiasi, E Allegrini, L Bazoli, P Casson, M Marin, M Padovan, M Picogna, P Taddia, D Salmaso, P Chiari, O Marognolli, F Canzan, L Saiani
BACKGROUND: To date, few studies have investigated the occurrence of phlebitis related to insertion of a peripheral venous cannula (PVC) in an emergency department (ED). AIM: To describe the natural history of ED-inserted PVC site use; the occurrence and severity of PVC-related phlebitis; and associations with patient, PVC and nursing care factors. METHODS: A prospective study was undertaken of 1262 patients treated as urgent cases in EDs who remained in a medical unit for at least 24h...
March 2016: Journal of Hospital Infection
https://www.readbyqxmd.com/read/26707581/psychosocial-care-for-injured-children-worldwide-survey-among-hospital-emergency-department-staff
#20
Eva Alisic, Claire Hoysted, Nancy Kassam-Adams, Markus A Landolt, Sarah Curtis, Anupam B Kharbanda, Mark D Lyttle, Niccolò Parri, Rachel Stanley, Franz E Babl
OBJECTIVE: To examine emergency department (ED) staff's knowledge of traumatic stress in children, attitudes toward providing psychosocial care, and confidence in doing so, and also to examine differences in these outcomes according to demographic, professional, and organizational characteristics, and training preferences. STUDY DESIGN: We conducted an online survey among staff in ED and equivalent hospital departments, based on the Psychological First Aid and Distress-Emotional Support-Family protocols...
March 2016: Journal of Pediatrics
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