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Emergency Department Safety

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https://www.readbyqxmd.com/read/28226252/linkage-of-traffic-crash-and-hospitalization-records-with-limited-identifiers-for-enhanced-public-health-surveillance
#1
Sarah Conderino, Lawrence Fung, Slavenka Sedlar, Jennifer M Norton
BACKGROUND: Motor vehicle traffic (MVT) crashes kill or seriously injure approximately 4250 people in New York City (NYC) each year. Traditionally, NYC surveillance practices use hospitalization and crash data separately to monitor trends in MVT-related injuries, but key information linking crash circumstances to health outcomes is lost when analyzing these data sources in isolation. Our objective was to match crash reports to hospitalization records to create a traffic injury surveillance dataset that can be used to describe crash circumstances and related injury outcomes...
February 19, 2017: Accident; Analysis and Prevention
https://www.readbyqxmd.com/read/28222830/impact-of-early-vasopressor-administration-on-neurological-outcomes-after-prolonged-out-of-hospital-cardiac-arrest
#2
Michael W Hubble, Clark Tyson
: Introduction Vasopressors are associated with return of spontaneous circulation (ROSC), but no long-term benefit has been demonstrated in randomized trials. However, these trials did not control for the timing of vasopressor administration which may influence outcomes. Consequently, the objective of this study was to develop a model describing the likelihood of favorable neurological outcome (cerebral performance category [CPC] 1 or 2) as a function of the public safety answering point call receipt (PSAP)-to-pressor-interval (PPI) in prolonged out-of-hospital cardiac arrest...
February 22, 2017: Prehospital and Disaster Medicine
https://www.readbyqxmd.com/read/28221275/changes-in-emergency-department-utilization-after-early-medicaid-expansion-in-california
#3
Lindsay M Sabik, Peter J Cunningham, Ali Bonakdar Tehrani
BACKGROUND: Medicaid expansions aim to improve access to primary care, which could reduce nonemergent (NE) use of the emergency department (ED). In contrast, Medicaid enrollees use the ED more than other groups, including the uninsured. Thus, the expected impact of Medicaid expansion on ED use is unclear. OBJECTIVES: To estimate changes in total and NE ED visits as a result of California's early Medicaid expansion under the Affordable Care Act. In addition to overall changes in the number of visits, changes by payer and safety net hospital status are examined...
February 17, 2017: Medical Care
https://www.readbyqxmd.com/read/28219617/techniques-and-outcomes-of-emergency-airway-management-in-japan-an-analysis-of-two-multicentre-prospective-observational-studies-2010-2016
#4
Yukari Goto, Tadahiro Goto, Yusuke Hagiwara, Yusuke Tsugawa, Hiroko Watase, Hiroshi Okamoto, Kohei Hasegawa
OBJECTIVES: Continuous surveillance of emergency airway management practice is imperative in improving quality of care and patient safety. We aimed to investigate the changes in the practice of emergency airway management and the related outcomes in the emergency departments (EDs) in Japan. METHODS: We conducted an analysis of the data from two prospective, observational, multicentre registries of emergency airway management-the Japanese Emergency Airway Network (JEAN)-1 and -2 Registries from April 2010 through May 2016...
February 17, 2017: Resuscitation
https://www.readbyqxmd.com/read/28212836/point-of-care-ultrasonography-for-evaluation-of-acute-dyspnea-in-the-emergency-department
#5
Maurizio Zanobetti, Margherita Scorpiniti, Chiara Gigli, Peiman Nazerian, Simone Vanni, Francesca Innocenti, Valerio T Stefanone, Caterina Savinelli, Alessandro Coppa, Sofia Bigiarini, Francesca Caldi, Irene Tassinari, Alberto Conti, Stefano Grifoni, Riccardo Pini
BACKGROUND: Acute dyspnea is a common symptom in the emergency department (ED). Standard approach to dyspnea often relies on radiologic and laboratoristic results, causing excessive delay before adequate therapy is started; an integrated point-of-care ultrasonography (PoCUS) approach can shorten the time needed to formulate a diagnosis maintaining an acceptable safety profile. METHODS: Consecutive adult patients presenting with dyspnea and admitted after ED evaluation were prospectively enrolled...
February 14, 2017: Chest
https://www.readbyqxmd.com/read/28210321/telemedicine-in-chronic-obstructive-pulmonary-disease
#6
Nicolino Ambrosino, Guido Vagheggini, Stefano Mazzoleni, Michele Vitacca
: Telemedicine is a medical application of advanced technology to disease management. This modality may provide benefits also to patients with chronic obstructive pulmonary disease (COPD). Different devices and systems are used. The legal problems associated with telemedicine are still controversial. Economic advantages for healthcare systems, though potentially high, are still poorly investigated. A European Respiratory Society Task Force has defined indications, follow-up, equipment, facilities, legal and economic issues of tele-monitoring of COPD patients including those undergoing home mechanical ventilation...
December 2016: Breathe
https://www.readbyqxmd.com/read/28207996/the-use-of-a-contextual-modal-and-psychological-classification-of-medication-errors-in-the-emergency-department-a-retrospective-descriptive-study
#7
C J Cabilan, J A Hughes, C Shannon
BACKGROUND: The causes of medication errors are unique in every clinical setting; hence error minimisation strategies are not always effective. For this reason, it is fundamental to understand the causes specific to the emergency department so that targeted strategies can be implemented. OBJECTIVES: To describe the contextual, modal, and psychological classification of medication errors in the emergency department to know the factors associated with the reported medication errors...
February 16, 2017: Journal of Clinical Nursing
https://www.readbyqxmd.com/read/28205248/a-framework-for-transition-to-specialty-practice-programs
#8
Julia Morphet, Virginia Plummer, Bridie Kent, Julie Considine
AIM: To develop a framework for emergency nursing transition to specialty practice programs. BACKGROUND: Transition to Specialty Practice programs were introduced to fill workforce shortages and facilitate the transition of nurses to specialty nursing practice. These programs are recognised as essential preparation for emergency nurses. Emergency nursing Transition to Specialty Practice programs have developed in an ad hoc manner and as a result, program characteristics vary...
February 15, 2017: Journal of Advanced Nursing
https://www.readbyqxmd.com/read/28196705/an-exploration-of-emergency-nurses-perceptions-attitudes-and-experience-of-teamwork-in-the-emergency-department
#9
Elise Grover, Joanne E Porter, Julia Morphet
BACKGROUND: Teamwork may assist with increased levels of efficiency and safety of patient care in the emergency department (ED), with emergency nurses playing an indispensable role in this process. METHOD: A descriptive, exploratory approach was used, drawing on principles from phenomenology and symbolic interactionism. Convenience, purposive sampling was used in a major metropolitan ED. Semi structured interviews were conducted, audio recorded, and transcribed verbatim...
February 11, 2017: Australasian Emergency Nursing Journal: AENJ
https://www.readbyqxmd.com/read/28193080/inappropriate-packed-rbc-transfusion-in-a-tertiary-care-center
#10
Anahita Sadeghi, Safieh Belali, Ali Ali Asgari, Zahra Morovat, Reza Malekzadeh, Ashkan Emadi
INTRODUCTION: Transfusion of packed red blood cells (pRBC) with appropriate indications is not only important for patient safety and well-being but is also crucial for proper utilization of resources and health care-related cost reduction. We aimed to investigate the clinical appropriateness of blood transfusion in Shariati Hospital, one of the largest academic medical centers in Tehran. METHODS: In this prospective observational study, 1000 transfusions of allogenic pRBCs from April 1st to October 31st, 2015 were included...
February 2017: Archives of Iranian Medicine
https://www.readbyqxmd.com/read/28192567/development-and-internal-validation-of-a-clinical-risk-score-for-treating-children-with-mild-head-trauma-and-intracranial-injury
#11
Jacob K Greenberg, Yan Yan, Christopher R Carpenter, Angela Lumba-Brown, Martin S Keller, Jose A Pineda, Ross C Brownson, David D Limbrick
Importance: The appropriate treatment of children with mild traumatic brain injury (mTBI) and intracranial injury (ICI) on computed tomographic imaging remains unclear. Evidence-based risk assessments may improve patient safety and reduce resource use. Objective: To derive a risk score predicting the need for intensive care unit observation in children with mTBI and ICI. Design, Setting, and Participants: This retrospective analysis of the prospective Pediatric Emergency Care Applied Research Network (PECARN) head injury cohort study included patients enrolled in 25 North American emergency departments from 2004 to 2006...
February 13, 2017: JAMA Pediatrics
https://www.readbyqxmd.com/read/28187803/management-of-acute-traumatic-spinal-cord-injuries
#12
C D Shank, B C Walters, M N Hadley
Acute traumatic spinal cord injury (SCI) is a devastating disease process affecting tens of thousands of people across the USA each year. Despite the increase in primary prevention measures, such as educational programs, motor vehicle speed limits, automobile running lights, and safety technology that includes automobile passive restraint systems and airbags, SCIs continue to carry substantial permanent morbidity and mortality. Medical measures implemented following the initial injury are designed to limit secondary insult to the spinal cord and to stabilize the spinal column in an attempt to decrease devastating sequelae...
2017: Handbook of Clinical Neurology
https://www.readbyqxmd.com/read/28186825/balancing-safety-and-harm-for-older-adults-with-dementia-in-rural-emergency-departments-healthcare-professionals-perspectives
#13
Kathleen F Hunter, Belinda Parke, Maureen Babb, Dorothy Forbes, Laurel Strain
INTRODUCTION: The emergency department (ED) is a potentially harmful environment for older adults with dementia, and rural EDs face unique challenges in providing care to this population. The purpose of this study was to understand safety and harm in rural ED transitional care for community dwelling older adults with dementia from the perspective of healthcare professionals (HCPs). METHODS: An interpretive, descriptive exploratory design from a social ecological perspective was used...
January 2017: Rural and Remote Health
https://www.readbyqxmd.com/read/28185626/prevalence-of-concomitant-acute-bacterial-meningitis-in-neonates-with-febrile-urinary-tract-infection-a-retrospective-cross-sectional-study
#14
Sowdhamini S Wallace, Danielle N Brown, Andrea T Cruz
OBJECTIVE: To describe the frequency of concomitant acute bacterial meningitis (ABM) in neonates with febrile urinary tract infection (UTI). STUDY DESIGN: This was a retrospective cross-sectional study from 2005 to 2013 of infants ≤30 days old evaluated in the emergency department of a quaternary care children's hospital with fever and laboratory-confirmed UTI. Definite ABM was defined as cerebrospinal fluid (CSF) culture with growth of pathogenic bacteria and probable ABM if pleocytosis with ≥ 20 white blood cell was present in an antibiotic-pretreated patient...
February 6, 2017: Journal of Pediatrics
https://www.readbyqxmd.com/read/28185509/developing-an-advanced-nurse-practitioner-approach-to-clinical-assessments
#15
Caroline Prescott, Nick Stackhouse
Emergency departments (EDs) often experience reduced patient flow, which results in low capacity, increased congestion and delays in patient care. Advanced nurse practitioners (ANPs) possess the skills required to relieve these pressures and enhance care delivery. This article describes how introducing ANP-led rapid assessment triage in an ED has enabled these practitioners to use advanced practice skills in assessment and intervention, and to request early diagnostic processes to improve patient flow. The system enables the ANPs to identify high-acuity patients who can be cared for in the ED without the need for admission, while ensuring their safety, rapid assessment and timely interventions...
February 10, 2017: Emergency Nurse: the Journal of the RCN Accident and Emergency Nursing Association
https://www.readbyqxmd.com/read/28185499/improving-patient-safety-through-the-introduction-of-a-formal-triage-process
#16
Cliff Evans, Clare Hughes, John Ferguson
Emergency departments (EDs) in the UK are facing unprecedented increases in attendance, and the ability to safely assess, diagnose, treat, refer or discharge patients is a national challenge. This article discusses one component of a comprehensive ED strategy created to address serious concerns identified by regulators and develop and improve services in the department at Medway NHS Foundation Trust, Kent.
February 10, 2017: Emergency Nurse: the Journal of the RCN Accident and Emergency Nursing Association
https://www.readbyqxmd.com/read/28181815/onsite-versus-offsite-radiation-treatment-of-malignant-spinal-cord-compression-lessons-from-a-safety-net-health-system
#17
Albert C Chen, Mark D Bonnen, Henry Mok
OBJECTIVE: Metastatic spinal cord compression (MSCC) is an oncologic emergency that often warrants emergent treatment, but it is unclear if radiation treatment can be optimally managed from an offsite radiotherapy facility. METHODS: Patient charts from consecutive MSCC patients that were treated with radiotherapy alone either at an onsite hospital radiation department (from 2008 to 2012) or an offsite radiotherapy center (2012-2015) were reviewed. Patients' clinical parameters were compared across groups with either the Chi-squared test or Fisher's exact test, while survival curves were compared with the log-rank test...
February 9, 2017: British Journal of Radiology
https://www.readbyqxmd.com/read/28181109/a-retrospective-review-of-farm-injuries-presenting-to-an-irish-hospital-emergency-department-in-2013
#18
A Abdulkarim, P Carroll, P Coffey, E Sheehan
BACKGROUND: The agricultural and equestrian businesses are an important source of employment in the Midlands. This is a retrospective study examining the demographics, characteristics, and outcomes of agricultural and equestrian related injuries presenting to the Midland Regional Hospital, Tullamore, Co. Offaly. There were a total of 30,700 attendances to the Emergency Department for 2013. AIMS: This study is an epidemiological review of agricultural injuries, their mechanisms, and consequences presenting to a rural regional hospital over a 1 year period...
February 8, 2017: Irish Journal of Medical Science
https://www.readbyqxmd.com/read/28176924/high-stakes-and-high-emotions-providing-safe-care-in-canadian-emergency-departments
#19
Samina Ali, Denise Thomson, Timothy A D Graham, Sean E Rickard, Antonia S Stang
BACKGROUND: The high-paced, unpredictable environment of the emergency department (ED) contributes to errors in patient safety. The ED setting becomes even more challenging when dealing with critically ill patients, particularly with children, where variations in size, weight, and form present practical difficulties in many aspects of care. In this commentary, we will explore the impact of the health care providers' emotional reactions while caring for critically ill patients, and how this can be interpreted and addressed as a patient safety issue...
2017: Open Access Emergency Medicine: OAEM
https://www.readbyqxmd.com/read/28173740/emergency-department-redirection-to-primary-care-a-prospective-evaluation-of-practice
#20
James A Bentley, Shobhan Thakore, William Morrison, Weijie Wang
Background and aim Non-urgent Emergency Department presentations contribute to overcrowding, which can adversely affect patient care. Redirecting patients to a more appropriate service is an option to help address this. We conducted a prospective evaluation of a major Scottish hospital's Emergency Department redirection policy to assess its safety. Methods and results Over two months, 620 patients triggered senior assessment for redirection with 444 (72%) redirected to primary care. Information on presentation was collected with subsequent management and outcome of redirection provided by the patient's general practitioner...
January 1, 2017: Scottish Medical Journal
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