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Emergency department nursing

Jerry Y Du, Alexander S Rascoe, Randall E Marcus
BACKGROUND: In an era of increasing healthcare costs, the number and value of nonclinical workers, especially hospital management, has come under increased study. Compensation of hospital executives, especially at major nonprofit medical centers, and the "wage gap" with physicians and clinical staff has been highlighted in the national news. To our knowledge, a systematic analysis of this wage gap and its importance has not been investigated. QUESTIONS/PURPOSES: (1) How do wage trends compare between physicians and executives at major nonprofit medical centers? (2) What are the national trends in the wages and the number of nonclinical workers in the healthcare industry? (3) What do nonclinical workers contribute to the growth in national cost of healthcare wages? (4) How much do wages contribute to the growth of national healthcare costs? (5) What are the trends in healthcare utilization? METHODS: We identified chief executive officer (CEO) compensation and chief financial officer (CFO) compensation at 22 major US nonprofit medical centers, which were selected from the US News & World Report 2016-2017 Hospital Honor Roll list and four health systems with notable orthopaedic departments, using publicly available Internal Revenue Service 990 forms for the years 2005, 2010, and 2015...
July 10, 2018: Clinical Orthopaedics and related Research
Mingyang Shan, Roee Gutman, David Dosa, Pedro L Gozalo, Jessica A Ogarek, Sarah Kler, Kali S Thomas
BACKGROUND: Access to social services (eg, nutrition) can impact older adults' health care utilization and health outcomes. However, data documenting the relationship between receiving services and objective measures of health care utilization remain limited. OBJECTIVES: To link Meals on Wheels (MOW) program data to Medicare claims to enable examination of clients' health and health care utilization and to highlight the utility of this linked dataset. RESEARCH DESIGN: Using probabilistic linking techniques, we matched MOW client data to Medicare enrollment and claims data...
July 11, 2018: Medical Care
Ines Basso, Laura Simionato, Valerio Dimonte, Serena Scaglione, Sara Campagna
. The Emergency Department visits of Nursing Home residents: descriptive study in a Nursing Home. INTRODUCTION: Many Emergency Departments (ED) transfers of Nursing Home (NH) residents are potentially avoidable or even inappropriate since problems could be prevented or managed in the NH. AIM: To describe characteristics and outcomes of NH residents transferred to ED for respiratory, cardiovascular and neurological problems and symptoms of infection. METHODS: A retrospective descriptive study using clinical records data from 2013-2016 of a NH was conducted...
April 2018: Assistenza Infermieristica e Ricerca: AIR
Marius Wamsiedel
Most studies on gatekeeping at the emergency department (ED) have emphasised the assessment of clients in terms of perceived legitimacy and deservingness, showing that lay considerations lead to exclusionary practices, and the ED contributes to the social reproduction of inequality. Some recent works have challenged this representation, providing compelling evidence of staff's concern for the access to care of the most vulnerable users. I extend this perspective by presenting the criterion of reasonableness of the visit to the ED that nurses in Romania commonly use during the triage admission interview...
July 10, 2018: Sociology of Health & Illness
John Sather, Craig Rothenberg, Emily B Finn, Kevin N Sheth, Charles Matouk, Laura Pham, Vivek Parwani, Andrew Ulrich, Arjun K Venkatesh
Critically ill patients may be exposed to unique safety threats as a result of the complexity of interhospital and intrahospital transitions involving the emergency department (ED). Real-time surveys were administered to clinicians in the ED and neuroscience intensive care unit of a tertiary health care system to assess perceptions of handoff safety and quality in transitions involving critically ill neurologic patients. In all, 115 clinical surveys were conducted among 26 patient transfers. Among all clinician types, 1 in 5 respondents felt the handoff process was inadequate...
July 1, 2018: American Journal of Medical Quality: the Official Journal of the American College of Medical Quality
Libby Haskell, Emma J Tavender, Catherine Wilson, Sharon O'Brien, Franz E Babl, Meredith L Borland, Liz Cotterell, Tibor Schuster, Francesca Orsini, Nicolette Sheridan, David Johnson, Ed Oakley, Stuart R Dalziel
BACKGROUND: Bronchiolitis is the most common reason for admission to hospital for infants less than one year of age. Although management is well defined, there is substantial variation in practice, with infants receiving ineffective therapies or management. This study will test the effectiveness of tailored, theory informed knowledge translation (KT) interventions to decrease the use of five clinical therapies or management processes known to be of no benefit, compared to usual dissemination practices in infants with bronchiolitis...
July 6, 2018: BMC Pediatrics
Daniel Tsoy, Paula Sneath, Josh Rempel, Simon Huang, Nicole Bodnariuc, Mathew Mercuri, Alim Pardhan, Teresa M Chan
PROBLEM: As patient volumes increase, it is becoming increasingly important to find novel ways to teach junior medical learners about the intricacies of managing multiple patients simultaneously, as well as about working in a resource-limited environment. APPROACH: Serious games (i.e., games not intended purely for fun) are a teaching modality that have been gaining momentum as teaching tools in medical education. From May 2016 to August 2017, the authors designed and tested a serious game, called "GridlockED," to provide a focused educational experience for medical trainees to learn about multipatient care and patient flow...
July 3, 2018: Academic Medicine: Journal of the Association of American Medical Colleges
Jonathan D Sonis, Emily L Aaronson, Rebecca Y Lee, Lisa L Philpotts, Benjamin A White
Introduction: Patient experience with emergency department (ED) care is an expanding area of focus, and recent literature has demonstrated strong correlation between patient experience and meeting several ED and hospital goals. The objective of this study was to perform a systematic review of existing literature to identify specific factors most commonly identified as influencing ED patient experience. Methods: A literature search was performed, and articles were included if published in peer-reviewed journals, primarily focused on ED patient experience, employed observational or interventional methodology, and were available in English...
June 2018: Journal of Patient Experience
Andrea Gruneir, Candemir Cigsar, Xuesong Wang, Alice Newman, Susan E Bronskill, Geoff M Anderson, Paula A Rochon
BACKGROUND: Nursing home (NH) residents are frequent users of emergency departments (ED) and while prior research suggests that repeat visits are common, there is little data describing this phenomenon. Our objectives were to describe repeat ED visits over one year, identify risk factors for repeat use, and characterize "frequent" ED visitors. METHODS: Using provincial administrative data from Ontario, Canada, we identified all NH residents 65 years or older who visited an ED at least once between January 1 and March 31, 2010 and then followed them for one year to capture all additional ED visits...
July 5, 2018: BMC Geriatrics
Danielle McDonald, Rupal Mansukhani, Suzannah Kokotajlo, Frank Diaz, Christine Robinson
OBJECTIVE: This study was conducted to evaluate the impact of education on optimizing medication histories in a single-center pediatric emergency department. METHODS: This was a prospective, 2-phase study of 200 patients ages 21 years and younger who presented to the pediatric emergency department in January and February 2017. In phase I of the study, 100 patients were interviewed by both a nurse and a pharmacist. Between phases I and II, the pharmacist educated each nurse and disseminated standardized education materials...
May 2018: Journal of Pediatric Pharmacology and Therapeutics: JPPT: the Official Journal of PPAG
Annika Brucksch, Falk Hoffmann, Katharina Allers
BACKGROUND: Nursing home residents (NHRs) are often transferred to emergency departments (EDs). A great proportion of ED visits is considered inappropriate. There is evidence that male NHRs are more often hospitalised, but this is less clear for ED visits. It is unclear, which influence age has on ED visits. We aimed to study the epidemiology of ED visits in NHRs focusing on age- and sex-specific differences. METHODS: A systematic review was carried out based on articles found in MEDLINE (via PubMed), CINAHL and Scopus...
July 3, 2018: BMC Geriatrics
Sun Hee Moon, Yeon Hwan Park
PURPOSE: This study aimed to develop a triage competency scale (TCS) for emergency nurses, and to evaluate its validity and reliability. METHODS: Preliminary items were derived based on the attributes and indicators elicited from a concept analysis study on triage competency. Ten experts assessed whether the preliminary items belonged to the construct factor and determined the appropriateness of each item. A revised questionnaire was administered to 250 nurses in 18 emergency departments to evaluate the reliability and validity of the scale...
June 2018: Journal of Korean Academy of Nursing
Sahithi Sharma, Shubhatara Swamy, Anupam Bhambhani, Pratibha Nadig
Introduction: This study was carried out to collect and analyze the adverse drug reactions (ADRs) reported with use of anticoagulants, heparin and fondaparinux. These drugs are vital in the treatment of unstable coronary artery diseases and emergencies. Materials and Methods: A cross-sectional study with active reporting of ADRs from cardiology and medicine department was conducted. The type of reaction was assessed by Rawlins and Thomson criteria, causality by Naranjo probability scale, severity by modified Hartwig criteria, and preventability by Schumock and Thornton criteria...
April 2018: Journal of Pharmacy & Bioallied Sciences
Kristin L Rising, Shannon K Doyle, Rhea E Powell, Amanda M B Doty, Marianna LaNoue, Angela M Gerolamo
INTRODUCTION: Prior research suggests that uncertainty related to symptoms is a driver of emergency department (ED) use, and that patients often leave the ED with uncertainty not being addressed. Our objective was to engage patients to identify domains that contribute to feelings of uncertainty and decisions to use the ED. METHODS: We used Group Concept Mapping, a quasi-qualitative/quasi-quantitative method, to elicit patients' views on how uncertainty related to experiencing symptoms contributes to decisions to access the ED...
June 27, 2018: Journal of Emergency Nursing: JEN: Official Publication of the Emergency Department Nurses Association
Anders Moellekaer, Iben Duvald, Borge Obel, Bo Madsen, Jacob Eskildsen, Hans Kirkegaard
INTRODUCTION: Twenty-one new Danish emergency departments (EDs) were established following a 2007 policy reform that included ED autonomy to self-organize. The aim of this study was to describe the organization of the 21 departments and their organizational challenges. PARTICIPANTS AND METHODS: We used a qualitative design based on COREQ guidelines. All 21 EDs participated, and 123 semi-structured interviews with hospital and ED leaders, physicians, nurses, and secretaries were performed between 2013 and 2015...
June 28, 2018: European Journal of Emergency Medicine: Official Journal of the European Society for Emergency Medicine
Jawad M Husain, Marc LaRochelle, Julia Keosaian, Ziming Xuan, Karen E Lasser, Jane M Liebschutz
Objective: To identify reasons for opioid discontinuation and post-discontinuation outcomes among patients in the Transforming Opioid Prescribing in Primary Care (TOPCARE) study. Design: In TOPCARE, an intervention to improve adherence to opioid prescribing guidelines, randomized intervention primary care providers (PCPs) received nurse care manager support, an electronic registry, academic detailing, and electronic tools, and control PCPs received electronic tools only...
June 27, 2018: Pain Medicine: the Official Journal of the American Academy of Pain Medicine
Chun-Chih Lin, Hwey-Fang Liang, Chin-Yen Han, Li-Chin Chen, Chun-Lan Hsieh
PURPOSE: Professional resilience has become increasingly important for nurses in adverse work environments to reduce the negative results and increase the positive outcomes of stress. This study aimed to explore and understand the experiences of resilience among nurses in an overcrowded emergency department (ED) and increase knowledge about what nurses identified as protective factors, which may be useful for future planning. METHODS: A construction-grounded theory (CGT) approach was adopted...
June 25, 2018: International Emergency Nursing
M Raurell-Torredà, E Argilaga-Molero, M Colomer-Plana, A Ródenas-Francisco, M Garcia-Olm
OBJECTIVES: To assess non-invasive ventilation knowledge and skills among nurses and physicians in different contexts: equipment and contextual influences. METHOD: Cross-sectional, descriptive study in 4 intensive care units (ICU) (1 surgical, 3 medical-surgical), 1 postsurgical recovery unit, 2 emergency departments (ED) and 3 wards, in 4 hospitals (3 university, 1 community) with 407 professionals. A 13-item survey, validated in the setting, was applied (Kappa index, 0...
June 25, 2018: Enfermería Intensiva
Rouhollah Zaboli, Zainab Malmoon, Mohammad Reza Soltani-Zarandi, Mohammad Hassani
Purpose A sentinel event is an unexpected occurrence resulting in death or serious physical or psychological injury or the risk thereof. The purpose of this paper is to investigate the influencing factors of sentinel events in the emergency department of a military hospital in Tehran to find out some of the effective solutions. Design/methodology/approach In this qualitative study with content analysis approach, 20 hospital healthcare personnel participated as participants from the fields of medicine and nursing...
July 9, 2018: International Journal of Health Care Quality Assurance
Allie Slemon
Standardization has emerged as the dominant principle guiding the organization and provision of healthcare, with standards resultantly shaping how nurses conceptualize and deliver patient care. Standardization has been critiqued as homogenizing diverse patient experiences and diminishing nurses' skills and critical thinking; however, there has been limited examination of the philosophical implications of standardization for nursing knowledge and practice. In this manuscript, I draw on Foucault's philosophy of order and categorization to inform an analysis of the consequences of healthcare standardization for the profession of nursing...
June 27, 2018: Nursing Philosophy: An International Journal for Healthcare Professionals
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