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Emergency department nursing

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https://www.readbyqxmd.com/read/29453155/evaluation-of-the-triage-performed-by-registered-nurses-in-the-hospital-cl%C3%A3-nico-universitario-%C3%A2-lozano-blesa%C3%A2-emergency-service-saragossa-spain
#1
Isabel Viñuales, Araceli Monzón-Fernández, Manuel Viñuales, Teresa Sanclemente
OBJECTIVE: To evaluate nurses' triage quality and adequacy in Saragossa's Hospital Clínico and to compare the main characteristics of "urgent" and "non-urgent" visits to the Hospital Emergency Department (HED). METHOD: This exploratory-retrospective research study was carried out over the last 3 months of 2015 (paediatrics, gynaecological and ophthalmologic emergencies were excluded). Data were obtained from the "Puesto Clínico Hospitalario" programme used in the HED...
February 13, 2018: Enfermería Clínica
https://www.readbyqxmd.com/read/29450938/hot-off-the-press-sgem-197-cannulation-in-the-ed
#2
Sahaana Rangarajan, Justin Morgenstern, William K Milne, Corey Heitz
This is a prospective before-after study comparing peripheral intravenous cannulation (PIVC) placement and usage rates following a 10 week long multimodal intervention provided to medical and nursing staff working in a tertiary emergency department (ED). The intervention focused on improving appropriate use of PIVCs in an emergency setting by emphasizing to clinicians that a PIVC should only be placed if it was believed there was more than an 80% chance that it would be used. Patients were eligible for the study if they presented to the ED and were >18 years of age...
February 16, 2018: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
https://www.readbyqxmd.com/read/29447352/improvement-of-emergency-department-patient-flow-using-lean-thinking
#3
Miquel Sánchez, Montse Suárez, María Asenjo, Ernest Bragulat
Objective: To apply lean thinking in triage acuity level-3 patients in order to improve emergency department (ED) throughtput and waiting time. Design: A prospective interventional study. Setting: An ED of a tertiary care hospital. Participants: Triage acuity level-3 patients. Intervention(s): To apply lean techniques such as value stream mapping, workplace organization, reduction of wastes and standardization by the frontline staff...
February 13, 2018: International Journal for Quality in Health Care
https://www.readbyqxmd.com/read/29446155/not-just-trust-factors-influencing-learners-attempts-to-perform-technical-skills-on-real-patients
#4
Susan L Bannister, Mark S Dolson, Lorelei Lingard, David A Keegan
CONTEXT: As part of their training, physicians are required to learn how to perform technical skills on patients. The previous literature reveals that this learning is complex and that many opportunities to perform these skills are not converted into attempts to do so by learners. This study sought to explore and understand this phenomenon better. METHODS: A multi-phased qualitative study including ethnographic observations, interviews and focus groups was conducted to explore the factors that influence technical skill learning...
February 15, 2018: Medical Education
https://www.readbyqxmd.com/read/29444899/comparison-of-glasgow-admission-prediction-score-and-amb-score-in-predicting-need-for-inpatient-care
#5
Allan Cameron, Dominic Jones, Eilidh Logan, Colin A O'Keeffe, Suzanne M Mason, David J Lowe
AIM: We compared the abilities of two established clinical scores to predict emergency department (ED) disposition: the Glasgow Admission Prediction Score (GAPS) and the Ambulatory Score (Ambs). METHODS: The scores were compared in a prospective, multicentre cohort study. We recruited consecutive patients attending ED triage at two UK sites: Northern General Hospital in Sheffield and Glasgow Royal Infirmary, between February and May 2016. Each had a GAPS and Ambs calculated at the time of triage, with the triage nurses and treating clinicians blinded to the scores...
February 14, 2018: Emergency Medicine Journal: EMJ
https://www.readbyqxmd.com/read/29444853/interprofessional-teamwork-innovation-model-itim-to-promote-communication-and-patient-centred-coordinated-care
#6
Jing Li, Preetham Talari, Andrew Kelly, Barbara Latham, Sherri Dotson, Kim Manning, Lisa Thornsberry, Colleen Swartz, Mark V Williams
BACKGROUND: Despite recommendations and the need to accelerate redesign of delivery models to be team-based and patient-centred, professional silos and cultural and structural barriers that inhibit working together and communicating effectively still predominate in the hospital setting. Aiming to improve team-based rounding, we developed, implemented and evaluated the Interprofessional Teamwork Innovation Model (ITIM). METHODS: This quality improvement (QI) study was conducted at an academic medical centre...
February 14, 2018: BMJ Quality & Safety
https://www.readbyqxmd.com/read/29444787/randomised-controlled-pragmatic-clinical-trial-evaluating-the-effectiveness-of-a-discharge-follow-up-phone-call-on-30-day-hospital-readmissions-balancing-pragmatic-and-explanatory-design-considerations
#7
Maame Yaa A B Yiadom, Henry Domenico, Daniel Byrne, Michele Marie Hasselblad, Cheryl L Gatto, Sunil Kripalani, Neesha Choma, Sarah Tucker, Li Wang, Monisha C Bhatia, Johnston Morrison, Frank E Harrell, Tina Hartert, Gordon Bernard
INTRODUCTION: Hospital readmissions within 30 days are a healthcare quality problem associated with increased costs and poor health outcomes. Identifying interventions to improve patients' successful transition from inpatient to outpatient care is a continued challenge. METHODS AND ANALYSIS: This is a single-centre pragmatic randomised and controlled clinical trial examining the effectiveness of a discharge follow-up phone call to reduce 30-day inpatient readmissions...
February 14, 2018: BMJ Open
https://www.readbyqxmd.com/read/29443395/subcutaneous-infusion-of-fluids-for-hydration-or-nutrition-a-review
#8
REVIEW
Riccardo Caccialanza, Thierry Constans, Paolo Cotogni, Gary P Zaloga, Alessandro Pontes-Arruda
Subcutaneous infusion, or hypodermoclysis, is a technique whereby fluids are infused into the subcutaneous space via small-gauge needles that are typically inserted into the thighs, abdomen, back, or arms. In this review, we provide an overview of the technique, summarize findings from studies that have examined the use of subcutaneous infusion of fluids for hydration or nutrition, and describe the indications, advantages, and disadvantages of subcutaneous infusion. Taken together, the available evidence suggests that, when indicated, subcutaneous infusion can be effective for administering fluids for hydration or nutrition, with minimal complications, and has similar effectiveness and safety to the intravenous route...
February 2018: JPEN. Journal of Parenteral and Enteral Nutrition
https://www.readbyqxmd.com/read/29442470/overview-of-the-incidence-early-identification-and-management-of-sepsis
#9
Cathy Ward, Nicola Morrell-Scott
Sepsis is a potentially life-threatening condition that is triggered by an infection. Sepsis is an urgent public health issue globally, and is one of the leading causes of death in emergency departments and hospitals. However, consensus definitions of sepsis are imprecise and the incidence and costs of the condition are thought to be underestimated. This article discusses the incidence of sepsis globally and nationally, and the effects of the condition. It emphasises the early identification and effective management of sepsis, which remain crucial to improving patient outcomes such as morbidity and mortality...
February 14, 2018: Nursing Standard
https://www.readbyqxmd.com/read/29438575/primary-care-professionals-providing-non-urgent-care-in-hospital-emergency-departments
#10
REVIEW
Daniela Gonçalves-Bradley, Jaspreet K Khangura, Gerd Flodgren, Rafael Perera, Brian H Rowe, Sasha Shepperd
BACKGROUND: In many countries emergency departments (EDs) are facing an increase in demand for services, long waits, and severe crowding. One response to mitigate overcrowding has been to provide primary care services alongside or within hospital EDs for patients with non-urgent problems. However, it is unknown how this impacts the quality of patient care and the utilisation of hospital resources, or if it is cost-effective. This is the first update of the original Cochrane Review published in 2012...
February 13, 2018: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/29438193/defining-and-assessing-geriatric-risk-factors-and-associated-health-care-utilization-among-older-adults-using-claims-and-electronic-health-records
#11
Hong J Kan, Hadi Kharrazi, Bruce Leff, Cynthia Boyd, Ashwini Davison, Hsien-Yen Chang, Joe Kimura, Shannon Wu, Laura Anzaldi, Tom Richards, Elyse C Lasser, Jonathan P Weiner
BACKGROUND: Using electronic health records (EHRs), in addition to claims, to systematically identify patients with factors associated with adverse outcomes (geriatric risk) among older adults can prove beneficial for population health management and clinical service delivery. OBJECTIVE: To define and compare geriatric risk factors derivable from claims, structured EHRs, and unstructured EHRs, and estimate the relationship between geriatric risk factors and health care utilization...
March 2018: Medical Care
https://www.readbyqxmd.com/read/29437531/improving-population-health-among-uninsured-patients-with-diabetes
#12
Michele H Talley, Shea Polancich, Jason B Williamson, Jennifer S Frank, William Curry, John F Russell, Cynthia Selleck
Diabetes is a leading cause of morbidity and mortality; prevalence of diabetes is especially high in the southeastern United States among minority populations and those from lower socioeconomic sectors without access to health care services. The purpose of this project was to evaluate the clinical and financial outcomes of a nurse-led, interprofessional collaborative practice model that provides care coordination and transitional care for uninsured patients with diabetes. Data for this study were collected and evaluated from medical records of patients seen at the Providing Access to Health Care (PATH) Clinic between August 1, 2015, through May 30, 2017...
February 13, 2018: Population Health Management
https://www.readbyqxmd.com/read/29437310/suhcat-study-part-5-comparison-of-staff-and-chiefs-perceptions-of-emergency-department-quality-in-catalonia
#13
Javier Jacob, Emili Gené, Gilberto Alonso, Pere Rimbau, José Zorrilla, Francesc Casarramona, Cristina Netto, Pere Sánchez, Ricard Hernández, Xavier Escalada, Òscar Miró
OBJECTIVES: To study the perceptions of Catalan Society of Emergency Medicine (SoCMUE) members who staff hospital emergency departments regarding measures taken to cope with overcrowding, staff rest areas, and staff size. MATERIAL AND METHODS: Descriptive cross-sectional analysis of a survey sent to SoCMUE members. We compared opinions expressed by physicians and nurses in this survey and also compared them to opinions expressed by heads of departments in prior SUHCAT studies...
February 2018: Emergencias: Revista de la Sociedad Española de Medicina de Emergencias
https://www.readbyqxmd.com/read/29437305/adjustment-of-antidiabetic-treatment-regimens-on-discharge-from-the-emergency-department-effect-on-90-day-outcomes-in-patients-admitted-to-a-short-stay-unit
#14
Rafael Cuervo Pinto, Sol Hernández López, Nerea Aguirre Juaristi, David Chaparro Pardo, Juan Jorge González Armengol, Francisco Javier Martín-Sánchez
OBJECTIVES: To measure cervical spine movement during removal of a motorcycle helmet by health care professionals. MATERIAL AND METHODS: Observational study using biomechanical inertial sensors to detect movement in the spinal column during removal of helmets. RESULTS: Thirty-four emergency medicine specialists and nurses participated. The mean (SD) rotation was 1.14° (0.82°) to the left and 3.30° (1.69°) to the right (P<.001). Mean flexion was 9...
February 2018: Emergencias: Revista de la Sociedad Española de Medicina de Emergencias
https://www.readbyqxmd.com/read/29437221/the-complexity-of-determining-whether-a-nursing-home-transfer-is-avoidable-at-time-of-transfer
#15
Kathleen T Unroe, Jennifer L Carnahan, Susan E Hickman, Greg A Sachs, Zachary Hass, Greg Arling
OBJECTIVES: To describe the relationship between nursing facility resident risk conditions and signs and symptoms at time of acute transfer and diagnosis of conditions associated with potentially avoidable acute transfers (pneumonia, urinary tract infection, congestive heart failure (CHF), chronic obstructive pulmonary disease (COPD) or asthma, dehydration, pressure sores). DESIGN: As part of a demonstration project to reduce potentially avoidable hospital transfers, Optimizing Patient Transfers, Impacting Medical Quality, Improving Symptoms: Transforming Institutional Care (OPTIMISTIC) project clinical staff collected data on residents who transferred to the emergency department (ED) or hospital...
February 13, 2018: Journal of the American Geriatrics Society
https://www.readbyqxmd.com/read/29436003/is-hospitalisation-necessary-a-survey-of-frail-older-persons-with-cognitive-impairment-transferred-from-nursing-homes-to-the-emergency-department
#16
Maria Björck, Helle Wijk
BACKGROUND: Providing care for frail older persons is complex and demanding, and the transfer of older persons with cognitive impairment to the emergency department is associated with a high risk of them developing complications. AIM: To survey the most ill and frail older persons with cognitive impairment who were transferred from nursing homes to the emergency department, considering reasons for referral, symptoms and actions taken at the hospital. METHOD: A retrospective descriptive survey, conducting a review of 588 referral notes and medical records, analysed and presented with descriptive statistics and visualised with typical case narratives...
February 12, 2018: Scandinavian Journal of Caring Sciences
https://www.readbyqxmd.com/read/29431046/intermediate-care-units-a-survey-of-organization-practices-across-the-united-states
#17
Blair Wendlandt, Thomas Bice, Shannon Carson, Lydia Chang
PURPOSE: Intermediate care units (IMCUs) represent an alternative care setting with nurse staffing levels between those of the general ward and the intensive care unit (ICU). Despite rising prevalence, little is known about IMCU practices across US hospitals. The purpose of this study is to characterize utilization patterns and assess for variation. MATERIALS AND METHODS: A 14-item survey was distributed to a random nationwide sample of pulmonary and critical care physicians between January and April 2017...
January 1, 2018: Journal of Intensive Care Medicine
https://www.readbyqxmd.com/read/29429847/the-impact-of-geriatric-focused-nurse-assessment-and-intervention-in-the-emergency-department-a-systematic-review
#18
REVIEW
M Malik, Z Moore, D Patton, T O'Connor, L E Nugent
BACKGROUND: Nursing assessment of elderly patients is imperative in Emergency Departments (ED) while providing interventions that increase independence facilitating discharge to primary healthcare. AIMS: To systematically review the impact of geriatric focused nurse assessment and intervention in the ED on hospital utilisation in terms of admission rate, ED revisits and length of hospital stay (LOHS). METHODS: Search strategy used following databases; Cochrane, Medline, CINAHL, Embase, Scopus and Web of Knowledge; And terms; geriatric nurse assessment, nurse discharge planning, geriatric nurse specialist, nurse intervention, emergency department, accident and emergency, patient outcomes, discharge, admissions, readmissions, hospital utilization, hospitalization, length of stay/hospital stay...
February 8, 2018: International Emergency Nursing
https://www.readbyqxmd.com/read/29427832/violence-towards-emergency-nurses-the-italian-national-survey-2016-a-qualitative-study
#19
Nicola Ramacciati, Andrea Ceccagnoli, Beniamino Addey, Laura Rasero
INTRODUCTION: Physical and verbal aggression against health professionals, particularly nurses, is globally serious and widespread, with the most vulnerable being nurses working in the Accident and Emergency Department. Most international research into this issue focused on quantifying aggression, describing its nature, identifying perpetrators, stratifying risk and implementing preventive or mitigating interventions. Few studies investigated the nurses' subjective perceptions. As part of the 2016 Italian National Survey on Violence against Accident and Emergency Nurses, our research team collected qualitative data to explore their perceptions of Workplace Violence...
February 2, 2018: International Journal of Nursing Studies
https://www.readbyqxmd.com/read/29424494/accidents-and-ethics-a-visual-narrative-approach
#20
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
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