Lavoro

BACKGROUND: Clinical handover plays a vital role in patient care and has been investigated in hospital settings, but less attention has been paid to the interface between prehospital and hospital settings. This paper reviews the published research on these handovers. METHODS: A computerised literature search was conducted for papers published between 2000 and 2013 using combinations of terms: 'handover', 'handoff', 'prehospital', 'ambulance', 'paramedic' and 'emergency' and citation searching...

BACKGROUND: Fluid resuscitation is the cornerstone of sepsis treatment. However, whether balanced or unbalanced crystalloids or natural or synthetic colloids confer a survival advantage is unclear. PURPOSE: To examine the effect of different resuscitative fluids on mortality in patients with sepsis. DATA SOURCES: MEDLINE, EMBASE, ACP Journal Club, CINAHL, HealthSTAR, the Allied and Complementary Medicine Database, and the Cochrane Central Register of Controlled Trials through March 2014...

BACKGROUND: Anaphylaxis is a potentially life-threatening allergic reaction that may require emergency medical system (EMS) transport. Fatal anaphylaxis is associated with delayed epinephrine administration. Patient outcome data to assess appropriateness of EMS epinephrine administration are sparse. OBJECTIVES: The objectives of this study are to (1) determine the frequency of epinephrine administration in EMS-transported patients with allergic complaints, (2) identify predictors of epinephrine administration, and (3) determine frequency of emergency department (ED) epinephrine administration after EMS transport...

Spinal injury can result in morbidity and mortality. Research suggests that only a small percentage of patients assessed for spinal fracture have sustained the injury, however, and even fewer have unstable fractures. Protection of the spine and spinal cord is critically important and although many trauma patients leave hospital having had no spinal trauma, despite their mechanism of injury, most arrive with spinal precautions in place. Such patients must be moved and it is common practice to do this using the log-roll procedure...

Documentation in healthcare services is important but often lacks detail. This article describes a pilot study of whether staff who have completed an emergency nurse practitioner course provide more detail in their patient assessments. Post-course audits demonstrate that standards of documentation had been maintained or had improved in some areas, but had declined in others.

PURPOSE: The Index of Work Satisfaction (IWS) is a comprehensive scale assessing nurses' professional satisfaction. The aim of the present study was to explore: a) the applicability, reliability and validity of the Greek version of the IWS and b) contrasts among the factors addressed by IWS against the main themes emerging from a qualitative phenomenological investigation of nurses' professional experiences. METHODS: A descriptive correlational design was applied using a sample of 246 emergency and critical care nurses...

BACKGROUND: Since the early 1990s a shift has occurred in the understanding of what constitutes quality healthcare. This is evidenced by the emergence of new concepts in the nursing literature, including best practice. Although authors have analyzed the concept of best practice in the healthcare sector, further analysis is required to distinguish the concept's unique meanings, and significance for the nursing discipline. OBJECTIVES: This paper seeks to clarify use of the concept of best practice in the nursing literature over the last two decades, and contributes to explaining its defining characteristics, applicability, and significance...

In light of the rapidly shifting landscape regarding the legalization of marijuana for medical and recreational purposes, patients may be more likely to ask physicians about its potential adverse and beneficial effects on health. The popular notion seems to be that marijuana is a harmless pleasure,..

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No abstract text is available yet for this article.

Searching, reviewing and appraising published research evidence is a fundamental skill of the graduate nurse and a cornerstone of evidence-based nursing practice. Honours degree students demonstrate competence in this skill in their final-year dissertations.

People with chronic obstructive pulmonary disease (COPD) are very sedentary and this contributes to their health problems. The aim of this systematic review was to examine the effects of interventions designed to increase physical activity (PA) in people with COPD. Studies were included when PA was the primary outcome and measured objectively. Six databases were searched and 15 studies with a total of 761 subjects were identified that met inclusion criteria. Nine of the studies were quasi-experimental (QE) and six were randomized controlled trials (RCT)...

BACKGROUND: Variation in hospital admission rates of patients presenting to the emergency department (ED) may represent an opportunity to improve practice. We seek to describe national variation in hospital admission rates from the ED and to determine the degree to which variation is not explained by patient characteristics or hospital factors. METHODS: We conducted a cross-sectional analysis of a nationally representative sample of ED visits among adults within the 2010 National Hospital Ambulatory Care Survey ED data of hospitals with admission rates from the ED between 5% and 50%...

BACKGROUND: In a single-center study published more than a decade ago involving patients presenting to the emergency department with severe sepsis and septic shock, mortality was markedly lower among those who were treated according to a 6-hour protocol of early goal-directed therapy (EGDT), in which intravenous fluids, vasopressors, inotropes, and blood transfusions were adjusted to reach central hemodynamic targets, than among those receiving usual care. We conducted a trial to determine whether these findings were generalizable and whether all aspects of the protocol were necessary...