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Ed.d nursing

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
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
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
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
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
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: Eur Med J Reprod Health
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)...
September 6, 2016: Journal of the American Geriatrics Society
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
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
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
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
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
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
Clayton Wu, Joy Melnikow, Tu Dinh, James F Holmes, Samuel D Gaona, Thomas Bottyan, Debora Paterniti, Daniel K Nishijima
INTRODUCTION: Understanding patient perceptions and preferences of hospital care is important to improve patients' hospitalization experiences and satisfaction. The objective of this study was to investigate patient preferences and perceptions of hospital care, specifically differences between intensive care unit (ICU) and hospital floor admissions. METHODS: This was a cross-sectional survey of emergency department (ED) patients who were presented with a hypothetical scenario of a patient with mild traumatic brain injury (TBI)...
September 2015: Western Journal of Emergency Medicine
Daniel J Elliott, Kimberly D Williams, Pan Wu, Hemant V Kher, Barret Michalec, Natalie Reinbold, Christian M Coletti, Badrish J Patel, Robert M Dressler
BACKGROUND: Early evidence suggests that multidisciplinary programs designed to expedite transfer from the emergency department (ED) may decrease boarding times. However, few models exist that provide effective ways to improve the ED- to-ICU transition process. In 2012 Christiana Care Health System (Newark, Delaware) created and implemented an interdepartmental program designed to expedite the transition of care from the ED to the medical ICU (MICU). METHODS: This quasi-experimental study compared ED length of stay (LOS), MICU LOS, and overall hospital LOS before and after the MICU Alert Team (MAT) intervention program...
December 2015: Joint Commission Journal on Quality and Patient Safety
Lisa A Wolf, Cydne Perhats, Altair M Delao, Michael D Moon, Paul R Clark, Kathleen E Zavotsky
INTRODUCTION: Moral distress in nursing has been studied in many settings, but there is a paucity of research on moral distress as it manifests in the emergency department. One study suggests a correlation between moral distress and aspects of burnout, and other researchers report that nurses have considered leaving their position or even their profession because of moral distress. Further exploration of these issues may provide insight into their effects on ED patient care and the emergency nursing profession...
January 2016: Journal of Emergency Nursing: JEN: Official Publication of the Emergency Department Nurses Association
Xiao C Zhang, Leo Kobayashi, Markus Berger, Pranav M Reddy, Darin B Chheng, Sara A Gorham, Shivany Pathania, Sarah P Stern, Elio Icaza Milson, Gregory D Jay, Jay M Baruch
OBJECTIVES: The objective was to assess and categorize the understandable components of patient-audible information (e.g., provider conversations) in emergency department (ED) care areas and to initiate a baseline ED soundscape assessment. METHODS: Investigators at an academic referral hospital accessed 21 deidentified transcripts of recordings made with binaural in-ear microphones in patient rooms (n = 10) and spaces adjacent to nurses' stations (n = 11), during ED staff sign-outs as part of an approved quality management process...
October 2015: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
Kelli Innes, Kimberley Crawford, Tamsin Jones, Renee Blight, Catherine Trenham, Allison Williams, D Griffiths, Julia Morphet
In response to increasing demands some emergency departments have introduced transdisciplinary care coordination teams. Such teams comprise staff from multiple disciplines who are trained to perform roles outside their usual scope of practice. This study aimed to critically evaluate the patient, carer and ED staff perceptions of the transdisciplinary model of care in an emergency department in a Melbourne metropolitan hospital. The evaluation of the transdisciplinary team involved interviews with patients and carers who have received the transdisciplinary team services, and focus groups with emergency nursing and transdisciplinary team staff...
March 2016: International Emergency Nursing
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