Journal of Emergency Nursing|
[périodique] Voir les bulletins disponibles Rechercher dans ce périodique
|  |
Liste des numéros ou bulletins :
Paru le : 01/11/2018
|
Dépouillements
Ajouter le résultat dans votre panierBarriers to Clinical Practice Guideline Implementation for Septic Patients in the Emergency Department / Elizabeth N. Reich in Journal of Emergency Nursing, Vol. 44, n° 6 (November 2018)
Titre : Barriers to Clinical Practice Guideline Implementation for Septic Patients in the Emergency Department Type de document : Article Auteurs : Elizabeth N. Reich ; Karen L. Then ; James A. Rankin Année de publication : 2018 Article en page(s) : p. 552-562 Note générale : DOI: https://doi.org/10.1016/j.jen.2018.04.004 Langues : Anglais (eng) Descripteurs : HE Vinci
Infirmiere d'urgence ; Recommandations ; Relations entre professionnels de santé et patients ; Service hospitalier d'urgencesMots-clés : Scepticisme du patient Disponible en ligne : Non Permalink : https://bib.vinci.be/opac_css/index.php?lvl=notice_display&id=86888
in Journal of Emergency Nursing > Vol. 44, n° 6 (November 2018) . - p. 552-562[article]Exemplaires (1)
Cote Support Localisation Section Disponibilité REV Périodique papier Woluwe périodiques Consultation sur place uniquement
Exclu du prêt
Titre : Implementation of a Comprehensive Program to Improve Child Physical Abuse Screening and Detection in the Emergency Department Type de document : Article Auteurs : Sheri M. Carson Année de publication : 2018 Article en page(s) : p. 576-581 Note générale : DOI: https://doi.org/10.1016/j.jen.2018.04.003 Langues : Anglais (eng) Descripteurs : HE Vinci
Dépistage systématique ; Formation ; Infirmiere d'urgence ; Programme ; Services des urgences médicales ; Traumatisme ; Violence sexuelle chez l'enfantRésumé : Introduction
Children often present to the emergency department for treatment of abuse-related injuries. ED providers—including emergency nurses—do not consistently screen children for abuse, which may allow abuse to go undetected and increases the risk for reinjury and death. ED providers frequently cite lack of knowledge or confidence in screening for and detecting child abuse. The purpose of this quality improvement project was to implement an evidence-based screening program that included provider education on child physical abuse, a systematic screening protocol, and use of the validated Escape Instrument.
Methods
A pre-test/post-test design was used to measure the effect of a 20-minute educational session on ED provider knowledge and confidence in screening for and recognizing child physical abuse. Diagnostic codes for child physical abuse were analyzed for a 30-day period before and after implementation of the screening protocol. A final survey was administered 4 months after project implementation to evaluate the impact of the screening program.
Results
There were significant increases in provider knowledge and confidence scores for child physical abuse screening and recognition (P Discussion
The results of this project support comprehensive screening programs to improve ED provider knowledge and confidence in screening for and recognizing child physical abuse. Future research should focus on the impact of screening on the diagnosis and treatment of child physical abuse. Unlabelled Box
Contribution to Emergency Nursing Practice
•The current state of scientific knowledge on child physical abuse indicates that early detection of abuse reduces the rate of subsequent reinjury and death by as much as 50%.
•The main findings of this research are that educational sessions, combined with a systematic screening protocol and the validated Escape Instrument, increase ED health care providers’ knowledge and confidence in screening for and recognizing child physical abuse.
•Key implications for emergency nursing practice from this research are great. Emergency nurses are uniquely positioned to improve the detection of nonaccidental childhood injuries and reduce the rate of subsequent reinjury and death by implementing comprehensive child physical abuse screening programs in their facilities.Disponible en ligne : Non Permalink : https://bib.vinci.be/opac_css/index.php?lvl=notice_display&id=86889
in Journal of Emergency Nursing > Vol. 44, n° 6 (November 2018) . - p. 576-581[article]Exemplaires (1)
Cote Support Localisation Section Disponibilité REV Périodique papier Woluwe périodiques Consultation sur place uniquement
Exclu du prêt
Titre : Stop the Bottleneck: Improving Patient Throughput in the Emergency Department Type de document : Article Auteurs : Ray DeAnda Année de publication : 2018 Article en page(s) : p. 582-588 Note générale : DOI: https://doi.org/10.1016/j.jen.2018.05.002 Langues : Anglais (eng) Descripteurs : HE Vinci
Autorité ; Démarche qualité ; Efficacité ; Recommandations ; Satisfaction des patients ; Satisfaction professionnelle ; Service d'aide médicale urgente ; TriageRésumé : Problem
Emergency department nurses are faced with an overwhelming number of patients each day. The average number of emergency department visits is increasing by 3.5% per year. Numerous studies have been conducted to improve the patient throughput process, which has impact on patient flow. A disruption of the process can cause a backlog of patients and create a hardship for both patients and staff.
Methods
The Plan-Do-Study-Act (PDSA) cycle was used as a specific improvement methodology for improving patient throughput and served as a component for the Model for Improvement approach. The article presents a quality improvement initiative created and implemented to improve patient flow by adding a flow nurse coordinator. The flow nurse coordinator was proposed to improve patient throughput by expediting and facilitating transport of the admitted patient to an inpatient bed.
Results
The average time from notification of bed assignment to patient arrival to an inpatient bed was 104 minutes, almost twice the proposed benchmark and more than the regional average. The results of the quality initiative changed patient arrival to inpatient bed from 104 minutes to 84 minutes, a decrease of 20%.
Discussion
The quality initiative team made several recommendations based on the research of a flow nurse coordinator. The recommendations included a weekly ED staffing committee meeting, consisting of frontline ED staff, nurse educators, ED leadership, and flow nurse coordinator. The support and active involvement of the executive leadership team would assist in sustaining changes to the new process. Unlabelled Box
Contribution to Emergency Nursing Practice
•The current state of scientific knowledge on emergency department overcrowding indicates a need to improve patient throughput.
•The main finding of this research is to improve patient throughput, improve patient and staff satisfaction, and improve patient outcomes.
•Key implications for emergency nursing practice from this research are to decrease the risk for medical errors, missed and delayed treatments.Disponible en ligne : Non Permalink : https://bib.vinci.be/opac_css/index.php?lvl=notice_display&id=86890
in Journal of Emergency Nursing > Vol. 44, n° 6 (November 2018) . - p. 582-588[article]Exemplaires (1)
Cote Support Localisation Section Disponibilité REV Périodique papier Woluwe périodiques Consultation sur place uniquement
Exclu du prêt
Titre : ED Triage Process Improvement: Timely Vital Signs for Less Acute Patients Type de document : Article Auteurs : Stella S. Falconer ; Corinne M. Karuppan ; Emily Kiehne ; Shravan Rama Année de publication : 2018 Article en page(s) : p. 589-597 Note générale : DOI: https://doi.org/10.1016/j.jen.2018.05.006 Langues : Anglais (eng) Descripteurs : HE Vinci
Constante biologique ; Démarche qualité ; TriageRésumé : Problem
Vital signs can result in an upgrade of patients’ Emergency Severity Index (ESI) levels. It is therefore preferable to obtain vital signs early in the triage process, particularly for ESI level 3 patients. Emergency departments have an opportunity to redesign triage processes to meet required protocols while enhancing the quality and experience of care.
Methods
We performed process analyses to redesign the door-to-vital signs process. We also developed spaghetti diagrams to reconfigure the patient arrival area.
Results
The door-to-vital signs time was reduced from 43.1 minutes to 6.44 minutes. Both patients and triage staff seemed more satisfied with the new process. The patient arrival area was less congested and more welcoming.
Discussion
Performing activities in parallel reduces flow time with no additional resources. Staff involvement in process planning, redesign, and control ensures engagement and early buy-in. One should anticipate how changes to one process might affect other processes. Unlabelled Box
Contribution to Emergency Nursing Practice
•The purpose of this practice improvement initiative was to decrease door-to-vital signs time through a process redesign.
•The primary outcome of this practice improvement project was that parallel processing and layout redesign can improve triage efficiency and ensure timely vital signs with no additional resources.
•Key implications for emergency nursing practice based on this project are (1) triage staff should be involved early in the redesign process, and (2) process change control is imperative.Disponible en ligne : Non Permalink : https://bib.vinci.be/opac_css/index.php?lvl=notice_display&id=86891
in Journal of Emergency Nursing > Vol. 44, n° 6 (November 2018) . - p. 589-597[article]Exemplaires (1)
Cote Support Localisation Section Disponibilité REV Périodique papier Woluwe périodiques Consultation sur place uniquement
Exclu du prêt
Titre : Pediatric triage education: An integrative literature review Type de document : Article Auteurs : Catherine T. Recznik ; Lynn M. Simko Année de publication : 2018 Article en page(s) : p. 605-613 Note générale : DOI: https://doi.org/10.1016/j.jen.2018.01.003 Langues : Anglais (eng) Descripteurs : HE Vinci
Constante biologique ; Formation ; Pédiatrie ; TriageRésumé : Introduction
The objective of this study was to review the currently published literature on the topic of pediatric triage education.
Method
An integrative review of the literature was conducted using database searching and historical record review.
Results
A wide variety of pediatric triage educational methods exist, but studies with the highest-quality ratings most often used simulation programs or a standardized curriculum. Although there was a good deal of heterogeneity in terms of the outcomes measured, the accuracy of triage improved following educational interventions.
Discussion
Additional research is needed to compare different methods of pediatric triage education directly. Emergency nurses should be aware that pediatric triage is a high-risk event, and some educational methods may have advantages over others. In addition, although retention of pediatric triage skills is affected by the method and timing of pediatric triage education, emergency nurses should remain aware that improved pediatric triage skills could lead to improved pediatric outcomes, and target this as an area for further research. Unlabelled Box
Contribution to Emergency Nursing Practice
•The reviewed articles indicate that additional training in pediatric triage improves pediatric triage accuracy; however, only 1 article described a very large group of educators teaching the same content, making it difficult to reproduce the same results and difficult to draw generalizations outside the given populations.
•Emergency nurses should recognize that undertriage of pediatric patients is a recurrent concern in the literature.
•Studies indicate that general emergency nurses may triage pediatric patients less accurately than pediatric emergency nurses.
•Current literature does not support a particular type of pediatric triage education.Disponible en ligne : Non Permalink : https://bib.vinci.be/opac_css/index.php?lvl=notice_display&id=86892
in Journal of Emergency Nursing > Vol. 44, n° 6 (November 2018) . - p. 605-613[article]Exemplaires (1)
Cote Support Localisation Section Disponibilité REV Périodique papier Woluwe périodiques Consultation sur place uniquement
Exclu du prêt
Titre : Interruptions Experienced by Emergency Nurses: Implications for Subjective and Objective Measures of Workload Type de document : Article Auteurs : Katherine L. Forsyth ; Hunter J. Hawthorne ; Nibras El-Sherif ; [et al.] Année de publication : 2018 Article en page(s) : p. 614-623 Note générale : DOI: https://doi.org/10.1016/j.jen.2018.02.001 Langues : Anglais (eng) Descripteurs : HE Vinci
Condition de travail ; Sécurité des patients ; Service hospitalier d'urgences ; TravailMots-clés : Interruption de l'infirmière d'urgence Résumé : Introduction
This study aimed to describe interruptions experienced by emergency nurses and establish convergence validity of 1 objective workload measure by linking interruption characteristics to objective and subjective measures of workload.
Methods
Interruptions were captured in real time across 8- or 12-hour shifts using a previously validated Workflow Interruptions Tool (WIT). Data collected on each interruption included type, priority, and location where the interruption occurred. At mid- and end-shift, the Surgery Task Load Index (SURG-TLX) and the Rapid Cognitive Assessment Tool (RCAT) were administered to participating nurses to measure workload subjectively and objectively.
Results
Thirty-eight emergency nurse shifts were observed. A total of 3,229 interruptions were recorded across 372.5 clinical hours and 38 shifts (means [M] = 85.0 interruptions per shift, standard deviation [SD] = 34.9; M = 8.7 interruptions per hour, SD = 3.36). The median duration per interruption was 13.0 seconds. A moderate positive association was identified between the number of interruptions experienced during a shift and the increased overall SURG-TLX workload reported at end-shift, r(36) = 0.323, P = 0.048. Also, a moderate positive association was identified between increased reaction times during the RCAT task and increased mental demand experienced at end of shift, r(36) = 0.460, P Discussion
This study observed interruptions throughout the entirety of a nursing shift and found that the majority of interruptions caused by the environment were low priority. Targeting interventions to reduce low-priority and environmental interruptions may aid in alleviating the impact of interruptions on clinical staff and patient care. Furthermore, results demonstrate that the frequency of interruptions was perceived to increase the nursing staff workload overall. Unlabelled Box
Contribution to Emergency Nursing Practice
•Emergency nurses perceived their own workload accurately.
•Interruptions occur every 6 to 7 minutes for emergency nurses.
•Frequency of interruptions increased the nursing staff workload overall.Disponible en ligne : Non Permalink : https://bib.vinci.be/opac_css/index.php?lvl=notice_display&id=86893
in Journal of Emergency Nursing > Vol. 44, n° 6 (November 2018) . - p. 614-623[article]Exemplaires (1)
Cote Support Localisation Section Disponibilité REV Périodique papier Woluwe périodiques Consultation sur place uniquement
Exclu du prêt
Titre : Emergency Department Crowding and Time at the Bedside: A Wearable Technology Feasibility Study Type de document : Article Auteurs : Jessica Castner Année de publication : 2018 Article en page(s) : p. 624-631 Note générale : DOI: https://doi.org/10.1016/j.jen.2018.03.005 Langues : Anglais (eng) Descripteurs : HE Vinci
Dispositifs électroniques portables ; Durée du séjour ; Service hospitalier d'urgencesMots-clés : Encombrement Résumé : Introduction
ED crowding is a public health crisis, limiting quality and access to lifesaving care. The purpose of this study was to (1) evaluate the feasibility of radio-frequency identification tags to measure clinician-patient contact and (2) to test the relationship between ED occupancy and clinician-patient contact time.
Methods
In this 4-week observational study, radio-frequency identification tags were worn by emergency clinicians in a 21-bay urban teaching hospital emergency department. The time-motion data were merged with electronic medical repository patient information (N = 3,237) to adjust for occupancy, age, gender, and acuity. Qualitative themes were generated from focus group (N = 39) debriefings of the quantitative results.
Results
Data were collected on 56,342 total clinician events. Adjusting for patient age, increasing ED occupancy increased the number of times the attending physician entered and left the patient room (b = 0 .008, 95% confidence interval [CI] = [0.001-0.016], P = 0.03). There was no relationship for patient gender, triage acuity, shift at arrival, disposition to home, or discharge diagnosis category with either total minutes or number of encounters per patient visit. No time-motion and occupancy associations were observed for nurses, residents, or nurse practitioners/physician assistants. Debriefings indicated occupancy influenced the quality of care, despite maintaining the same quantity of contact time.
Discussion
The physical environment and clinician privacy concerns limit the feasibility of wearable tracking technology in the emergency setting. Attending physician care becomes more fragmented with increasing ED occupancy. Other clinicians report changes in the quality of care, whereas the quantity of time and encounters were unchanged with occupancy rates. Unlabelled Box
Contribution to Emergency Nursing Practice
•The current state of scientific knowledge on clinical-patient contact time indicates ED crowding may be detrimental to the quality, quantity, and consistency of care.
•The main findings of this research include the following: As occupancy increases, we did not observe differences in time and motion for nurses and nurse practitioners/physician assistants, and we found that attending-physician care becomes more fragmented. There are several physical, architectural barriers to deploying radio-frequency identification tags in the emergency setting. Participating clinicians relayed several qualitative benefits and drawbacks to wearable tracking technology.
•Key implications for emergency nursing practice indicate that additional revisions and considerations are needed to enhance wearable tracker feasibility for emergency clinicians.Disponible en ligne : Non Permalink : https://bib.vinci.be/opac_css/index.php?lvl=notice_display&id=86894
in Journal of Emergency Nursing > Vol. 44, n° 6 (November 2018) . - p. 624-631[article]Exemplaires (1)
Cote Support Localisation Section Disponibilité REV Périodique papier Woluwe périodiques Consultation sur place uniquement
Exclu du prêt
Titre : Improving Emergency Health Care Workers’ Knowledge, Competency, and Attitudes Toward Lesbian, Gay, Bisexual, and Transgender Patients Through Interdisciplinary Cultural Competency Training Type de document : Article Auteurs : Sarah Bristol ; Teresa Kostelec ; Ryan MacDonald Année de publication : 2018 Article en page(s) : p. 632-639 Note générale : DOI: https://doi.org/10.1016/j.jen.2018.03.013 Langues : Anglais (eng) Descripteurs : HE Vinci
Démarche qualité ; Disparités d'accès aux soins ; Interdisciplinarité ; Soins d'urgence ; UrgencesRésumé : Introduction
Emergency staff members have a unique role in providing episodic care to marginalized populations. The lesbian, gay, bisexual, and transgender (LGBT) community is a marginalized population that is routinely encountered by ED staff. Implicit prejudice may influence emergency staff interactions and contribute to distrust of health care providers by some members of the LGBT community. The purpose of our study is to evaluate aggregate ED health care team member’s knowledge and attitudes toward lesbian, gay, bisexual, and transgender people pre- and post-cultural competency training education.
Methods
A pre-/post-intervention design was used to assess the impact of LGBT cultural competency training. The Ally Identity Measure (AIM) was administered to an unmatched sample of ED nurses, nurse practitioners, unit secretaries, and physicians. Consisting of 3 domains— knowledge and skills, openness and support, and awareness of oppression experienced by the LGBT community (Cronbach’s alphas of 0.76 to 0.88)—the AIM assessed for aggregate differences among our staff pre- and post-cultural competency training.
Results
Pre-survey data revealed 85.3 % (n = 81) of staff had no previous LGBT education specific to the needs of the population. Post-survey data collected between 3 to 5 months after the education intervention demonstrated a total index mean increase of 8.8% (P Discussion
Status post-cultural competency training, the AIM results indicated that our team’s collective knowledge about challenges facing the LGBT community increased, and the aggregate scores reflected more openness, support, and awareness of oppression by our staff. This elevated self-awareness and increased knowledge may aid in creating a more open, supportive patient experience for the LGBT community members seeking care at our facility. Unlabelled Box
Contribution to Emergency Nursing Practice
•The current state of scientific knowledge on lesbian, gay, bisexual, and transgender (LGBT) education and training indicates the need for further research on the impact of this cultural competency training.
•The main findings of this research suggests that educational interventions show potential for creating an increase in awareness of LGBT issues, leading to more open and accepting attitudes toward LGBT patients and their family members.
•Key implications for emergency nursing practice from this research are how assumptions about a person’s gender identity or sexual orientation can have an unintended impact on the nurse-patient relationship and how LGBT cultural competency education can provide emergency nurses strategies to meet the cultural needs of LGBT patients.Disponible en ligne : Non Permalink : https://bib.vinci.be/opac_css/index.php?lvl=notice_display&id=86895
in Journal of Emergency Nursing > Vol. 44, n° 6 (November 2018) . - p. 632-639[article]Exemplaires (1)
Cote Support Localisation Section Disponibilité REV Périodique papier Woluwe périodiques Consultation sur place uniquement
Exclu du prêt
Exemplaires (1)
| Cote | Support | Localisation | Section | Disponibilité |
|---|---|---|---|---|
| REV | Périodique papier | Woluwe | périodiques | Consultation sur place uniquement Exclu du prêt |
Paru le : 01/09/2018
|
Dépouillements
Ajouter le résultat dans votre panier
Titre : Teaching Nurses How to Infiltrate Lacerations in the Emergency Department Type de document : Article Auteurs : Gayla Miles ; Michael Olmos ; Elliott Trotter ; Patricia Newcomb Année de publication : 2018 Article en page(s) : p. 453-458 Note générale : DOI: https://doi.org/10.1016/j.jen.2018.03.020 Langues : Anglais (eng) Descripteurs : HE Vinci
Apprentissage ; Infiltration ; Infirmiere d'urgence ; Lacérations ; Service hospitalier d'urgencesRésumé : Contribution to Emergency Nursing Practice
•The current state of scientific knowledge on infiltration of lacerations by registered nurses in emergency departments is unknown because no published studies of the practice exist in relevant research databases.
•The main findings of this case observation are that the practice of RN infiltration of lacerations with local anesthesia is feasible, safe, and effective.
•Key implications for emergency nursing practice include RN infiltration of lacerations in the ED allows nurses to be more involved in wound management, promotes top-of-license practice, and promotes more efficient patient throughput.Disponible en ligne : Non Permalink : https://bib.vinci.be/opac_css/index.php?lvl=notice_display&id=86238
in Journal of Emergency Nursing > Vol. 44, n° 5 (September 2018) . - p. 453-458[article]Exemplaires (1)
Cote Support Localisation Section Disponibilité REV Périodique papier Woluwe périodiques Consultation sur place uniquement
Exclu du prêt
Titre : Improvement of Door-to-Electrocardiogram Time Using the First-Nurse Role in the ED Setting Type de document : Article Auteurs : Laura M. Stanfield Année de publication : 2018 Article en page(s) : p. 466-471 Note générale : DOI: https://doi.org/10.1016/j.jen.2017.12.011 Langues : Anglais (eng) Descripteurs : HE Vinci
Délai jusqu'au traitement ; Infirmières et infirmiers ; Service hospitalier d'urgences ; Syndrome coronarien aigu ; TriageMots-clés : Salle d'attente Résumé : Introduction
This quality improvement project compared door-to-electrocardiogram (ECG) times for patients presenting with symptoms suggestive of acute coronary syndrome within a community hospital emergency department before and after first-nurse (emergency nurse stationed in the ED waiting room) training.
Method
Door-to-ECG time was compared before and after the educational intervention using Acute Coronary Treatment and Intervention Outcomes Network (ACTION) registry data reported by the facility.
Results
Statistical significance was not achieved using a 2-group t-test. However, when comparing monthly means, data trend lines showed favorable improvement for door-to-ECG time after the intervention.
Discussion
Limitations included using only those patients in the ACTION registry and not accounting for RN turnover with first-nurse education. Future studies should focus on all patients presenting with symptoms of acute coronary syndrome as well as other patients presenting with time-sensitive needs to determine the efficacy of the first-nurse role. Unlabelled Box
Contribution to Emergency Nursing Practice
•Presents support for first-nurse training and for the importance of the emergency nurse’s presence in the ED lobby
•Provides an example to emergency nurses for how quality improvement projects can lead to a positive culture changeDisponible en ligne : Non Permalink : https://bib.vinci.be/opac_css/index.php?lvl=notice_display&id=86239
in Journal of Emergency Nursing > Vol. 44, n° 5 (September 2018) . - p. 466-471[article]Exemplaires (1)
Cote Support Localisation Section Disponibilité REV Périodique papier Woluwe périodiques Consultation sur place uniquement
Exclu du prêt
Titre : Innovations in Emergency Nursing: Transforming Emergency Care Through a Novel Nurse-Driven ED Telehealth Express Care Service Type de document : Article Auteurs : Catherine McHugh ; Rhonda Krinsky ; Rahul Sharma Année de publication : 2018 Article en page(s) : p. 472-477 Note générale : DOI: https://doi.org/10.1016/j.jen.2018.03.001 Langues : Anglais (eng) Descripteurs : HE Vinci
Evolution scientifique et technique ; Soins d'urgence ; Télémédecine ; TriageRésumé : Problem
Emergency department overcrowding and acuity are significant challenges to patients and staff. Low-acuity patients have extended wait times, and decreased satisfaction can have a negative effect on patient flow.
Methods
A multidisciplinary ED team developed and launched the first ED-based Telehealth Express Care Service, where patients who present to the emergency department with minor complaints are offered a “virtual visit” with a board-certified emergency physician located remotely.
Results
More than 6 months into the program, more than 1,300 patients have been treated. These patients experienced decreased length of stay (2.5 hours to 38 minutes) and increased satisfaction. The program is very well received by staff members who appreciate its efficiency.
Discussion
Telehealth has the potential to optimize ED efficiency, increase patient satisfaction, and promote safe, high-quality provision of care. Image 1
Contribution to Emergency Nursing Practice
•Improved patient flow and care
•Allows nurses to be with patients who require more acute care
•Patient and Staff satisfactionDisponible en ligne : Non Permalink : https://bib.vinci.be/opac_css/index.php?lvl=notice_display&id=86240
in Journal of Emergency Nursing > Vol. 44, n° 5 (September 2018) . - p. 472-477[article]Exemplaires (1)
Cote Support Localisation Section Disponibilité REV Périodique papier Woluwe périodiques Consultation sur place uniquement
Exclu du prêt
Titre : Assessing for Occult Suicidality at Triage: Experiences of Emergency Nurses Type de document : Article Auteurs : Lisa A. Wolf ; Cydne Perhats ; Altair M. Delao ; Paul R. Clark ; Michael D. Moon ; Kathleen Evanovitch Zavosky Année de publication : 2018 Article en page(s) : p. 491-498 Note générale : DOI: https://doi.org/10.1016/j.jen.2018.01.013 Langues : Anglais (eng) Descripteurs : HE Vinci
Méthodologie ; Recherche qualitative ; Risque ; Soins d'urgence ; Suicide ; TriageRésumé : Introduction
Screening for suicidality is a critical nursing function at the initial ED encounter. Suicide is the tenth leading cause of death in the United States, and a substantial percentage of people who die by suicide present for health care in the year before their deaths. The emergency department provides health care professionals with a critical opportunity to identify patients at risk for suicide and intervene appropriately.
Methods
Qualitative exploratory study using focus-group data.
Findings
Effective and accurate suicidality assessment occurs not by asking a single question but also with the assessment of patient behaviors and presentation (appearance, hygiene, etc). When emergency nurses suspected occult suicidality, additional actions (finding private space, keeping patients safe, and passing on information), took priority.
Discussion
The Joint Commission recommends using clinical judgment tools for the final determination of safety for a patient at suspected risk of suicide, as research findings suggest that a screening tool can identify persons at risk for suicide more reliably than a clinician’s personal judgment. Our participants report that when they assessed suicide risk at triage, it was usually by asking a single question such as “Do you have thoughts or plans to harm yourself?” and they expressed concern about the effectiveness of doing so. Participants described their efforts to improve suicide screening across the duration of the patient’s ED stay through an iterative process of assessment that included further probing and eliciting, evaluating, and reacting to the patient’s response. Unlabelled Box
Contribution to Emergency Nursing Practice
•Screening for suicidality is a critical function of triage nursing.
•Screening is a process that involves recognition and interpretation of verbal and nonverbal cues.
•Future efforts to improve triage assessment of suicide risk should include screening tools that are deployed continuously through the ED visit.Disponible en ligne : Non Permalink : https://bib.vinci.be/opac_css/index.php?lvl=notice_display&id=86241
in Journal of Emergency Nursing > Vol. 44, n° 5 (September 2018) . - p. 491-498[article]Exemplaires (1)
Cote Support Localisation Section Disponibilité REV Périodique papier Woluwe périodiques Consultation sur place uniquement
Exclu du prêt
Titre : Counseling Suicidal Patients About Access to Lethal Means: Attitudes of Emergency Nurse Leaders Type de document : Article Auteurs : Marian E. Betz ; Ashley Brooks-Russell ; Sara Brandspigel ; Douglas K. Novins ; Gregory J. Tung ; Carol Runyan Année de publication : 2018 Article en page(s) : p. 499-504 Note générale : DOI: https://doi.org/10.1016/j.jen.2018.03.012 Langues : Anglais (eng) Descripteurs : HE Vinci
Autorité ; Prévention primaire ; Relation d'aide ; Services des urgences médicales ; SuicideMots-clés : Moyens létaux Résumé : Introduction
For ED patients at risk of suicide, counseling to reduce access to lethal means (including firearms) is recommended yet not routine. To enhance practice uptake, we sought to examine the attitudes and beliefs of emergency nurse leaders concerning the acceptability and effectiveness of lethal-means counseling.
Methods
We invited a nurse leader (ED nurse manager or Chief Nursing Officer [CNO]) at each hospital-based emergency department in the 8-state Mountain West region of the United States to complete a closed-ended telephone survey. Questions assessed current practices and leaders’ views on suicide prevention and lethal-means counseling. Reponses were weighted to all eligible hospitals to adjust for nonresponse.
Results
From 363 eligible hospitals, 190 emergency nurse leaders responded (overall response rate: 52%). Emergency nurse leaders thought providers at their emergency departments did an excellent job of safety counseling (74%) for suicidal patients. Most respondents believed that talking about firearms with suicidal patients is acceptable to patients (77%), supported by hospital administration (64%), effective in preventing suicide (69%), and something that providers should do (91%). However, the majority also had doubts about whether suicide is preventable (60%).
Discussion
Despite expressing high levels of support for the acceptability and effectiveness of lethal-means counseling, high proportions of emergency nurse leaders expressed skepticism regarding the preventability of suicide, a finding consistent with previous work. Our results support the need to address and modify misperceptions about prevention of suicide in any efforts for widespread implementation and dissemination of lethal-means counseling. Image 1
Contribution to Emergency Nursing Practice
•Examination of ED nurse leaders across the United States Mountain West region found general support for lethal-means counseling for patients at risk of suicide.
•Skepticism about the preventability of suicide highlights the need for better, focused suicide prevention training of nurses during training and through continuing education.
•Efforts to implement, sustain, or improve lethal-means counseling practices in emergency departments can be more successful if they engage nurse leaders.Disponible en ligne : Non Permalink : https://bib.vinci.be/opac_css/index.php?lvl=notice_display&id=86242
in Journal of Emergency Nursing > Vol. 44, n° 5 (September 2018) . - p. 499-504[article]Exemplaires (1)
Cote Support Localisation Section Disponibilité REV Périodique papier Woluwe périodiques Consultation sur place uniquement
Exclu du prêt
Titre : A 32-Year-Old Woman with Postpartum Cardiac Arrest Type de document : Article Auteurs : Joseph Taylor ; Laura Taylor Année de publication : 2018 Article en page(s) : p. 514-516 Note générale : DOI: https://doi.org/10.1016/j.jen.2017.05.014 Langues : Anglais (eng) Descripteurs : HE Vinci
Arrêt cardiaque ; Embolie amniotique ; Période du postpartum ; Présentations de casRésumé : Contribution to Emergency Nursing Practice:
•To inform emergency nurses of a life-threatening obstetric condition that can be encountered in the hospital setting
•To reinforce the emergency nurse’s role in the resuscitative care of patients experiencing amniotic fluid embolismDisponible en ligne : Non Permalink : https://bib.vinci.be/opac_css/index.php?lvl=notice_display&id=86243
in Journal of Emergency Nursing > Vol. 44, n° 5 (September 2018) . - p. 514-516[article]Exemplaires (1)
Cote Support Localisation Section Disponibilité REV Périodique papier Woluwe périodiques Consultation sur place uniquement
Exclu du prêt
Exemplaires (1)
| Cote | Support | Localisation | Section | Disponibilité |
|---|---|---|---|---|
| REV | Périodique papier | Woluwe | périodiques | Consultation sur place uniquement Exclu du prêt |
Paru le : 01/07/2018
|
Dépouillements
Ajouter le résultat dans votre panier
Titre : Bridging the Gap: Drug and Alcohol Screening in Adolescent Trauma Patients Type de document : Article Auteurs : Francine Falvo ; Alexis Schmid Année de publication : 2018 Article en page(s) : p. 325-330 Note générale : DOI: https://doi.org/10.1016/j.jen.2018.01.002 Langues : Anglais (eng) Descripteurs : HE Vinci
Adolescent ; Alcool ; Dépistage systématique ; Drogue ; TraumatismeDisponible en ligne : Non Permalink : https://bib.vinci.be/opac_css/index.php?lvl=notice_display&id=85523
in Journal of Emergency Nursing > Vol. 44, n° 4 (July 2018) . - p. 325-330[article]Exemplaires (1)
Cote Support Localisation Section Disponibilité REV Périodique papier Woluwe périodiques Consultation sur place uniquement
Exclu du prêt
Titre : The Use of Clinical Cervical Spine Clearance in Trauma Patients: A Literature Review Type de document : Article Auteurs : Sandra Larson ; Andrew U. Delnat ; Jill Moore Année de publication : 2018 Article en page(s) : p. 368-374 Note générale : DOI: https://doi.org/10.1016/j.jen.2017.10.013 Langues : Anglais (eng) Descripteurs : HE Vinci
Rachis ; Revue de la littérature ; Traumatismes de la moelle épinièreMots-clés : Collier cervical Résumé : Introduction
Five million patients in America are placed in spinal immobilization annually, with only 1% to 2% of these patients suffering from an unstable cervical spine injury. Prehospital agencies are employing selective and limited immobilization practices, but there is concern that this practice misses cervical spine injuries and therefore possibly predisposes patients to worsening injuries.
Methods
A systematic review was conducted that examined literature from the last 5 years that reviewed cervical spine immobilization application and/or clearance in alert trauma patients.
Results
Prehospital selective immobilization protocols and bedside clinical clearance examinations are becoming more commonplace, with few missed injuries or poor outcomes. Prehospital providers can evaluate patients in the field safely to assess who needs or does not need cervical collars; similar criteria can be used in the emergency department. Harm from cervical collars is increasingly documented, with concerns that risks exceed possible benefits.
Discussion
The literature suggests that alert trauma patients can be cleared from cervical spine immobilization safely through a structured algorithm in either the prehospital or ED setting. The evidence is primarily observational. Thus, many providers who fear missing cervical injuries may be reluctant to follow the recommendations despite few or no published cases of sudden deterioration from missed cervical spine injuries. Image 1Disponible en ligne : Non Permalink : https://bib.vinci.be/opac_css/index.php?lvl=notice_display&id=85524
in Journal of Emergency Nursing > Vol. 44, n° 4 (July 2018) . - p. 368-374[article]Exemplaires (1)
Cote Support Localisation Section Disponibilité REV Périodique papier Woluwe périodiques Consultation sur place uniquement
Exclu du prêt
Titre : Nurses' Perceptions of Victims of Human Trafficking in an Urban Emergency Department: A Qualitative Study Type de document : Article Auteurs : Elizabeth Long ; Elizabeth Dowdell Année de publication : 2018 Article en page(s) : p. 375-383 Note générale : DOI: https://doi.org/10.1016/j.jen.2017.11.004 Langues : Anglais (eng) Descripteurs : HE Vinci
Perception ; Service hospitalier d'urgences ; Trafic d'êtres humains ; Victime ; Villes ; ViolenceRésumé : Introduction
Human trafficking is estimated to surpass the drug trade as the leading illegal industry in the world. According to a recent study, over 87.8% of trafficking survivors came into contact with a healthcare professional while they were enslaved and were not identified as a victim of human trafficking. The aims of this study are to understand the perceptions of emergency nurses about human trafficking, victims of violence, and prostitution.
Methods
A qualitative, descriptive study using a semi-structured interview approach was done with ten registered nurses in a large, urban Emergency Department in the northeastern U.S. Interviews were recorded and transcribed; thematic analysis was performed.
Results
Six themes emerged from the interviews including, “human trafficking exists in the patient population” yet no nurse has screened or treated a victim; human trafficking victims are perceived to be “young, female, and foreign born”; all of the emergency nurses reported having worked with or screened a victim of violence; victims of violence were viewed as patients who present as “sad and grieving”; prostitutes are seen as “hard and tough”; and emergency nurses did not have education on human trafficking victims’ needs or resources.
Discussion
Emergency nurses should be more aware about victims of human trafficking. The media portrayal of human trafficking victims had influenced the nurses’ perceptions of this population. Victims of violence are perceived to be very different from prostitutes, but there is a desire for education about violence as well as information about specific resources open to victims. Image 1Disponible en ligne : Non Permalink : https://bib.vinci.be/opac_css/index.php?lvl=notice_display&id=85525
in Journal of Emergency Nursing > Vol. 44, n° 4 (July 2018) . - p. 375-383[article]Exemplaires (1)
Cote Support Localisation Section Disponibilité REV Périodique papier Woluwe périodiques Consultation sur place uniquement
Exclu du prêt
Titre : Injuries of Women Surviving Intimate Partner Strangulation and Subsequent Emergency Health Care Seeking: An Integrative Evidence Review Type de document : Article Auteurs : Michelle Patch ; Jocelyn C Anderson ; Jacquelyn C. Campbell Année de publication : 2018 Article en page(s) : p. 384-393 Note générale : DOI: https://doi.org/10.1016/j.jen.2017.12.001 Langues : Anglais (eng) Descripteurs : HE Vinci
Étouffement ; Femmes ; Survivants ; Violence conjugaleMots-clés : Strangulation Résumé : Introduction
Nonfatal strangulation by a current or former intimate partner is a distinct mechanism of violence with the potential for severe injury or death. As nonfatal strangulation has gained recognition for its significant medical and legal implications, there have been multiple calls for nursing and other health care providers to improve practices related to strangulation screening, assessment, and treatment. Given that US estimates suggest higher prevalence of strangulation of women than of men, this integrative evidence review examines existing literature related to women’s injuries and their subsequent experiences in seeking health care after surviving intimate partner strangulation.
Methods
Following PRISMA guidelines, 5 electronic databases were searched, ultimately resulting in 13 articles for inclusion.
Results
Overall, nonfatal intimate partner strangulation was associated with multiple negative physical and psychological outcomes for women, although only 5% to 69% of strangled women sought health care in studies reporting this finding.
Discussion
Nonprobability sampling, participant self-reports, and relatively small sample sizes were frequently encountered limitations across studies. Heterogeneity of women’s ages and race/ethnicities also limited comparisons. However, existing research provides a beginning framework to support practice and future inquiry. Image 1Disponible en ligne : Non Permalink : https://bib.vinci.be/opac_css/index.php?lvl=notice_display&id=85526
in Journal of Emergency Nursing > Vol. 44, n° 4 (July 2018) . - p. 384-393[article]Exemplaires (1)
Cote Support Localisation Section Disponibilité REV Périodique papier Woluwe périodiques Consultation sur place uniquement
Exclu du prêt
Exemplaires (1)
| Cote | Support | Localisation | Section | Disponibilité |
|---|---|---|---|---|
| REV | Périodique papier | Woluwe | périodiques | Consultation sur place uniquement Exclu du prêt |
Paru le : 01/05/2018
|
Dépouillements
Ajouter le résultat dans votre panier
Titre : Cervical Spine Collar Removal by Emergency Room Nurses : A Quality Improvement Project Type de document : Article Auteurs : Guillaume Fontaine ; Massimo Forgione ; Francis Lusignan ; [et al.] Année de publication : 2018 Article en page(s) : p. 228-235 Note générale : DOI: https://doi.org/10.1016/j.jen.2017.07.018 Langues : Anglais (eng) Descripteurs : HE Vinci
Démarche qualité ; Infirmiere d'urgence ; Microcéphalie fusions des vertèbres cervicalesMots-clés : Collier cervical Résumé : Introduction
The Canadian C-Spine Rule (CCR) is a clinical decision aid to facilitate the safe removal of cervical collars in the alert, orientated, low-risk adult trauma patient. Few health care settings have assessed initiatives to train charge nurses to use the CCR. This practice improvement project conducted in a secondary trauma center in Canada aimed to (1) train charge nurses of the emergency room to use the CCR, (2) monitor its use throughout the project period, and (3) compare the assessments of the charge nurses with those of emergency physicians.
Methods
The project began with the creation of an interdisciplinary team. Clinical guidelines were established by the interdisciplinary project team. Nine charge nurses of the emergency room were then trained to use the CCR (3 on each 8-hour shift). The use of the CCR was monitored throughout the project period, from June 1 to October 5, 2016.
Results
The 3 aims of this practice improvement project were attained successfully. Over a 5-month period, 114 patients were assessed with the CCR. Charge nurses removed the cervical collars for 54 of 114 patients (47%). A perfect agreement rate (114 of 114 patients, 100%) was attained between the assessments of the nurses and those of physicians.
Discussion
This project shows that the charge nurses of a secondary trauma center can use the CCR safely on alert, orientated, and low-risk adult trauma patients as demonstrated by the agreement in the assessments of emergency room nurses and physicians. Image 1
Contribution to Emergency Nursing Practice
•A practice improvement program to monitor the use of the Canadian C-Spine Rule (CCR) by emergency room charge nurses and compare their assessments with those of physicians
•An overview of challenges and key elements to take into account when training charge nurses to use the CCR to facilitate the safe removal of cervical collars in the alert, orientated, low-risk adult trauma patient
•An overview of the training and clinical coaching should accompany the implementation of CCR guidelines for nurse-led cervical collar removal in nonspecialized centers.Disponible en ligne : Non Permalink : https://bib.vinci.be/opac_css/index.php?lvl=notice_display&id=84686
in Journal of Emergency Nursing > Vol. 44, n°3 (May 2018) . - p. 228-235[article]Exemplaires (1)
Cote Support Localisation Section Disponibilité REV Périodique papier Woluwe périodiques Consultation sur place uniquement
Exclu du prêt
Titre : Emergency Nurse Implementation of the Brief Smoking-Cessation Intervention : Ask, Advise, and Refer Type de document : Article Auteurs : Darlie Simerson ; Diana Hackbarth Année de publication : 2018 Article en page(s) : p. 242-248 Note générale : Ask, Advise, and Refer Langues : Anglais (eng) Descripteurs : HE Vinci
Infirmiere d'urgence ; Programme ; Recommandations ; Relation d'aide ; Risque ; Sevrage tabagique ; TabagismeRésumé : Problem
Smoking is the single most avoidable risk factor for many health problems such as cardiovascular disease and pulmonary dysfunction. Emergency departments provide care for many patients who smoke. Patients who smoke and are discharged to home from emergency departments do not customarily receive smoking-cessation information. This project explored the feasibility and acceptability of a brief smoking-cessation intervention as part of emergency nursing practice.
Methods
This practice improvement project was conducted in a large midwestern emergency department. A review of data from 12 months before the project revealed a 17.6% prevalence of smoking among patients discharged from the emergency department with no patient having received smoking-cessation information, confirming the need for intervention. A survey of emergency nurse attitudes and learning needs indicated that nurses believed offering advice to quit was appropriate but that they had limited smoking-cessation training. A total of 83 nurses received training on an “Ask, Advise, Refer” protocol.
Results
Evaluation after training indicated that emergency nurses gained knowledge about brief smoking-cessation intervention methods, and 75.7% (n=74) felt adequately trained. During the 12-week intervention, data were collected on 7,465 emergency visits. Nurses advised all smokers to quit using the protocol, and 6.3% of patients accepted smoking-cessation referrals.
Implications for Practice
Emergency nurses felt comfortable performing the smoking-cessation intervention, suggesting that training was effective. Data indicated that patients were consistently advised to quit smoking. Results suggest that brief smoking-cessation interventions are feasible and acceptable in emergency settings. The training and protocol could be used in other emergency departments, and lessons learned can guide future efforts by emergency nurses to help patients quit smoking. Image 1
Contribution to Emergency Nursing Practice
•Many ED patients smoke, and emergency nurses are uniquely positioned to provide a brief smoking-cessation intervention during the teachable moment that occurs when screening for smoking status.
•It is known that a patient who smokes is more likely to quit when counseled to do so by a trusted clinician such as a nurse.
•Training in brief smoking cessation techniques provides another skill that emergency nurses can use to contribute actively to the promotion of patient health and reduction of risk.Disponible en ligne : Non Permalink : https://bib.vinci.be/opac_css/index.php?lvl=notice_display&id=84687
in Journal of Emergency Nursing > Vol. 44, n°3 (May 2018) . - p. 242-248[article]Exemplaires (1)
Cote Support Localisation Section Disponibilité REV Périodique papier Woluwe périodiques Consultation sur place uniquement
Exclu du prêt
Titre : Parental Perceptions, Risks, and Incidence of Pediatric Unintentional Injuries Type de document : Article Auteurs : Catherine M. Hogan ; Claire Cioni ; Nancy L. Weaver ; [et al.] Année de publication : 2018 Article en page(s) : p. 267-273 Note générale : DOI: https://doi.org/10.1016/j.jen.2017.07.017 Langues : Anglais (eng) Descripteurs : HE Vinci
Blessure ; Communication sur la santé ; Parents ; Perception ; Prévention ; Risque ; Soins de l'enfantRésumé : Introduction
More than 9,000 children die annually from various causes of unintentional injury. Of all the pediatric unintentional injuries occurring in the United States, 8.7 million are treated in emergency departments, and 225,000 require hospitalization annually. Health education programs are available to address these injuries. The objective of this research was to examine the distribution of self-reported high priority injury risks in an urban Midwestern pediatric level 1 trauma center and investigate the relationship between parental perceptions and injury-prevention behaviors. Prevalence rates for 3 data sources are compared.
Methods
Missouri Information for Community Assessment (MICA) was categorized to mirror variables corresponding with risks of injury presented in the Safe ‘n’ Sound (SNS) program. Level 1 trauma center data were examined to determine how the variables were distributed compared with MICA data and with the parent-reported levels.
Results
A total of 429 SNS surveys were compared with ED data and MICA data. For SNS users, car crashes were identified as the highest risk, specifically due to the use of incorrect car seats. The injuries seen most often in the emergency department were falls, and falls were also the most prevalent injury captured by MICA. Controlling for demographics, parental perceptions predicted several risks for injury.
Discussion
Because parental perceptions are significantly related to risks of injury, prevention programs aiming to decrease injuries could focus on the perceptions. Not only can perceptions be used to tailor health communication materials, these perceptions can be the targets of change. Further work might investigate the extent to which changes in perceptions result in increased adoption of safety practices. Image 1
Contribution to Emergency Nursing Practice
•Examines parental injury perceptions so that these factors can be considered when communicating with parents about prevention
•Analyzes current ED and statewide trends and client perceptions of injury threat, the nurse may tailor information to an individual, thus making health education more relevant.Disponible en ligne : Non Permalink : https://bib.vinci.be/opac_css/index.php?lvl=notice_display&id=84688
in Journal of Emergency Nursing > Vol. 44, n°3 (May 2018) . - p. 267-273[article]Exemplaires (1)
Cote Support Localisation Section Disponibilité REV Périodique papier Woluwe périodiques Consultation sur place uniquement
Exclu du prêt
Exemplaires (1)
| Cote | Support | Localisation | Section | Disponibilité |
|---|---|---|---|---|
| REV | Périodique papier | Woluwe | périodiques | Consultation sur place uniquement Exclu du prêt |
Paru le : 01/03/2018
|
Dépouillements
Ajouter le résultat dans votre panier
Titre : Use of Capnography to Optimize Procedural Sedation in the Emergency Department Pediatric Population Type de document : Article Auteurs : Leonie Rose Bovino Année de publication : 2018 Article en page(s) : p. 110-116 Note générale : https://doi.org/10.1016/j.jen.2017.10.016 Langues : Anglais (eng) Descripteurs : HE Vinci
Démarche qualité ; SédationMots-clés : Capnographie Procédure de sédation Service hospitalier d'urgences pédiatriques Disponible en ligne : Non Permalink : https://bib.vinci.be/opac_css/index.php?lvl=notice_display&id=84115
in Journal of Emergency Nursing > Vol. 44, n°2 (March 2018) . - p. 110-116[article]Exemplaires (1)
Cote Support Localisation Section Disponibilité REV Périodique papier Woluwe périodiques Consultation sur place uniquement
Exclu du prêt
Titre : The Priority of Administering HIV Postexposure Prophylaxis in Cases of Sexual Assault in an Emergency Department Type de document : Article Auteurs : Meredith Scannell Année de publication : 2018 Article en page(s) : p. 117-122 Note générale : https://doi.org/10.1016/j.jen.2017.10.014 Langues : Anglais (eng) Descripteurs : HE Vinci
Abus sexuel ; Infirmiere d'urgence ; Prévention ; Simulation ; Syndrome d'immunodéficience acquise (SIDA)Mots-clés : Service hospitalier d'urgence Exposition au VIH Résumé : Introduction
Contracting the human immunodeficiency virus (HIV) is a genuine concern for sexually assaulted patients. Emergency departments are a place where sexually assaulted patients seek care, including treatment to prevent HIV. Prompt administration of nonoccupational postexposure prophylaxis is essential because of the time-sensitive nature of the medications. Quality improvement measures at an urban hospital revealed delays in administration of postexposure prophylaxis to these patients.
Methods
A forensic simulation course and checklist was developed for emergency departments to improve care for sexually assaulted patients. Data used for analysis included time of administration of nonoccupational postexposure medication and length of stay before and after intervention with the simulation course and checklist. Points of measurement included student t-test to assess any significant differences and regression analysis to determine associations.
Results
When comparing differences between time of nonoccupational postexposure before and after intervention, there was a trend toward improving the time of administration, but it was not found to be significant. Before intervention, an association was found with sexually assaulted patients’ lengths of stay and the time that nonoccupational postexposure medication was administered, with a regression equation of R2, 0.76. After intervention, this association was absent, with an R2 of 0.017.
Discussion
Implementing a simulation course and checklist for emergency nurses in caring for sexually assaulted patients helps to improve the timeliness of administration of nonoccupational postexposure medications and resolve the association between the length of stay and time of administration of medication. Image 1
Contribution to Emergency Nursing Practice
•The only method of preventing the human immunodeficiency virus (HIV) in sexually assaulted patients is the prompt administration of nonoccupational postexposure prophylaxis.
•Implementing a simulation course and checklist for emergency nurses improved the timeliness of administering nonoccupational postexposure prophylaxis.
•Data demonstrate that, with simulation, emergency nurses are better prepared to address the needs of sexually assaulted patients.Disponible en ligne : Non Permalink : https://bib.vinci.be/opac_css/index.php?lvl=notice_display&id=84116
in Journal of Emergency Nursing > Vol. 44, n°2 (March 2018) . - p. 117-122[article]Exemplaires (1)
Cote Support Localisation Section Disponibilité REV Périodique papier Woluwe périodiques Consultation sur place uniquement
Exclu du prêt
Titre : Key Players in Key Roles: The Baystate Patient Progress Initiative to Improve Emergency Department Efficiency and Productivity Type de document : Article Auteurs : Niels K. Rathlev ; Jacqualyn Anderson ; Joseph Schmidt ; [et al.] Année de publication : 2018 Article en page(s) : p. 123-131 Note générale : https://doi.org/10.1016/j.jen.2017.10.015 Langues : Anglais (eng) Descripteurs : HE Vinci
Autorité ; Efficacité ; Infirmiere d'urgenceMots-clés : Service hospitalier d'urgence Productivité Résumé : Background
The percentage of patients who leave the emergency department without being seen by a provider is a measure of efficiency and presents risk-management concerns. The number of patients actually “seen” by a provider is a measure of productivity. The opening of our new emergency department in December 2012, resulted in increases in both demand and the percentage of patients who left without being seen. Operational nursing leadership managed ED patient flow, but the structure was loosely organized on an ad hoc basis.
Methods
Operational nursing leadership roles were re-assigned to personnel with management aptitude and interest. The charge nurse coordinated care throughout all sections (pods) of the department while the pod lead nurse coordinated care in each pod. The flow coordinator nurse accepted transfers and emergency medical services arrivals. Nursing and physician staffing remained unchanged, and measures were calculated over a 3-year period (December 3, 2012, to December 2, 2015). The number of patients seen per day was analyzed using simple linear regression. The percentage of patients who left without being seen was analyzed using fractional logistic regression; P Results
The weekly mean number of patients seen per day rose 13% from 265 to 299 patients. The weekly mean percentage of patients who left without being seen declined 45% from 8.2% to 4.5%. The regression lines for both measures were significant at P Conclusion
Measures of efficiency and productivity can be improved significantly with a dedicated operational nursing leadership structure without adding nursing or physician staffing. Image 1
Contribution to Emergency Nursing Practice
•In the emergency department, the number of patients seen per day is a measure of productivity.
•The percentage of patients who leave without being seen is a measure of efficiency.
•Dedicated nursing management structure can improve productivity in the emergency department and the efficiency of flow.Disponible en ligne : Non Permalink : https://bib.vinci.be/opac_css/index.php?lvl=notice_display&id=84117
in Journal of Emergency Nursing > Vol. 44, n°2 (March 2018) . - p. 123-131[article]Exemplaires (1)
Cote Support Localisation Section Disponibilité REV Périodique papier Woluwe périodiques Consultation sur place uniquement
Exclu du prêt
Titre : Clinical Presentation to the Emergency Department Predicts Subarachnoid Hemorrhage-Associated Myocardial Injury Type de document : Article Auteurs : Khalil M. Yousef ; Elizabeth Crago ; Theodore F. Lagattuta ; [et al.] Année de publication : 2018 Article en page(s) : p. 132-138 Note générale : https://doi.org/10.1016/j.jen.2017.06.005 Langues : Anglais (eng) Descripteurs : HE Vinci
Hémorragie ; Myocarde ; Plaies et blessures ; PréventionMots-clés : Lésion du myocarde Service hospitalier d'urgences Hémorragie sous-arachnoïdienne Résumé : Introduction
Aneurysmal subarachnoid hemorrhage (aSAH) is frequently seen in emergency departments. Secondary injury, such as subarachnoid hemorrhage-associated myocardial injury (SAHMI), affects one third of survivors and contributes to poor outcomes. SAHMI is not attributed to ischemia from myocardial disease but can result in hypotension and arrhythmias. It is important that emergency nurses recognize which clinical presentation characteristics are predictive of SAHMI to initiate proper interventions. The aim of this study was to determine whether patients who present to the emergency department with clinical aSAH are likely to develop SAHMI, as defined by troponin I ≥0.3 ng/mL.
Methods
This was a prospective descriptive study. SAHMI was defined as troponin I ≥0.3 ng/mL. Predictors included demographics and clinical characteristics, severity of injury, admission 12-lead electrogardiogram (ECG), initial emergency department vital signs, and pre-hospital symptoms at time of aneurysm rupture.
Results
Of 449 patients, 126 (28%) had SAHMI. Patients with SAHMI were more likely to report seizures and unresponsiveness with significantly lower Glasgow coma score and higher proportion of Hunt and Hess grades 3 to 5 and Fisher grades III and IV (all P Discussion
Components of the clinical presentation of subarachnoid hemorrhage to the emergency department predict SAHMI. Identifying patients with SAHMI in the emergency department can be helpful in determining surveillance and care needs and informing transfer unit care.
Contribution to Emergency Nursing Practice
•Neurocardiac nursing assessment in the emergency department can be utilized to triage patients with subarachnoid hemorrhage.
•Emergency nurses need to be vigilant for cardiac complications in patient with unresponsiveness at the time of subarachnoid hemorrhage.
•Nurses are the first step in patient care. To provide patients with the best care possible, nurses need to be highly competent in recognizing alarming symptoms.Disponible en ligne : Non Permalink : https://bib.vinci.be/opac_css/index.php?lvl=notice_display&id=84118
in Journal of Emergency Nursing > Vol. 44, n°2 (March 2018) . - p. 132-138[article]Exemplaires (1)
Cote Support Localisation Section Disponibilité REV Périodique papier Woluwe périodiques Consultation sur place uniquement
Exclu du prêt
Titre : The Role of Space in Patients’ Experience of an Emergency Department : A Qualitative Study Type de document : Article Auteurs : Margo Annemans ; C. Van Audenhove ; Hilde Vermolen Année de publication : 2018 Article en page(s) : p. 139-145 Note générale : https://doi.org/10.1016/j.jen.2017.11.002 Langues : Anglais (eng) Descripteurs : HE Vinci
Interaction sociale ; Recherche qualitative ; Relations entre professionnels de santé et patientsMots-clés : Temps d'attente Aspect matériel Service hospitalier d'urgences Résumé : Introduction
Nurses are increasingly involved in the design of health care facilities. Although their experience differs from that of patients, they are often expected to represent patients in design processes. Especially in the context of an emergency department, patients’ states of mind alter their experiences. Knowledge about the role of space in ED patients’ experience is limited. Our study aims to gain insight into this role and thus provide ED nurses with information to better represent ED patients’ perspectives in design.
Methods
We conducted qualitative interviews with 22 patients. The interviews were supported by visual material collected through ethnographic methods to facilitate participants’ reflections on the role of space in their experience. Participants were selected during their stays at the emergency department by convenience sampling. Interviews were audio-recorded, transcribed, and analyzed in combination with the visual material through open and axial coding.
Results
We found that the role of space in ED patients’ experiences is affected by their altered sensory awareness and shaped by material, social, and time-related aspects. These aspects are intertwined and influenced by the transient character of the emergency department.
Discussion
The study indicates that paying attention to the role of space yields a nuanced understanding of ED patients’ experiences. The challenge for hospital designers and staff lies in taking into account patients’ altered sensory awareness and in designing interventions that support staff in emphasizing a human approach without counteracting the medical-technical aspect of emergency care. Image 1
Contribution to Emergency Nursing Practice
•Raising awareness regarding patients’ altered experience of the (built) environment when being admitted to the emergency department.
•Providing an improved understanding of how adaptations to the built environment affect patients and can improve their experience, thus impacting on the functioning of the department.
•Better preparing nurses for the role of design team members they are increasingly expected to play.Disponible en ligne : Non Permalink : https://bib.vinci.be/opac_css/index.php?lvl=notice_display&id=84119
in Journal of Emergency Nursing > Vol. 44, n°2 (March 2018) . - p. 139-145[article]Exemplaires (1)
Cote Support Localisation Section Disponibilité REV Périodique papier Woluwe périodiques Consultation sur place uniquement
Exclu du prêt
Titre : A Review of the Management of Loss of Pregnancy in the Emergency Department Type de document : Article Auteurs : Brittany E. Punches ; Kimberly D. Johnson ; Gordon L. Gillepsie ; [et al.] Année de publication : 2018 Article en page(s) : p. 146-155 Note générale : https://doi.org/10.1016/j.jen.2017.11.001 Langues : Anglais (eng) Descripteurs : HE Vinci
Avortement spontane ; Grossesse ; UrgencesMots-clés : Management Service hospitalier d'urgences Résumé : Introduction
Women frequently seek ED care for complications in early pregnancy, including loss of pregnancy. This review evaluates the current literature and discusses the care of patients experiencing loss of pregnancy in the emergency department.
Methods
A review of pertinent studies identified through multiple database searches was conducted to determine the existing body of knowledge for the care of ED patients diagnosed with loss of pregnancy. Each of the studies was examined for inclusion criteria and a subsequent analysis of the included studies identified themes related to the care of the women.
Results
Thirty-two original research articles and systematic reviews published between 1990 and 2016 were included in the review. Eleven articles addressed recommendations for clinical practice, 5 reported statistics related to pregnancy outcome and clinical presentation, 4 discussed the use of speculum examinations, 4 discussed interventions to decrease ED length of stay, and 3 investigated the use of ultrasound in the emergency department. Only 5 of the articles reviewed discussed emotional support and/or experiences of women with loss of pregnancy in the emergency department.
Conclusion
Although there are multiple recommendations for the clinical management of loss of pregnancy in the emergency department, the psychological and emotional support of women was addressed infrequently. Additional studies investigating holistic care would be beneficial for ED providers in the management of early loss of pregnancy. Image 1
Contribution to Emergency Nursing Practice
•This review identifies current best practice for management of loss of pregnancy in the emergency department, including incorporating targeted ultrasound, decreased use of speculum examinations, and operational changes to improve patient length of stay.
•Emergency care should incorporate clinical and psychological care for patients experiencing loss of pregnancy; however, few resources are available for psychological care.
•This review recognizes a need for additional research and education in the emotional care and psychological health of women experiencing loss of pregnancy in the emergency department.Disponible en ligne : Non Permalink : https://bib.vinci.be/opac_css/index.php?lvl=notice_display&id=84120
in Journal of Emergency Nursing > Vol. 44, n°2 (March 2018) . - p. 146-155[article]Exemplaires (1)
Cote Support Localisation Section Disponibilité REV Périodique papier Woluwe périodiques Consultation sur place uniquement
Exclu du prêt
Titre : Clinical Skills Performed By Iranian Emergency Nurses: Perceived Competency Levels and Attitudes Toward Expanding Professional Roles Type de document : Article Auteurs : Hadi Hassankhani ; Firooz Hasanzadeh ; Kelly A. Powers ; [et al.] Année de publication : 2018 Article en page(s) : p. 156-163 Note générale : https://doi.org/10.1016/j.jen.2017.06.007 Langues : Anglais (eng) Descripteurs : HE Vinci
Compétence ; Infirmiere d'urgence ; Iran ; Rôle propre infirmierMots-clés : Compétences cliniques Résumé : Introduction
Emergency nurses play an important role in the care of critically ill and injured patients, and their competency to perform clinical skills is vital to safe and effective patient care. The aim of this study was to evaluate the frequency of clinical skills performed and perceived competency levels among Iranian emergency nurses. In addition, attitudes toward expanding the professional roles of Iranian emergency nurses were also assessed.
Methods
In this descriptive correlational study, 319 emergency nurses from 30 hospitals in northwest Iran participated. Data were collected using a self-report questionnaire. Descriptive statistics and Pearson’s correlation coefficient were used to present the findings.
Results
Overall competency of the emergency nurses was 73.31 ± 14.2, indicating a good level of perceived competence. The clinical skills most frequently performed were in the domains of organizational and workload competencies (3.43 ± 0.76), diagnostic function (3.25 ± 0.82), and the helping role (3.17 ± 0.83). A higher level of perceived competence was found for skills within these domains. Less frequently, participants performed skills within the domains of effective management of rapidly changing situations (2.70 ± 0.94) and administering and monitoring therapeutic interventions (2.60 ± 0.97); a lower perceived level of competence was noted for these clinical skills. There was a significant correlation between frequency of performing clinical skills and perceived competency level (r = 0.651, P Discussion
Higher perceived competency levels were significantly associated with more frequent performance of clinical skills. This has implications for nurse managers and educators who may consider offering more frequent experiential and educational opportunities to emergency nurses. Expansion of nurses’ roles could also result in increased experience in clinical skills and higher levels of competency. Research is needed to investigate nurses’ clinical competence using direct and observed measures. Image 1
Contribution to Emergency Nursing Practice
•Emergency nurses in Iran take part in an extensive variety of activities with different levels of perceived competence and are willing to perform more advanced practice roles, some of which are described in Iran and other countries as falling into physicians’ scope of practice.
•Nurse educators and clinicians must collaborate to establish models for clinical education that take into account current activities that are practiced with low levels of competence.
•Health care regulatory authorities are needed to provide guidance programs to support emergency nurses to be knowledgeable about relevant policies, procedures, and laws that inform their scope of practice and legal boundaries.
•Health care regulatory authorities, nurse educators, and clinicians should collaborate to support the ongoing advancement of emergency nursing roles and guide safe nursing practice.Disponible en ligne : Non Permalink : https://bib.vinci.be/opac_css/index.php?lvl=notice_display&id=84121
in Journal of Emergency Nursing > Vol. 44, n°2 (March 2018) . - p. 156-163[article]Exemplaires (1)
Cote Support Localisation Section Disponibilité REV Périodique papier Woluwe périodiques Consultation sur place uniquement
Exclu du prêt
Titre : Outcomes of a Simplified Ultrasound-Guided Intravenous Training Course for Emergency Nurses Type de document : Article Auteurs : Sarah Feinsmith ; Ryan Huebinger ; Michael Pitts ; [et al.] Année de publication : 2018 Article en page(s) : p. 169-175 Note générale : https://doi.org/10.1016/j.jen.2017.10.001 Langues : Anglais (eng) Descripteurs : HE Vinci
Compétence ; Échographie ; Financement ; Formation ; Infirmiere d'urgence ; Injection intraveineuse ; ProgrammeMots-clés : Programme d'entraînement Résumé : Introduction
Various medical or anatomical conditions can lead to difficult intravenous access (DIVA) in the emergency department. It was hypothesized that developing an emergency nurse-training program could reduce IV attempts in the emergency department, improving throughput and patient care.
Methods
Emergency nurses completed a 4-hour ultrasound-guided intravenous (USGIV) access course and achieved competency after 10 successful supervised USGIV insertions on patients. Data were collected from a nurse-completed USGIV log and the electronic medical record. Experience levels, rates of completion, rates of success, and the effects on attempts of IV access were analyzed.
Results
Thirty-four emergency nurses enrolled in the study over 9 months, and 12 (35%) developed competency. Successful cannulation rates improved from 81% for procedure attempts 1 to 10, to 96% for attempts 21 to 30. Overall IV attempts by nurses and physicians (n = 24,471) decreased by 2%, P = 0.013. DIVA IV attempts (n = 1,366) decreased by 7%, P = 0.003.
Discussion
USGIV training programs can decrease total number of IV attempts. A simplified and economical USGIV training program for emergency nurses can be successful and may be dependent on emergency nurse experience levels and initiative. Image 1
Contribution to Emergency Nursing Practice
•This research evaluates the outcomes of an ultrasound-guided intravenous (USGIV) training program for newly trained emergency nurses on an emergency department’s ability to deliver cost-effective and efficacious care by reducing attempts at IV access in the emergency department.
•A simplified and economical USGIV program is described, and potential rates of completion and nurses most likely to succeed are identified.
•USGIV placement is a skill that can be mastered by emergency nurses of all skill levels, including novice emergency nurses.Disponible en ligne : Non Permalink : https://bib.vinci.be/opac_css/index.php?lvl=notice_display&id=84122
in Journal of Emergency Nursing > Vol. 44, n°2 (March 2018) . - p. 169-175[article]Exemplaires (1)
Cote Support Localisation Section Disponibilité REV Périodique papier Woluwe périodiques Consultation sur place uniquement
Exclu du prêt
Exemplaires (1)
| Cote | Support | Localisation | Section | Disponibilité |
|---|---|---|---|---|
| REV | Périodique papier | Woluwe | périodiques | Consultation sur place uniquement Exclu du prêt |
Paru le : 01/01/2018
|
Dépouillements
Ajouter le résultat dans votre panier
Titre : Preventing Emergency Department Violence through Design Type de document : Article Auteurs : Patricia A. Lenaghan ; Nicole M. Cirrincione ; Steven Henrich Année de publication : 2018 Article en page(s) : p. 7-12 Langues : Anglais (eng) Descripteurs : HE Vinci
Prévention ; ViolenceMots-clés : Service hospitalier d'urgence Pensée (activité mentale) Disponible en ligne : Non Permalink : https://bib.vinci.be/opac_css/index.php?lvl=notice_display&id=83479
in Journal of Emergency Nursing > Vol. 44, n°1 (January 2018) . - p. 7-12[article]
Titre : Water Intoxication and Child Abuse Type de document : Article Auteurs : N. Metheny ; K. Meert Année de publication : 2018 Article en page(s) : p. 13-18 Langues : Anglais (eng) Descripteurs : HE Vinci
Consommation ; Eau ; Enfant (6-12 ans) ; Hyponatremie ; IntoxicationMots-clés : Consommation excessive d'eau Service hospitalier d'urgences Disponible en ligne : Non Permalink : https://bib.vinci.be/opac_css/index.php?lvl=notice_display&id=83480
in Journal of Emergency Nursing > Vol. 44, n°1 (January 2018) . - p. 13-18[article]
Titre : Impact of a TeamSTEPPS Trauma Nurse Academy at a Level 1 Trauma Center Type de document : Article Auteurs : V. Kristen Peters ; Ellen M. Harvey ; Andy Wright ; [et al.] Année de publication : 2018 Article en page(s) : p. 19-25 Langues : Anglais (eng) Descripteurs : HE Vinci
Education ; Equipe soignante ; Erreurs médicales ; Infirmiere d'urgence ; Matériel d'enseignement ; Simulation ; TraumatismeMots-clés : Unité hospitalière d'urgences Résumé : Problem
Nurses are crucial members of the team caring for the acutely injured trauma patient. Until recently, nurses and physicians gained an understanding of leadership and supportive roles separately. With the advent of a multidisciplinary team approach to trauma care, formal team training and simulation has transpired.
Methods
Since 2007, our Level I trauma system has integrated TeamSTEPPS (Team Strategies & Tools to Enhance Performance & Patient Safety; Agency for Healthcare Research and Quality, Rockville, MD) into our clinical care, joint training of nurses and physicians, using simulations with participation of all health care providers. With the increased expectations of a well-orchestrated team and larger number of emergency nurses, our program created the Trauma Nurse Academy. This academy provides a core of experienced nurses with an advanced level of training while decreasing the variability of personnel in the trauma bay. Components of the academy include multidisciplinary didactic education, the Essentials of TeamSTEPPS, and interactive trauma bay learning, to include both equipment and drug use. Once completed, academy graduates participate in the orientation and training of General Surgery and Emergency Medicine residents’ trauma bay experience and injury prevention activities.
Results
Internal and published data have demonstrated growing evidence linking trauma teamwork training to knowledge and self-confidence in clinical judgment to team performance, patient outcomes, and quality of care.Disponible en ligne : Non Permalink : https://bib.vinci.be/opac_css/index.php?lvl=notice_display&id=83481
in Journal of Emergency Nursing > Vol. 44, n°1 (January 2018) . - p. 19-25[article]
Titre : Use of a Standardized Procedure to Improve Behavioral Health Patients’ Care : A Quality Improvement Initiative Type de document : Article Auteurs : Elizabeth J. Winokur ; Jeannine Loucks ; Glenn H. Raup Année de publication : 2018 Article en page(s) : p. 26-32 Langues : Anglais (eng) Descripteurs : HE Vinci
Anxiété ; Comportement social ; Evidence-based nursing ; Interdisciplinarité ; Patients ; Psychiatrie ; Sécurité ; Soins d'urgence ; Soins infirmiers ; ViolenceMots-clés : Unité hospitalière d'urgences Procédure normalisée Agressivité du patient Résumé : Problem
Meeting the complex needs of behavioral health (BH) patients in the emergency department is an ongoing challenge. Delays in care can have adverse consequences for patient and staff safety and delay transfer to specialized care.
Methods
A quality improvement, nurse-driven initiative using a standardized procedure (STP) was developed and implemented in our busy Southern California Emergency Department, which focused on improving time to first medication and reduction of restraints. The project used a multidisciplinary team to develop the STP scoring tool and corresponding medications. Improvement was seen in all quality metrics. Time to first medication decreased from 43 minutes to less than 5 minutes. Adopting the STP resulted in a 50% decrease in use of restraints and time in restraints. Staff injuries remained low, with less than 3.6% of staff sustaining physical injuries.
Discussion
The STP is an effective method to initiate immediate treatment of patients with signs of anxiety and aggression and thus reduce risk of violence. Additional benefits are reduced time to disposition and earlier initiation of specialized BH care. This process can be replicated in other emergency departments with similar clinical environments through the use of STPs or protocols based on state regulations.
Contribution to Emergency Nursing Practice
•A quality improvement, nurse-driven initiative can improve care for behavioral health patients while maintaining staff and patient safety.
•Demonstrates how a nurse-driven protocol reduced time to first medication for behavioral health patients from 43 minutes to 5 minutes.
•Standardized procedure instituted by nursing reduced use of restraints by more than 50%.Disponible en ligne : Non Permalink : https://bib.vinci.be/opac_css/index.php?lvl=notice_display&id=83539
in Journal of Emergency Nursing > Vol. 44, n°1 (January 2018) . - p. 26-32[article]
Titre : Development and Implementation of an Ultrasound-Guided Peripheral Intravenous Catheter Program for Emergency Nurses Type de document : Article Auteurs : Courtney Edwards ; Jodie Jones Année de publication : 2018 Article en page(s) : p. 33-36 Langues : Anglais (eng) Descripteurs : HE Vinci
Catheterisme intra veineux ; Equipement ; Infirmiere d'urgence ; Matériel médical ; Ondes ultrasonoresMots-clés : Guidance par ultrasons Résumé : Abstract
Problem
Emergency medical care often necessitates placement of peripheral intravenous (PIV) catheters. When traditional methods for obtaining PIV access are not successful, ultrasound guidance is a rescue technique for peripheral vascular placement that improves the quality of patient care.
Methods
The aim of this training program was to develop a process where emergency nurses would be competent to perform ultrasound guided PIV to improve the quality of patient care delivered while reducing throughput time. Administrative program development required creating a nursing practice statement, procedure guideline, operational plan, and competency validation. A training program comprising both didactic and hands-on training was developed and provided by emergency medicine physicians with formal ultrasound fellowship training.
Results
In determining whether the training program was adequate in preparing the student to place an ultrasound-guided PIV, 92.9% of students “agreed” or “strongly agreed.” In having confidence in their ability to obtain an ultrasound guided PIV catheter placement, 35.7% of respondents “agreed” and 64.3% “strongly agreed.” In finding it difficult to be successful in achieving ultrasound guided PIV catheter placement, 71.4% of students “strongly disagreed” and 14.3% “disagreed.” All students (100%) felt it was a feasible task to train nurses to successfully place ultrasound-guided PIV catheters and 71.4% of students strongly support continuing to provide this training program and competency validation.
Discussion
Establishment of an effective didactic and hands-on training program resulted in emergency department nurses becoming competent in placement of ultrasound guided PIV catheters to provide optimal patient care. Image 1
Contribution to Emergency Nursing Practice
•Increasing rates of success and decreasing time for placement of vascular access are critical for optimal patient management in the emergency department.
•When obtaining peripheral intravenous access in the traditional manner has failed, ultrasound guidance is an effective and safe alternative available to emergency nurses.
•Development of an educational program, including both didactic and hands-on training, can achieve successful competency for emergency nurses in establishing ultrasound-guided peripheral intravenous access.Disponible en ligne : Non Permalink : https://bib.vinci.be/opac_css/index.php?lvl=notice_display&id=83540
in Journal of Emergency Nursing > Vol. 44, n°1 (January 2018) . - p. 33-36[article]
Titre : Using the Evidence-Based Practice Service Nursing Bundle to Increase Patient Satisfaction Type de document : Article Auteurs : Mary Kate Dilts Skaggs ; Juli F. Daniels ; Angela J. Hodge ; [et al.] Année de publication : 2018 Article en page(s) : p. 37-45 Langues : Anglais (eng) Descripteurs : HE Vinci
Démarche qualité ; Evidence-based nursing ; Interdisciplinarité ; Protocole ; Qualité des soins de santé ; Satisfaction ; UrgencesMots-clés : Satisfaction du patient Résumé : AbstractIntroduction
Patient satisfaction and patient experience goals are often linked to financial consequences. Although the link does exist, the bottom line is not only about money; it’s about providing a quality experience for ED patients and creating an environment that engages staff. Evidence-based practice (EBP) strategies that have positive impact on patient perceptions of their ED care and increased satisfaction ratings include AIDET, Hourly Rounding, and Bedside Shift Report, which incorporate updates of test results and explanations of events occurring during a patient’s visit. In addition to these outcomes, Hourly Rounding and Bedside Shift Report have been linked to patient safety improvements. Combining these strategies, our team created and implemented the service nursing bundle as a quality improvement (QI) initiative, with the goal of having a positive effect on patient experiences in emergency departments, represented by at least a 5% increase in overall quality-of-care ranking and ratings.
Methods
This QI project involved comparing professional research consultant (PRC) patient- satisfaction phone survey ratings from patients before and after ED staff members completed a 1-hour service nursing bundle class. In addition to the patient-satisfaction ratings, 1,104 audits evaluating staff use of the service bundle implementation were collected over an 8-week period.reading document:
Results
The random observational audits showed the adoption of the service nursing bundle as staff compliance started at 65% in week 1 compared with 100% by week 8. Before intervention (July 2015): 50% of patients rated their overall quality of care as excellent, yielding a benchmark ranking of 42.5 percentile. Postservice bundle education implementation (September 2015): 60% of patients rated their overall quality of care as excellent, increasing our ranking to the 85.5 percentile. The postservice bundle group was 1.5 times more likely to respond “excellent” to all 5 survey questions, which was statistically significant (z =2.82, P = 0.004). The patients’ perceptions of total time spent in the emergency department and ratings of “excellent” revealed a significant statistical difference (before: 35.0%, after: 49.5%, X2 (1) = 4.24, P Discussion
With the implementation of the bundle, our emergency department experienced an 11.8% increase in the number of patients rating their overall quality of care as excellent. This upsurge resulted in a 40% increase in overall quality of care, propelling our emergency department’s ranking to the 85th percentile. Image 1
Contribution to Emergency Nursing Practice
•This quality improvement project adds to the emergency nursing literature by demonstrating that the evidence-based practice (EBP) of AIDET (the acronym for the 5-step program: acknowledge, introduce, duration, explanation, and thank you), Hourly Rounding, and Bedside Shift Report (BSR) can have a positive impact on patient satisfaction.
•The use of auditing tools may improve compliance of AIDET, Hourly Rounding, and Bedside Shift Report.
•Our study found a relationship between patients' perception of time spent in the emergency department and quality-of-care ratings.Disponible en ligne : Non Permalink : https://bib.vinci.be/opac_css/index.php?lvl=notice_display&id=83541
in Journal of Emergency Nursing > Vol. 44, n°1 (January 2018) . - p. 37-45[article]
Titre : Depressive Symptoms and Perceptions of ED Care in Patients Evaluated for Acute Coronary Syndrome Type de document : Article Auteurs : Tara St. Onge ; Donald Edmondson ; Syed Husain ; [et al.] Année de publication : 2018 Article en page(s) : p. 46-51 Langues : Anglais (eng) Descripteurs : HE Vinci
Dépression ; Signes et symptômes ; Soins d'urgence ; Syndrome coronarien aiguMots-clés : Troubles de stress post-traumatique Unité hospitalière d'urgences Résumé : Introduction
Posttraumatic stress disorder (PTSD) develops in 1 out of 8 survivors of acute coronary syndrome (ACS) events, and these persons have a doubling of risk for recurrent ACS and mortality. Overcrowding in the emergency department during ACS evaluation has been associated with increased risk for PTSD, and depressed patients have been found to be particularly vulnerable. Little is known about the mechanisms by which overcrowding increases PTSD risk in depressed patients. Our aim was to evaluate one possible mechanism, patient perception of crowding and care, in depressed and nondepressed ED patients evaluated for ACS.
Methods
We enrolled 912 participants in the REactions to Acute Care and Hospitalization study, an ongoing observational cohort study assessing patients evaluated for ACS. Participants completed the Emergency Department Perceptions questionnaire. Depressive symptoms were screened using the Personal Health Questionnaire Depression Scale. Objective ED crowding was calculated using the Emergency Department Work Index (EDWIN).
Results
EDWIN scores did not significantly differ between groups. Although perceptions of ED crowding did not differ between groups, depressed patients perceived the emergency department as more stressful [t = 4.45, P Discussion
We found that depressed patients experienced the emergency department as more stressful as objectively measured crowding increased. Our study highlights the complex interplay between cardiovascular disease and mental health in impacting patient health outcomes in the emergency department. Image 1
Contribution to Emergency Nursing Practice
•Post-traumatic stress disorder symptoms develop in an estimated 1 in 8 survivors of acute coronary syndrome (ACS) events. Such negative psychological outcomes in these cardiac patients in turn have been associated with increased cardiac morbidity and mortality.
•Overcrowding in the emergency department has been associated with increased risk of the development of post-traumatic stress disorder, and depressed patients in particular appear vulnerable. This study found that currently depressed patients evaluated for ACS had significantly worse perceptions of ED care and stress during ED evaluation.
•Results from this study highlight the importance of emergency nurse providers in assessing both cardiovascular and psychological well-being when evaluating patients for potential ACS events.Disponible en ligne : Non Permalink : https://bib.vinci.be/opac_css/index.php?lvl=notice_display&id=83542
in Journal of Emergency Nursing > Vol. 44, n°1 (January 2018) . - p. 46-51[article]
Titre : Parental Knowledge and Recall of Concussion Discharge Instructions Type de document : Article Auteurs : Danny George Thomas ; Lia Bradley ; Suzanne Reilly ; [et al.] Année de publication : 2018 Article en page(s) : p. 52-56 Langues : Anglais (eng) Descripteurs : HE Vinci
Adolescent ; Commotion cérébrale ; Education thérapeutiqueMots-clés : État des connaissances des parents Éducation thérapeutique des parents Unité hospitalière d'urgences Résumé : Introduction
Children increasingly are being seen in the emergency department for a concussion, or mild traumatic brain injury (mTBI). A key aim of the ED visit is to provide discharge advice that can help parents to identify an evolving neurosurgical crisis, facilitate recovery, and prevent reinjury. The present study examined parents’ knowledge of symptoms and recall of discharge instructions after their adolescent’s mTBI and the effect of supplementing written discharge instructions with verbal instruction and reinforcement.
Methods
We performed a nested observational study of parents/caregivers of patients who participated in a larger mTBI study. After their adolescent’s mTBI, parents were given verbal and standardized written instructions. The ED discharge process was observed using a structured checklist, and parents were surveyed 3 days after discharge on knowledge and recall of discharge instructions.
Results
Ninety-three parents completed the postsurvey. Nearly 1 in 5 parents were confused about when to return to the emergency department after evaluation for head injury. Up to 1 in 4 parents could not recall specific discharge advice related to concussion. Parents who received verbal reinforcement of written discharge instructions were more likely to recall them.
Conclusion
Emergency nurses and clinicians should strive to utilize both verbal and written discharge instructions with families to help increase understanding. Image 1
Contribution to Emergency Nursing Practice
•Nearly 1 in 5 parents were confused about when to return to the emergency department after their child was evaluated for a head injury.
•Up to 1 in 4 parents could not recall specific discharge advice related to concussion.
•Verbal discharge instructions from emergency nurses increased parent recall and knowledge of concussion discharge instructions.Disponible en ligne : Non Permalink : https://bib.vinci.be/opac_css/index.php?lvl=notice_display&id=83549
in Journal of Emergency Nursing > Vol. 44, n°1 (January 2018) . - p. 52-56[article]
Titre : Comparison of Temporal Artery Versus Rectal Temperature in Emergency Department Patients Who Are Unable to Participate in Oral Temperature Assessment Type de document : Article Auteurs : Carmen Brosinski ; Sherwin Valdez ; Autumn Riddell ; [et al.] Année de publication : 2018 Article en page(s) : p. 57-63 Langues : Anglais (eng) Descripteurs : HE Vinci
Gérontologie ; Pédiatrie ; Soins d'urgence ; Temperature ; ThermomètreMots-clés : Artères temporales Température rectale Prise de température Unité hospitalière d'urgences Résumé : Introduction
In the emergency department, pediatric and geriatric patients who present with illnesses and are unable to participate in oral evaluation of temperature must undergo a rectal temperature (RT) assessment. This study asks if a temporal artery temperature (TAT) measure can supplant the RT measure.
Methods
A convenience sample, using a within-subject design, was used to evaluate the efficacy of TAT compared with RT in patients ≤ 3 and ≥ 65 years of age, who were unable to participate in oral temperature assessments.
Results
Instrument reliability of the TAT is adequate for both the pediatric and geriatric populations. An unadjusted TAT did not provide acceptable temperature measurements. We also found that adjusting a TAT reading by adding -17.22°C (1° F) rendered the TAT average (either mean or median) adequately similar to RT averages for research purposes for both pediatric and geriatric groups.
Discussion
No influence was detected on the differences between RT and TAT due to age, sex, or emergency severity index (ESI) score in patients or due to profession, years of education, or years of experience in caregivers for either the pediatric or geriatric groups. Furthermore, the adjusted TAT reading could detect fever in individual patients adequately in both the pediatric and geriatric groups. However, the adjusted TAT readings were too frequently divergent from RT readings to be used to measure temperature in individual patients for both pediatric and geriatric groups. Image 1
Contribution to Emergency Nursing Practice
●Temporal artery temperature (TAT) readings used for patients presenting to the emergency department must be adjusted and used with caution and attention to their limitations.
○Adjusted TAT readings should not be used with patients for whom an accurate reading is imperative for clinical decision making.
○Adjusted TAT readings may be used to detect fever.
○Group average adjusted TAT readings may be used in research.Disponible en ligne : Non Permalink : https://bib.vinci.be/opac_css/index.php?lvl=notice_display&id=83550
in Journal of Emergency Nursing > Vol. 44, n°1 (January 2018) . - p. 57-63[article]
Titre : The Unexpected Death of a Child and The Experience of Emergency Service Personnel Type de document : Article Auteurs : Julie Lindsay ; Diane Heliker Année de publication : 2018 Article en page(s) : p. 64-70 Langues : Anglais (eng) Descripteurs : HE Vinci
Enfant (6-12 ans) ; Mort ; Pédiatrie ; Stress psychologique ; Vécu du soignantMots-clés : Service hospitalier d'urgences Résumé : Introduction
In 2013, 55,000 infants and children, aged 0 to 14, died in the United States. Nearly 7,000 of those deaths were attributed to traumatic causes. A child’s death significantly affects emergency service personnel (ESP) caring for children and families. This study explores the lived experience of ESP involved in unsuccessful pediatric resuscitation efforts and how this experience affects them professionally and personally.
Methods
A phenomenologic approach guided this study. Using an open-ended format, an interview was conducted with a purposive sample of ESP who experienced unexpected pediatric death. Eight ESP participated in semistructured, face-to-face interviews, ranging in length from 35 to 75 minutes. The research question asked: “What is it like for you when a child dies after an unsuccessful resuscitation attempt?” Data were analyzed using thematic analysis.
Results
Van Manen’s 4 existentials guided this study, and 10 subthemes emerged that included: “what if,” “dying before my eyes,” “team,” “what if it was were my child?/being a parent,” “the environment,” “being trapped,” “wounded healer,” “education,” “anger,” and “coping.”
Discussion
This study explores the experience of ESP involved in unsuccessful pediatric resuscitation that resulted in unexpected pediatric death and ESP’s perceptions of this experience: thoughts of loss, a sense of anger, and a lack of preparation to cope with unexpected pediatric death and the unknowns of life. Image 1
Contributions to Emergency Practice
•The experience of dealing with unexpected pediatric death after unsuccessful resuscitations has a profound effect on emergency health care providers, personally and professionally.
•There is a pressing need for continuing ongoing education on pediatric end-of-life issues.
•Follow-up services would help with the grief emergency health care providers experience after the unexpected death of a child.Disponible en ligne : Non Permalink : https://bib.vinci.be/opac_css/index.php?lvl=notice_display&id=83551
in Journal of Emergency Nursing > Vol. 44, n°1 (January 2018) . - p. 64-70[article]
Paru le : 01/11/2017
|
Dépouillements
Ajouter le résultat dans votre panier
Titre : Nursing Code of Ethics: Provisions and Interpretative Statements for Emergency Nurses Type de document : Article Auteurs : Diane Gurney ; Gordon L. Gillepsie ; [et al.] Année de publication : 2017 Article en page(s) : p. 497-503 Langues : Anglais (eng) Descripteurs : HE Vinci
Ethique ; Soins
Autres descripteurs
codeRésumé : Integral to any discipline is its ethical foundation for practice. The American Nurses Association (ANA) describes the Nursing Code of Ethics as the non-negotiable ethical standard of the nursing profession,1 serving as an expression of nursing’s commitment to society. The code consists of 9 provisions with interpretative statements (herein italicized under each provision). Each interpretative statement is followed by an explication of its relationship to emergency nursing’s ethical values and professional obligations. Disponible en ligne : Non Permalink : https://bib.vinci.be/opac_css/index.php?lvl=notice_display&id=82740
in Journal of Emergency Nursing > Vol. 43, n°6 (November 2017) . - p. 497-503[article]Exemplaires (2)
Cote Support Localisation Section Disponibilité REV Périodique papier Woluwe périodiques Consultation sur place uniquement
Exclu du prêtREV Périodique papier Woluwe périodiques Consultation sur place uniquement
Exclu du prêt
Titre : West Nile Encephalitis in the Emergency Department: Prevalence and Recognition Type de document : Article Auteurs : Andrea Pallares C. ; Elizabeth J. Winokur Année de publication : 2017 Article en page(s) : p. 506-511 Langues : Anglais (eng) Descripteurs : HE Vinci
Infections ; Pratique infirmière avancée ; Présentations de cas ; Soins infirmiers ; VirusMots-clés : Symptome West Wile Résumé : •This article explores the prevalence and significance of West Nile virus encephalitis across the United States.
•The signs and symptoms of West Nile virus neuroinvasive infection in the emergency department are described.
•The primary prevention of West Nile Virus infections among patients seeking care in the emergency department is detailed.Disponible en ligne : Non Permalink : https://bib.vinci.be/opac_css/index.php?lvl=notice_display&id=82741
in Journal of Emergency Nursing > Vol. 43, n°6 (November 2017) . - p. 506-511[article]Exemplaires (2)
Cote Support Localisation Section Disponibilité REV Périodique papier Woluwe périodiques Consultation sur place uniquement
Exclu du prêtREV Périodique papier Woluwe périodiques Consultation sur place uniquement
Exclu du prêt
Titre : Achieving the Institute of Medicine’s 6 Aims for Quality in the Midst of the Opioid Crisis : Considerations for the Emergency Department Type de document : Article Auteurs : Daria L. Waszak ; Laura A. Fennimore Année de publication : 2017 Article en page(s) : p. 512-518 Langues : Anglais (eng) Descripteurs : HE Vinci
Analgésiques morphiniques ; Présentations de cas ; Service d'aide médicale urgenteMots-clés : Jessie grub Résumé : The health care community is inundated with news and data about the opiod crisis. One tragic example of an opioid overdose death is the story of Jessie Grub. She was a recovering heroin addict in Michigan who underwent hip surgery in febuary 2016 in preparation for running a marathon. Disponible en ligne : Non Permalink : https://bib.vinci.be/opac_css/index.php?lvl=notice_display&id=82757
in Journal of Emergency Nursing > Vol. 43, n°6 (November 2017) . - p. 512-518[article]Exemplaires (2)
Cote Support Localisation Section Disponibilité REV Périodique papier Woluwe périodiques Consultation sur place uniquement
Exclu du prêtREV Périodique papier Woluwe périodiques Consultation sur place uniquement
Exclu du prêt
Titre : Kick the Bucket: One Hospital System’s Journey to Reduce Clostridium Difficile Type de document : Article Auteurs : Molly B. Delaney Année de publication : 2017 Article en page(s) : p. 519-525 Langues : Anglais (eng) Descripteurs : HE Vinci
Clostridium ; Diarrhée ; Equipement ; Infections ; Maladie iatrogeneRésumé : Problem
Albert Einstein defines insanity as doing the same thing over again but expecting different results. Although the United States claims to reduce antibiotic abuse, practice strict isolation, and clean meticulously, the burden of Clostridium difficile outpaces goals. Unless innovative approaches are tried, we risk culling elderly, immunosuppressed, and otherwise debilitated populations. Emergency departments are a primary access point for patients who are unable to wait for primary care. As a result, many patients with diarrhea are seen in emergency departments.
Methods
This article describes one hospital system’s quality improvement trial of disposable commode pails (DCPs) for high-acuity patients in 3 of 5 institutions. The rationale was to prevent staff from touching surfaces heavily contaminated with C difficile. Staff members were not to wash or reuse commode buckets between patients. Instead, DCPs were substituted, and only the commode chairs were wiped. For quantitative date, C difficile infections (CDIs) were compared across hospitals. Staff members were surveyed for qualitative data.
Results
According to Survey Monkey, the rate of employee satisfaction with the new process was 95%. Fewer sewage backups resulted because nonbiodegradable wipes were disposed inside DCPs rather than in toilets or hoppers. Implementation and product costs were justified through labor savings and a reduced incidence of CDIs. CDI improvements were noted in system hospital emergency departments that used DCPs. Moreover, in one hospital that used DCPs in all nursing units for 1 year, CDI rates were reduced by 32%.
Implications for Practice
Third-party hospital laboratories generated all CDI data, which reduced bias. However, laboratories were unable to stratify CDIs as inpatient and outpatient in origin. More research is recommended with larger ED patient sample sizes.Disponible en ligne : Non Permalink : https://bib.vinci.be/opac_css/index.php?lvl=notice_display&id=82758
in Journal of Emergency Nursing > Vol. 43, n°6 (November 2017) . - p. 519-525[article]Exemplaires (2)
Cote Support Localisation Section Disponibilité REV Périodique papier Woluwe périodiques Consultation sur place uniquement
Exclu du prêtREV Périodique papier Woluwe périodiques Consultation sur place uniquement
Exclu du prêt
Titre : Implementation of Human Trafficking Education and Treatment Algorithm in the Emergency Department Type de document : Article Auteurs : Amber Egyud ; Kimberly Stephens ; [et al.] Année de publication : 2017 Article en page(s) : p. 526-532 Langues : Anglais (eng) Descripteurs : HE Vinci
Education ; Intervention de sauvetage ; Méthodes ; Personnel de santé ; Trafic d'êtres humainsRésumé : Problem
Health care professionals have not been successful in recognizing or rescuing victims of human trafficking. The purpose of this project was to implement a screening system and treatment algorithm in the emergency department to improve the identification and rescue of victims of human trafficking. The lack of recognition by health care professionals is related to inadequate education and training tools and confusion with other forms of violence such as trauma and sexual assault.
Methods
A multidisciplinary team was formed to assess the evidence related to human trafficking and make recommendations for practice. After receiving education, staff completed a survey about knowledge gained from the training. An algorithm for identification and treatment of sex trafficking victims was implemented and included a 2-pronged identification approach: (1) medical red flags created by a risk-assessment tool embedded in the electronic health record and (2) a silent notification process. Outcome measures were the number of victims who were identified either by the medical red flags or by silent notification and were offered and accepted intervention.
Results
Survey results indicated that 75% of participants reported that the education improved their competence level. The results demonstrated that an education and treatment algorithm may be an effective strategy to improve recognition. One patient was identified as an actual victim of human trafficking; the remaining patients reported other forms of abuse.
Implications for Practice
Education and a treatment algorithm were effective strategies to improve recognition and rescue of human trafficking victims and increase identification of other forms of abuse.Disponible en ligne : Non Permalink : https://bib.vinci.be/opac_css/index.php?lvl=notice_display&id=82759
in Journal of Emergency Nursing > Vol. 43, n°6 (November 2017) . - p. 526-532[article]Exemplaires (2)
Cote Support Localisation Section Disponibilité REV Périodique papier Woluwe périodiques Consultation sur place uniquement
Exclu du prêtREV Périodique papier Woluwe périodiques Consultation sur place uniquement
Exclu du prêt
Titre : Interprofessional Collaboration to Improve Sepsis Care and Survival Within a Tertiary Care Emergency Department Type de document : Article Auteurs : Elizabeth R. Tedesco ; K. Whiteman ; [et al.] Année de publication : 2017 Article en page(s) : p. 532-538 Langues : Anglais (eng) Descripteurs : HE Vinci
Algorithmes ; Infections ; Méthodes ; SepsieMots-clés : Pratique factuelle Amélioration de la qualité Résumé : Problem
Sepsis is a leading cause of death in the United States; however, health care providers struggle with timely recognition, diagnosis, and treatment of patients. Both the Centers for Medicare and Medicaid Services and the National Quality Forum have identified this diagnosis as a priority. Presently, many patients with sepsis are identified late, resulting in significant morbidity and death.
Methods
In this project, a collaborative, interprofessional approach was created for screening and early identification of ED patients with possible sepsis. The department has 38 beds with annual patient volumes of more than 40,000 visits. Education was provided about the symptoms and treatment of patients with sepsis. A screening and management algorithm tool was instituted that consisted of early identification triggers and how to intervene according to Surviving Sepsis Campaign recommendations. The tool allowed for assessment of the patient by the ED team; the team worked to determine if sepsis was present and the extent of the illness.
Results
During the first 4 months after implementation, more than 240 patients were screened, assessed, and treated according to the algorithm. Project outcomes resulted in an increase in staff knowledge of sepsis, a decrease in length of stay by 3 hours, and a significant decrease in mortality when compared with the previous year’s coded data.
Implications for Practice
This project demonstrates that sepsis education and team collaboration are an integral part of identifying and treating patients with sepsis. An interprofessional collaborative approach could be implemented in other institutions to combat the life-threatening complications of sepsis. Image 1
Contribution to Emergency Nursing Practice
•Building an interprofessional collaborative team around a disease-specific process, such as sepsis, was a successful strategy for solving a complex clinical problem.
•Creating and utilizing a sepsis management tool to guide practice for emergency department health care providers was the key to success.
•Implementing care in the emergency department according to the Surviving Sepsis Campaign recommendations improved patient outcomes.Disponible en ligne : Non Permalink : https://bib.vinci.be/opac_css/index.php?lvl=notice_display&id=82760
in Journal of Emergency Nursing > Vol. 43, n°6 (November 2017) . - p. 532-538[article]Exemplaires (2)
Cote Support Localisation Section Disponibilité REV Périodique papier Woluwe périodiques Consultation sur place uniquement
Exclu du prêtREV Périodique papier Woluwe périodiques Consultation sur place uniquement
Exclu du prêt
Titre : Hardiness Mediates Stress and Impact Level in ED Nurses Who Experienced a Violent Event Type de document : Article Auteurs : Jin H. Park ; Eun N. Lee ; [et al.] Année de publication : 2017 Article en page(s) : p. 539-544 Langues : Anglais (eng) Descripteurs : HE Vinci
étude scientifique ; Experimentation ; Stress ; ViolenceMots-clés : Hardiness Résumé : Introduction
This secondary analysis examined the mediating effect of hardiness between stress and impact level in ED nurses who experienced a violent event.
Method
This correlational study was conducted from June to August 2014. We used the visual analog scale to measure stress level, the Impact of Event Scale–Revised to measure impact level after the violent event, and the Dispositional Resilience Scale to measure hardiness. We then analyzed mediating effects with the Sobel test. Data were collected in 31 emergency medical centers located in B city in Korea. Data from 321 ED nurses who experienced a violent event were analyzed. Most nurses (91.9%) were women, with a mean age of 28.73 years. The main outcome measure was the mediating effect of hardiness between stress and impact level after ED nurses experienced violence.
Results
We found that both violence-related stress (B = 0.22, P Discussion
Hardiness had an effect on reducing the impact level of ED nurses who had experienced a violent event and had a mediating role in mitigating their stress. Therefore, we recommend the development of an intervention program that emphasizes the improvement of hardiness in ED nurses. Image 1
Contribution to Emergency Nursing Practice
•This research shows the impact level of violence in the emergency department on ED nurses and indicates that this level of impact could be decreased depending upon personal hardiness.
•This study result can be used as fundamental data for an intervention program to improve the hardiness of nurses who have experienced violence in the emergency department.Disponible en ligne : Non Permalink : https://bib.vinci.be/opac_css/index.php?lvl=notice_display&id=82761
in Journal of Emergency Nursing > Vol. 43, n°6 (November 2017) . - p. 539-544[article]Exemplaires (2)
Cote Support Localisation Section Disponibilité REV Périodique papier Woluwe périodiques Consultation sur place uniquement
Exclu du prêtREV Périodique papier Woluwe périodiques Consultation sur place uniquement
Exclu du prêt
Titre : Occupational Disappointment: Why Did I Even Become a Nurse? Type de document : Article Auteurs : Rebekah J. Howerton child ; Elizabeth J. Sussman Année de publication : 2017 Article en page(s) : p. 545-552 Langues : Anglais (eng) Descripteurs : HE Vinci
Soins infirmiers ; Théorie ; Urgences ; ViolenceMots-clés : Lieu de travail Théorie ancrée Déception professionnelle Résumé : Introduction
The aim of this study was to identify patterns of feelings and behavior of ED RNs who have experienced verbal workplace violence.
Methods
Twenty-eight registered nurses from across the state of California were recruited. Data were collected, using in-depth interviews, and were recorded. The tapes were transcribed and analyzed using Glaserian grounded-theory methodology.
Results
The main experiences of participants included occupational disappointment, peer support, lack of preparation by mandatory violence prevention classes, and unrealistic patient expectations.
Discussion
These findings can help staff, managers, and future educators of ED RNs examine feelings, mitigate the profound and pervasive effects of VWPV, and improve patient care.
Contribution to Emergency Practice:
•This research is new, as—to the researchers’ knowledge—very little research using grounded-theory methodology has been done about verbal workplace violence (VWPV) in emergency departments in the United States.
•Although the emergency nursing society is well aware of the problem of workplace violence, this study illuminates some new and interesting themes that will contribute information to the practice of emergency nursing. These themes include occupational disappointment and specific personality types that can prevent or de-escalate workplace violence.
•Translation of this article’s findings to emergency nursing practice includes discussing occupational disappointment with both new and seasoned nurses. Protective and causative factors should be identified internally and addressed as needed.
•Identifying specific personality types among staff members might be useful in protecting nurses from the deleterious effects of VWPV.
•Emergency departments need consistently to evaluate and re-evaluate mandatory violence prevention courses that are provided by hospitals and that ensure nurses are being provided “real time” tools for proper management of VWPV.Disponible en ligne : Non Permalink : https://bib.vinci.be/opac_css/index.php?lvl=notice_display&id=82762
in Journal of Emergency Nursing > Vol. 43, n°6 (November 2017) . - p. 545-552[article]Exemplaires (2)
Cote Support Localisation Section Disponibilité REV Périodique papier Woluwe périodiques Consultation sur place uniquement
Exclu du prêtREV Périodique papier Woluwe périodiques Consultation sur place uniquement
Exclu du prêt
Titre : Influences on Patient Satisfaction Among Patients Who Use Emergency Departments Frequently for Pain-Related Complaints Type de document : Article Auteurs : Patricia Newcomb ; Marian Wilson ; [et al.] Année de publication : 2017 Article en page(s) : p. 553-559 Langues : Anglais (eng) Descripteurs : HE Vinci
Analgésiques morphiniques ; Douleur ; Infirmières et infirmiers ; Médecins ; Patients ; Satisfaction ; UrgencesRésumé : Introduction
The primary purpose of this study was to assess relationships between opioid prescribing practices, patient and ED attributes, and patient satisfaction ratings of nursing and physician care among patients with high utilization of the emergency department for pain relief.
Methods
A retrospective cohort study was conducted to examine 305 individual patient satisfaction surveys from users with high ED utilization for pain complaints. Responses were compared with an age-matched control group (n = 305) of nonfrequent ED users. Patient satisfaction survey responses and electronic medical records were used to model relationships between patient satisfaction and predictor variables.
Results
ED frequent users with pain complaints were 75% less likely to return a satisfaction survey compared with other patients (odds ratio = 0.2488; P Discussion
Emergency nurses can influence patient satisfaction scores by promoting clean, caring environments and prioritizing patient flow and pain management. ED providers can withhold opioids when appropriate without fear of a significant impact on patient satisfaction. Image 1
Contribution to Emergency Nursing Practice
•Patient satisfaction with nursing care in the emergency department overall is dependent on wait time, precautions taken to protect patient safety, ability of staff to convey that they care about the patient as a person, and compassion shown by caregivers.
•Patient satisfaction with physicians is more dependent on ED cleanliness, pain control, wait time, and satisfaction with nursing care than on prescriptions for medication.
•Nurses can advocate for ED pain management protocols that align with best practices to limit opioid use without fear of poor patient satisfaction.
•Caring, clean, efficient ED environments are linked to improved patient satisfaction.Disponible en ligne : Non Permalink : https://bib.vinci.be/opac_css/index.php?lvl=notice_display&id=82763
in Journal of Emergency Nursing > Vol. 43, n°6 (November 2017) . - p. 553-559[article]Exemplaires (2)
Cote Support Localisation Section Disponibilité REV Périodique papier Woluwe périodiques Consultation sur place uniquement
Exclu du prêtREV Périodique papier Woluwe périodiques Consultation sur place uniquement
Exclu du prêt
Titre : Emergency Nurse Competence in Electrocardiographic Interpretation in Spain : A Cross-Sectional Study Type de document : Article Auteurs : Marina Coll-Badell ; Maria F. Jimenez-Herrera ; [et al.] Année de publication : 2017 Article en page(s) : p. 560-570 Langues : Anglais (eng) Descripteurs : HE Vinci
Electrocardiographie ; Espagne ; Infirmières et infirmiers ; Savoir-faire ; Soins infirmiers ; UrgencesRésumé : Introduction
Electrocardiographic interpretation skills are key to provide a fast attention to patients with thoracic pain. The aim of the study was to determine the current level of competence in electrocardiographic interpretation of nurses in emergency departments.
Methods
Cross-sectional, multicenter study via an ad hoc questionnaire. Subjects were nurses from three Spanish emergency departments with at least a year experience in this area. A two-part questionnaire was created consisting of a professional profile, and 12 questions (2 theoretical questions and 10 questions on practical cases with electrocardiographic register [readout]). A pilot test was carried out to evaluate the validity of the questionnaire, the content validity index. The reliability of the questionnaire was also tested on a subsample through intraclass correlation coefficient with a value of 0.869 (CI 95% 0.712-0.941). Descriptive and bivariate analyses were conducted using an independent t-test or one-way ANOVA as appropriate. A statistical significance of P Results
Fifty-seven usable questionnaires were obtained (47.2% response rate). Women comprised 84.2% of the sample and the mean age of the sample was 40.5 (SD = 9.3) years. Slightly more than 91% had taken electrocardiographic interpretation training courses, the main modality for which was face-to-face (84.2%). The average score on our questionnaire was 8.6 (SD=1.1) points. No significant differences between nursing experience and hospitals were observed. Nurses who had received training within the previous five years scored significantly higher than those who had not (P = .031).
Discussion
The electrocardiographic knowledge of emergency nurses is high. Level of knowledge was not influenced by experience or hospital but was influenced by training when provided in the previous 5 years. Therefore, refreshing courses should be taken at least every 5 years.
Contribution to Emergency Nursing Practice:
•Refresher courses in electrocardiography should be run at least every 5 years.
•Recognizing the most relevant pathologies in the electrocardiogram (ECG) is the key to hastening patient care.
•Nurses are the first step in patient care. To provide patients with the best care possible, nurses need to be highly competent in recognizing alarming symptoms.Disponible en ligne : Non Permalink : https://bib.vinci.be/opac_css/index.php?lvl=notice_display&id=82764
in Journal of Emergency Nursing > Vol. 43, n°6 (November 2017) . - p. 560-570[article]Exemplaires (2)
Cote Support Localisation Section Disponibilité REV Périodique papier Woluwe périodiques Consultation sur place uniquement
Exclu du prêtREV Périodique papier Woluwe périodiques Consultation sur place uniquement
Exclu du prêt
Titre : Oncology Emergency Department: A Nurse Practitioner Care Model Type de document : Article Auteurs : Barbara Beck Année de publication : 2017 Article en page(s) : p. 575-583 Langues : Anglais (eng) Descripteurs : HE Vinci
Chimiothérapie ; Modélisation ; Oncologie médicale ; TumeursRésumé : As of January 1, 2017, there were 15.5 million Americans living with cancer or currently undergoing treatment after a diagnosis of cancer.1 At our institution, patients who have cancer present to the hospital with high acuity and high rates of admission; often, 60% to 70% are admitted from our emergency department, as opposed to the 25% to 30% of patients who do not have cancer. Sixty percent of these patients with cancer have Emergency Severity Index (ESI) triage levels of 2 or higher, and 5% of our patients will receive new or suspected diagnoses of cancer in the emergency department. Disponible en ligne : Non Permalink : https://bib.vinci.be/opac_css/index.php?lvl=notice_display&id=82765
in Journal of Emergency Nursing > Vol. 43, n°6 (November 2017) . - p. 575-583[article]Exemplaires (2)
Cote Support Localisation Section Disponibilité REV Périodique papier Woluwe périodiques Consultation sur place uniquement
Exclu du prêtREV Périodique papier Woluwe périodiques Consultation sur place uniquement
Exclu du prêt
Titre : A Toddler With Severe Anemia, Pica, and Extremity Swelling Type de document : Article Auteurs : Mary Frey ; Kevin M. Overmann ; Alison Richert ; [et al.] Année de publication : 2017 Article en page(s) : p. 578-580 Langues : Anglais (eng) Descripteurs : HE Vinci
Anémie ; Hemoglobine ; Oedeme cerebral ; Présentations de casRésumé : A 20-month-old, previously healthy boy was referred to the pediatric emergency department (PED) for acute anemia. On the day of presentation, the child’s parents noted foot swelling, prompting a pediatrician visit. Office evaluation identified a hemoglobin level of 1.9 g/dL Disponible en ligne : Non Permalink : https://bib.vinci.be/opac_css/index.php?lvl=notice_display&id=82766
in Journal of Emergency Nursing > Vol. 43, n°6 (November 2017) . - p. 578-580[article]Exemplaires (2)
Cote Support Localisation Section Disponibilité REV Périodique papier Woluwe périodiques Consultation sur place uniquement
Exclu du prêtREV Périodique papier Woluwe périodiques Consultation sur place uniquement
Exclu du prêt
Titre : Child Human Trafficking: See, Pull, Cut the Threads of Abuse Type de document : Article Auteurs : Patricia A. Normandin Année de publication : 2017 Article en page(s) : p. 588-590 Langues : Anglais (eng) Descripteurs : HE Vinci
Enfant (6-12 ans) ; Enfant maltraité ; Santé ; Thérapeutique ; Trafic d'êtres humains ; ViolenceRésumé : Human trafficking is a hidden global public health epidemic among children and adults. Childhood should be a time of innocence, play, love, and security, but for some children it is not. Children victimized by human traffickers need to be identified when they enter emergency departments. Accurate human trafficking statistics are hard to find because of the hidden and illegal nature of this exploitation. It is estimated that there are more than 20 million victims of human trafficking globally, and more than 5 million are children. Disponible en ligne : Non Permalink : https://bib.vinci.be/opac_css/index.php?lvl=notice_display&id=82767
in Journal of Emergency Nursing > Vol. 43, n°6 (November 2017) . - p. 588-590[article]Exemplaires (2)
Cote Support Localisation Section Disponibilité REV Périodique papier Woluwe périodiques Consultation sur place uniquement
Exclu du prêtREV Périodique papier Woluwe périodiques Consultation sur place uniquement
Exclu du prêt
Exemplaires (2)
| Cote | Support | Localisation | Section | Disponibilité |
|---|---|---|---|---|
| REV | Périodique papier | Woluwe | périodiques | Consultation sur place uniquement Exclu du prêt |
| REV | Périodique papier | Woluwe | périodiques | Consultation sur place uniquement Exclu du prêt |
Paru le : 01/09/2017
|
Dépouillements
Ajouter le résultat dans votre panier
Titre : When Advanced Cardiac Life Support Isn't Enough Type de document : Article Auteurs : Molly B. Delaney Année de publication : 2017 Article en page(s) : p. 393-399 Langues : Anglais (eng) Descripteurs : HE Vinci
Etats-Unis ; Financement ; Maladies cardiovasculaires ; Mortalité ; ProtocoleMots-clés : Soins avancés de maintien des fonctions vitales Résumé : Heart disease is the leading cause of death in the United States. Approximately 1 of every 4 American deaths is heart related according to the Centers for Disease Control and Prevention.1 Cardiac arrest standards of care—that is, early defibrillation, cardiopulmonary resuscitation (CPR), advanced cardiac life support (ACLS), cardiac catheterization laboratory (CCL) access, and targeted temperature management—may not be enough. Australia and Denmark are improving resuscitation rates for dysrhythmia patients with ventricular fibrillation (VF) and ventricular tachycardia (VT) by adding complex modalities Disponible en ligne : Non Permalink : https://bib.vinci.be/opac_css/index.php?lvl=notice_display&id=81741
in Journal of Emergency Nursing > Vol. 43, n°5 (September 2017) . - p. 393-399[article]Exemplaires (1)
Cote Support Localisation Section Disponibilité REV Périodique papier Woluwe périodiques Consultation sur place uniquement
Exclu du prêt
Titre : Understanding Advance Care Documents: What the Nurse Advocate Needs to Know Type de document : Article Auteurs : Erika Kellogg Année de publication : 2017 Article en page(s) : p. 400-405 Langues : Anglais (eng) Descripteurs : HE Vinci
Compréhension ; DocumentationMots-clés : Infirmière avocate Planification anticipée des soins Unité de soins d'urgence Résumé : The emergency department is a specialty care area where lifesaving interventions are implemented daily for those with immediate health care needs. Recent changes in the ED environment, such as an increase in patient census, ED crowding, treatment challenges related to increasing comorbidities, and rising patient-to-nurse ratios have led emergency health professionals to encounter new and more complicated obstacles in providing patient care.1 Disponible en ligne : Non Permalink : https://bib.vinci.be/opac_css/index.php?lvl=notice_display&id=81742
in Journal of Emergency Nursing > Vol. 43, n°5 (September 2017) . - p. 400-405[article]Exemplaires (1)
Cote Support Localisation Section Disponibilité REV Périodique papier Woluwe périodiques Consultation sur place uniquement
Exclu du prêt
Titre : Evaluation of a Nurse-Initiated Acute Gastroenteritis Pathway in the Pediatric Emergency Department Type de document : Article Auteurs : Carson A. Rebecca ; Shawna S. Mudd ; Jamil P. Madati ; [et al.] Année de publication : 2017 Article en page(s) : p. 406-412 Langues : Anglais (eng) Descripteurs : HE Vinci
Evaluation ; Evidence-based nursing ; Gastroenterite ; Infirmiere d'urgence ; PédiatrieMots-clés : Unité de soins d'urgence Résumé : Problem
Acute gastroenteritis (AGE) is a common illness treated in the emergency department. Delays in initiating rehydration for children with mild or moderate dehydration from AGE can lead to prolonged ED visits and increased resource utilization that do not provide prognostic value or support family-centered care. The purpose of this quality improvement project was to promote early oral rehydration therapy (ORT) for persons with AGE in an attempt to reduce unnecessary resource utilization and length of stay (LOS).
Methods
This prospective quality improvement project used a nurse-initiated waiting room ORT pathway for patients 6 months to 21 years of age who presented to the emergency department with diarrhea with or without vomiting. Outcomes related to nurse-initiated ORT, intravenous fluid use, laboratory studies or diagnostic imaging, and LOS were measured before and after implementation.
Results
Of 643 patients for whom the pathway was initiated, 392 received nurse-initiated care. The proportion of intravenous fluid use was 10.2% lower (odds ratio [OR], 0.43; 95% confidence interval [CI], 0.27-0.68) and laboratory test ordering was 7.4% lower (OR, 0.64; 95% CI, 0.43-0.94) in patients receiving nurse-initiated care. Time to discharge after provider examination was 46 minutes faster in the nurse-initiated care group (P Implications for Practice
Nurse autonomy in using an AGE pathway facilitates evidence-based practice, improves ED efficiency, and decreases resource utilization and LOS. Future research should focus on family satisfaction and ED revisits within 72 hours of discharge.Disponible en ligne : Non Permalink : https://bib.vinci.be/opac_css/index.php?lvl=notice_display&id=81743
in Journal of Emergency Nursing > Vol. 43, n°5 (September 2017) . - p. 406-412[article]Exemplaires (1)
Cote Support Localisation Section Disponibilité REV Périodique papier Woluwe périodiques Consultation sur place uniquement
Exclu du prêt
Titre : A Full-Capacity Protocol Allows for Increased Emergency Patient Volume and Hospital Admissions Type de document : Article Auteurs : Erin Williard ; Elizabeth F. Carlton ; Lindsay Moffat ; [et al.] Année de publication : 2017 Article en page(s) : p. 413-418 Langues : Anglais (eng) Descripteurs : HE Vinci
Déclaration d'admission ; Efficacité ; Hôpitaux ; Protocole ; Soins d'urgenceMots-clés : Augmentation du volume d'admission Résumé : Problem
Our hospital was encountering problems with ED crowding. We sought to determine the impact of implementing a full-capacity protocol to respond to anticipated or actual crowding conditions. Our full-capacity protocol is based on collaboration among multiple hospital units.
Methods
We completed a quality improvement initiative using a pre/post analysis of all ED patient encounters after implementing a full-capacity protocol with a corresponding period from the prior year. The principal outcomes measured were patient volume, admission rate, patient left without being seen (LWBS) rate, length of stay, and ambulance diversion hours.
Results
In the post–full-capacity protocol period, a 7.4% increase in emergency patient encounters (P Implications for Practice
The collaborative full-capacity protocol was effective in reducing LWBS and ambulance diversion, while accommodating a significant increase in ED volume and increased hospital admission rates at our institution.Disponible en ligne : Non Permalink : https://bib.vinci.be/opac_css/index.php?lvl=notice_display&id=81744
in Journal of Emergency Nursing > Vol. 43, n°5 (September 2017) . - p. 413-418[article]Exemplaires (1)
Cote Support Localisation Section Disponibilité REV Périodique papier Woluwe périodiques Consultation sur place uniquement
Exclu du prêt
Titre : Effect of Concentrated Psychiatric Education on Perceived Competence to Care for Behavioral Health Patients Type de document : Article Auteurs : Elizabeth J. Winokur ; Jeannine Loucks ; Dana N. Rutledge Année de publication : 2017 Article en page(s) : p. 419-425 Langues : Anglais (eng) Descripteurs : HE Vinci
Adaptation ; Compétence ; Education ; Infirmiere d'urgence ; Psychiatrie ; Soins d'urgence ; Troubles mentauxRésumé : Abstract Introduction
Increasing numbers of behavioral patients are presenting to emergency departments, where competency of staff to care for this group is unknown.
Methods
This pre-post study measured the effects of a 7-hour conference on perceived competency of nurses and allied health professionals to care for behavioral health (BH) patients, as measured by the 23-item Behavioral Health Care Competency (BHCC) survey.
Results
Of 102 participants, most were emergency nurses (72%), acute care nurses and case managers (20%), and allied health personnel (trauma technicians and paramedics) (8%). Before the conference, participants had moderate average perceived competency in caring for BH patients. BHCC scores differed significantly by job category, with emergency nurses scoring higher than did nonemergency nurses and allied health personnel. Overall competence of participants increased significantly after the conference. The effect size, as reflected by partial eta squared, was 0.265. Significant increases in scores from before to after the conference occurred for the total BHCC and 2 competencies: practice/intervention and resource adequacy.
Discussion
This study provides needed research demonstrating improved perceived competency of nurses and allied health professionals to care for BH patients in emergency departments after brief concentrated education. Improvements occurred despite the fact that participants had initial baseline competencies that were higher than those of general hospital nurses from a historical sample.Disponible en ligne : Non Permalink : https://bib.vinci.be/opac_css/index.php?lvl=notice_display&id=81745
in Journal of Emergency Nursing > Vol. 43, n°5 (September 2017) . - p. 419-425[article]Exemplaires (1)
Cote Support Localisation Section Disponibilité REV Périodique papier Woluwe périodiques Consultation sur place uniquement
Exclu du prêt
Titre : The Experience of Advanced Practice Nurses in US Emergency Care Settings Type de document : Article Auteurs : Lisa A. Wolf ; Altair M. Delao ; Cydne Perhats ; [et al.] Année de publication : 2017 Article en page(s) : p. 426-434 Langues : Anglais (eng) Descripteurs : HE Vinci
Education ; Etats-Unis ; Infirmiere d'urgence ; MéthodologieMots-clés : Pratique infirmière avancée Unité de soins d'urgence Résumé : Introduction
Little information has been published regarding the actual practice, training, and validation of basic skills and competencies needed by the advanced practice registered nurse (APRN) in the emergency care setting. The purpose of this study was to (1) identify skills being performed by APRNs practicing in emergency care settings (2); explore types of training; and (3) describe competency validation. Additionally, we explored frequency of skill use and facilitators and barriers to performing a skill to the full extent of training and education.
Methods
An exploratory mixed-methods study was performed incorporating a self-report survey and focus group interviews.
Results
The educational path to advanced practice nursing in emergency care settings is not standardized. Few programs incorporate or address the need for APRNs to receive acute care training across the life span, which is the hallmark of emergency nursing practice. Similarly, training is reported as fragmented, and validation of skills for both nurse practitioners and clinical nurse specialists can vary. APRN practice autonomy is affected by the presence of other providers (specifically physicians), institutional culture, and state boards of nursing that regulate practice.
Discussion
Integrated educational and orientation programs are needed that address high-acuity patients across the life span. Additionally, a more nuanced approach to assessing APRN capabilities as a combination of hard (clinical emergency) and soft (communication and organizational) skills may be an appropriate framework within which to examine the advanced practice role. Future research should continue to evaluate training, competency assessment, and outcomes for APRNs in the emergency care setting. Image 1Disponible en ligne : Non Permalink : https://bib.vinci.be/opac_css/index.php?lvl=notice_display&id=81746
in Journal of Emergency Nursing > Vol. 43, n°5 (September 2017) . - p. 426-434[article]Exemplaires (1)
Cote Support Localisation Section Disponibilité REV Périodique papier Woluwe périodiques Consultation sur place uniquement
Exclu du prêt
Titre : Using Simulation to Assess the Impact of Triage Interruptions Type de document : Article Auteurs : Kimberly D. Johnson ; Abeer Alhaj-Ali Année de publication : 2017 Article en page(s) : p. 435-443 Langues : Anglais (eng) Descripteurs : HE Vinci
Entretien ; Infirmiere d'urgence ; Rôle ; Simulation ; Soins d'urgence ; TriageMots-clés : Unité de soin d'urgence Résumé : Abstract
Introduction
Interruptions are common in the emergency department and contribute to catastrophic errors. Care priorities and acuity levels are assigned during triage, meaning that mistakes and omissions during the triage process could have detrimental effects on patients. The purpose of this project was to assess the feasibility of investigating the impact of interruptions on triage and the decision-making process in a simulated setting.
Methods
A 2-phase, sequential exploratory mixed method design was used. Nine nurses from 3 emergency departments in a Midwest area participated. A short demographic questionnaire was used to collect information about the nurses’ education and experience. The Emergency Severity Index (ESI) was used for triage categorization. Each participant completed 2 scenarios (one interrupted and one uninterrupted). After completion of the scenarios, video-simulated recall interviews were used to assess the simulation experience and the impact that interruptions had on the triage decision-making process.
Results
Triage time had a mean of 10 minutes and ranged between 4.34 minutes and 13.45 minutes. However, triage was significantly longer during the interrupted scenarios. Seventy-seven percent of the acuity assessments (ESI) were correct. Of the 18 scenarios, 3 uninterrupted scenarios had incorrect ESI scores, and one interrupted scenario had a missing acuity score.
Discussion
This study provides the basis for future work that looks at how nurses successfully manage interruptions and tests interventions to assist triage nurses in managing or reducing interruptions during this important patient assessment process. Image 1Disponible en ligne : Non Permalink : https://bib.vinci.be/opac_css/index.php?lvl=notice_display&id=81747
in Journal of Emergency Nursing > Vol. 43, n°5 (September 2017) . - p. 435-443[article]Exemplaires (1)
Cote Support Localisation Section Disponibilité REV Périodique papier Woluwe périodiques Consultation sur place uniquement
Exclu du prêt
Titre : Identifying Social-Behavioral Health Needs of Adults with Sickle Cell Disease in the Emergency Department Type de document : Article Auteurs : Sophia K. Smith ; J. Johnston ; Carlton Rutherford ; [et al.] Année de publication : 2017 Article en page(s) : p. 444-450 Langues : Anglais (eng) Descripteurs : HE Vinci
Adulte (19-44 ans) ; DrépanocytoseMots-clés : Orthopsychiatrie Unité de soins d'urgence Résumé : Abstract
Introduction
Sickle cell disease (SCD) is a complex illness with many social-behavioral co-morbidities. The aim of this project was to describe unmet social-behavioral health needs for adults with SCD who presented to the emergency department for treatment of vaso-occlusive episodes (VOEs).
Methods
A descriptive study using 1:1 interviews during an ED visit for a VOE was conducted; a brief social behavioral health screening interview guide was used. A convenience sample of adults with SCD treated in the emergency department for a VOE were eligible for inclusion.
Results
We conducted 147 interviews over 14 months. Patients reported transportation and/or scheduling difficulties with clinic appointments in one third of the interviews. Four major themes emerged: clinic appointment barriers, medication barriers, other care barriers, and social-behavioral issues. A majority of patients (53%) reported being brought to the emergency department by a family member at their current visit. Patients cited having insurance coverage issues in more than one quarter (27%) of the interviews. Difficulties in obtaining prescriptions were cited as a result of a financial copay (17%), transportation (11%), and pharmacy (9%) issues. Almost one third of patients (29%) reported feeling depressed, and 20% reported feeling anxious.
Discussion
Many patients with SCD who are treated in the emergency department have social or behavioral health risk factors. Emergency departments have an opportunity to screen and refer patients for follow-up. Future research should investigate referral outcomes and their effect on ED and hospital use.Disponible en ligne : Non Permalink : https://bib.vinci.be/opac_css/index.php?lvl=notice_display&id=81748
in Journal of Emergency Nursing > Vol. 43, n°5 (September 2017) . - p. 444-450[article]Exemplaires (1)
Cote Support Localisation Section Disponibilité REV Périodique papier Woluwe périodiques Consultation sur place uniquement
Exclu du prêt
Exemplaires (1)
| Cote | Support | Localisation | Section | Disponibilité |
|---|---|---|---|---|
| REV | Périodique papier | Woluwe | périodiques | Consultation sur place uniquement Exclu du prêt |
Paru le : 01/07/2017
|
Dépouillements
Ajouter le résultat dans votre panier
Titre : Compartment Syndrome : an Orthopedic Emergency Type de document : Article Auteurs : Michael H. Walls Année de publication : 2017 Article en page(s) : p. 303-307 Langues : Anglais (eng) Descripteurs : HE Vinci
Douleur ; Orthopédie ; Présentations de cas ; RadiographieMots-clés : Unité de soins d'urgence Résumé : The medic unit has notified the trauma emergency department that a 22-year-old male helmeted motorcyclist is en route after being struck on his left side by a motor vehicle at an intersection. The biker experienced a brief loss of consciousness and sustained multiple lacerations and abrasions. In his lower left leg, he reports a pain level of 9 on a 10-point scale. His vital signs are stable. The patient is slightly confused with a Glasgow Coma Scale score of 14/15. The remainder of his physical examination is essentially unremarkable. Disponible en ligne : Non Permalink : https://bib.vinci.be/opac_css/index.php?lvl=notice_display&id=81252
in Journal of Emergency Nursing > Vol. 43, n°4 (July 2017) . - p. 303-307[article]Exemplaires (1)
Cote Support Localisation Section Disponibilité REV Périodique papier Woluwe périodiques Consultation sur place uniquement
Exclu du prêt
Titre : When There is No Sexual Assault Nurse Examiner: Emergency Nursing Care for Female Adult Sexual Assault Patients Type de document : Article Auteurs : Destiny Capri Delgadillo Année de publication : 2017 Article en page(s) : p. 308-315 Langues : Anglais (eng) Descripteurs : HE Vinci
Communication ; Consentement ; Examen ; Présentations de casMots-clés : Unité de soins d'urgence Agression sexuelle Soutien émotionnel Résumé : Ms. L is a 29-year-old woman who arrives at the emergency department and reports that she was sexually assaulted 2 hours ago. She states that she was running on a trail near her home when a man appeared, wrestled her to the ground, and raped her. Disponible en ligne : Non Permalink : https://bib.vinci.be/opac_css/index.php?lvl=notice_display&id=81253
in Journal of Emergency Nursing > Vol. 43, n°4 (July 2017) . - p. 308-315[article]Exemplaires (1)
Cote Support Localisation Section Disponibilité REV Périodique papier Woluwe périodiques Consultation sur place uniquement
Exclu du prêt
Titre : Evidence-Based Practice : Video-Discharge Instructions in the Pediatric Emergency Department Type de document : Article Auteurs : Elyssa B. Wood ; Gina Harrison ; Heather Trickey ; [et al.] Année de publication : 2017 Article en page(s) : p. 316-321 Langues : Anglais (eng) Descripteurs : HE Vinci
Evidence-based nursing ; Interdisciplinarité ; Pédiatrie ; RecommandationsMots-clés : Unité de soins d'urgence Résumé : Problem
While a high quality discharge from a Pediatric Emergency Department helps caregivers feel informed and prepared to care for their sick child at home, poor adherence to discharge instructions leads to unnecessary return visits, negative health outcomes, and decreased patient satisfaction. Nurses at the Inova Loudoun Pediatric ED utilized the Johns Hopkins Model of Evidence Based Practice to answer the following question: Among caregivers who have children discharged from the ED, does the addition of video discharge instructions (VDI) to standard written/verbal discharge instructions (SDI) result in improved knowledge about the child's diagnosis, treatment, illness duration, and when to seek further medical care?
Methods
A multidisciplinary team reviewed available evidence and created VDI for three common pediatric diagnoses: gastroenteritis, bronchiolitis, and fever. Knowledge assessments were collected before and after delivery of discharge instructions to caregivers for both the SDI and VDI groups.
Results
Analysis found that the VDI group achieved significantly higher scores on the post test survey (P Implications for Practice
VDI offer nurses an efficient, standardized method of providing enhanced discharge instructions in the ED. Future projects will examine whether VDI are effective for additional diagnoses and among caregivers for whom English is not the primary language.Disponible en ligne : Non Permalink : https://bib.vinci.be/opac_css/index.php?lvl=notice_display&id=81254
in Journal of Emergency Nursing > Vol. 43, n°4 (July 2017) . - p. 316-321[article]Exemplaires (1)
Cote Support Localisation Section Disponibilité REV Périodique papier Woluwe périodiques Consultation sur place uniquement
Exclu du prêt
Titre : Blood Withdrawal from Intravenous Catheters by ED Nurses : Comparison of Two Practices Type de document : Article Auteurs : Houry Haroutioun ; Beirut Lebanon Année de publication : 2017 Article en page(s) : p. 322-328 Langues : Anglais (eng) Descripteurs : HE Vinci
Catheterisme intra veineux ; Durée du séjour ; Pratique professionnelle ; Prélèvement sanguin ; Soins d'urgenceMots-clés : Unité de soins d'urgence Ponction artérielle avec prélèvement sanguin pour diagnostique Résumé : Abstract Problem
Laboratory tests are essential to diagnosis and treatment in the emergency department, but they can result in prolonged waiting times for patients, multiple needle pricks, and complaints about pain and discomfort. The goal of this project is to assess if a change in the blood collection process will lead to any improvement and benefit in care delivered with regard to time, patient comfort, and cost.
Methods
A feasibility study was conducted to evaluate the change in practice from cost, time, and applicability perspectives. Using an observational approach, data were collected about the management of a possible change in practice in the emergency department at American University of Beirut Medical Center. Trials of 2 proposed changes to practice were conducted and compared with the current practice. The nurses were trained in the proper use of blood withdrawal using a Vacutainer Luer adaptor.
Results
It was shown that intravenous line insertion and blood collection processes using the Vacutainer Luer adaptor were conducted in 46.2 seconds, which is less time spent than the current process but requires a small investment.
Implications for Practice
Allowing registered nurses to withdraw blood with the start of a peripheral intravenous line will significantly reduce length of stay and costs and enhance patient experience in the emergency department at American University of Beirut Medical Center.Disponible en ligne : Non Permalink : https://bib.vinci.be/opac_css/index.php?lvl=notice_display&id=81255
in Journal of Emergency Nursing > Vol. 43, n°4 (July 2017) . - p. 322-328[article]Exemplaires (1)
Cote Support Localisation Section Disponibilité REV Périodique papier Woluwe périodiques Consultation sur place uniquement
Exclu du prêt
Titre : A Systematic Approach to Evaluation of Performance Deficiencies in ED Triage Type de document : Article Auteurs : Mark R. Reinhardt Année de publication : 2017 Article en page(s) : p. 329-332 Langues : Anglais (eng) Descripteurs : HE Vinci
Démarche qualité ; Evaluation ; Performance ; TriageMots-clés : Approche systématique Unité de soins d'urgence Durée d'attente Résumé : AbtractProblem
Increasing ED crowding has resulted in greater demand and longer time-to-triage and time-to-provider wait times, making accurate triage more important than ever before to avoid poor patient outcomes and possible hospital liability. In one case, a 75-year-old patient presenting with chest pain became unconscious in the ED waiting area after initial registration but before triage. Although resuscitation was attempted, the patient did not survive. Continuous assessment and improvement are needed to streamline the triage process and improve accuracy and efficiency. Because nurses play a vital role in patient triage, they are uniquely positioned to evaluate and enhance the process.
Methods
When staff at an 18-bed emergency department in a rural hospital suspected potential quality deficiencies related to extended wait times and patients leaving without being seen, a panel of nurses was formed to characterize the problem by conducting a chart review to develop potential solutions.
Results
The chart review identified a correlation between wait times and patients leaving without being seen during hours of peak demand. Accordingly, the panel collaborated and proposed several interventions to alleviate these problems.
Implications for Practice
Formation of a panel of skilled nurses to assess problems and recommend potential solutions may represent a useful approach for active nurse participation in quality improvement in the emergency department, thus having a meaningful impact on patient outcomes and hospital liability.Disponible en ligne : Non Permalink : https://bib.vinci.be/opac_css/index.php?lvl=notice_display&id=81256
in Journal of Emergency Nursing > Vol. 43, n°4 (July 2017) . - p. 329-332[article]Exemplaires (1)
Cote Support Localisation Section Disponibilité REV Périodique papier Woluwe périodiques Consultation sur place uniquement
Exclu du prêt
Titre : Validating Signs and Symptoms From An Actual Mass Casualty Incident to Characterize An Irritant Gas Syndrome Agent (IGSA) Exposure : A First Step in The Development of a Novel IGSA Triage Algorithm Type de document : Article Auteurs : Joan M. Culley ; Jane Richter ; Sara Donevant ; [et al.] Année de publication : 2017 Article en page(s) : p. 333-338 Langues : Anglais (eng) Descripteurs : HE Vinci
Algorithmes ; Intoxication ; Signes et symptômes ; Triage ; VictimeRésumé : AbstractIntroduction
Chemical exposures can pose a significant threat to life. Rapid assessment by first responders/emergency nurses is required to reduce death and disability. Currently, no informatics tools for irritant gas syndrome agents (IGSA) exposures exist to process victims efficiently, continuously monitor for latent signs/symptoms, or make triage recommendations. This study describes the first step in developing ED informatics tools for chemical incidents: validation of signs/symptoms that characterize an IGSA syndrome.
Methods
Data abstracted from 146 patients treated for chlorine exposure in one emergency department during a 2005 train derailment and 152 patients not exposed to chlorine (a comparison group) were mapped to 93 possible signs/symptoms within 2 tools (WISER and CHEMM-IST) designed to assist emergency responders/emergency nurses with managing hazardous material exposures. Inferential statistics (χ2/Fisher’s exact test) and diagnostics tests were used to examine mapped signs/symptoms of persons who were and were not exposed to chlorine.
Results
Three clusters of signs/symptoms are statistically associated with an IGSA syndrome (P Discussion
This study uses actual patient data from a chemical incident to characterize and validate signs/symptoms of an IGSA syndrome. Validating signs/symptoms is the first step in developing new ED informatics tools with the potential to revolutionize the process by which emergency nurses manage triage victims of chemical incidents.Disponible en ligne : Non Permalink : https://bib.vinci.be/opac_css/index.php?lvl=notice_display&id=81257
in Journal of Emergency Nursing > Vol. 43, n°4 (July 2017) . - p. 333-338[article]Exemplaires (1)
Cote Support Localisation Section Disponibilité REV Périodique papier Woluwe périodiques Consultation sur place uniquement
Exclu du prêt
Titre : Teammate Familiarity, Teamwork, and Risk of Workplace Injury in Emergency Medical Services Teams Type de document : Article Auteurs : Ashley Hughes ; Daniel Patterson ; Matthew D. Weaver ; [et al.] Année de publication : 2017 Article en page(s) : p. 339-346 Langues : Anglais (eng) Descripteurs : HE Vinci
Blessure ; Equipe soignante ; Relation professionnelleMots-clés : Blessure professionnelle Unité de soins d'urgence Résumé : Introduction
Increased teammate familiarity in emergency medical services (EMS) promotes development of positive teamwork and protects against workplace injury.
Methods
Measures were collected using archival shift records, workplace injury data, and cross-sectional surveys from a nationally representative sample of 14 EMS agencies employing paramedics, prehospital nurses, and other EMS clinicians. One thousand EMS clinicians were selected at random to complete a teamwork survey for each of their recent partnerships and tested the hypothesized role of teamwork as a mediator in the relationship between teammate familiarity and injury with the PROCESS macro.
Results
We received 2566 completed surveys from 333 clinicians, of which 297 were retained. Mean participation was 40.5% (standard deviation [SD] = 20.5%) across EMS agencies. Survey respondents were primarily white (93.8%), male (67.3%), and ranged between 21-62 years of age (M = 37.4, SD = 9.7). Seventeen percent were prehospital nurses. Respondents worked a mean of 3 shifts with recent teammates in the 8 weeks preceding the survey (M = 3.06, SD = 4.4). We examined data at the team level, which suggest positive views of teamwork (M = 5.92, SD = 0.69). Our hypothesis that increased teammate familiarity protects against adverse safety outcomes through development of positive teamwork was not supported. Teamwork factor Partner Adaptability and Backup Behavior is a likely mediator (odds ratio = 1.03, P = .05). When dyad familiarity is high and there are high levels of backup behavior, the likelihood of injury is increased.
Discussion
The relationship between teammate familiarity and outcomes is complex. Teammate adaptation and backup behavior is a likely mediator of this relationship in EMS teams with greater familiarity.Disponible en ligne : Non Permalink : https://bib.vinci.be/opac_css/index.php?lvl=notice_display&id=81258
in Journal of Emergency Nursing > Vol. 43, n°4 (July 2017) . - p. 339-346[article]Exemplaires (1)
Cote Support Localisation Section Disponibilité REV Périodique papier Woluwe périodiques Consultation sur place uniquement
Exclu du prêt
Titre : A 55-Year-Old Woman with Shortness of Breath Type de document : Article Auteurs : Kristen M. Cline Année de publication : 2017 Article en page(s) : p. 358-359 Langues : Anglais (eng) Descripteurs : HE Vinci
Dyspnée ; Présentations de cas ; Soins d'urgenceRésumé : A 55-year-old woman was transported to the emergency department by ambulance after a syncopal episode, with subsequent shortness of breath. Medics reported that her peripheral oxygen saturation (Spo2) was 80% on a 15 L/min oxygen mask. Upon arrival at the emergency department, the patient was anxious, air hungry, and in extremis. An electrocardiogram was difficult to obtain because of motion artifact, but apart from a sinus tachycardia, the findings were unremarkable. A portable chest radiograph indicated clear bilateral lung fields, a normal mediastinum, and no acute disease. Disponible en ligne : Non Permalink : https://bib.vinci.be/opac_css/index.php?lvl=notice_display&id=81259
in Journal of Emergency Nursing > Vol. 43, n°4 (July 2017) . - p. 358-359[article]Exemplaires (1)
Cote Support Localisation Section Disponibilité REV Périodique papier Woluwe périodiques Consultation sur place uniquement
Exclu du prêt
Titre : Pediatric Cardiogenic Shock in a 7-Day-Old With Poor Feeding and Tachypnea: Case Review Type de document : Article Auteurs : Kaci A. Rainey Année de publication : 2017 Article en page(s) : p. 370-372 Langues : Anglais (eng) Descripteurs : HE Vinci
Choc cardiogénique ; Nouveau-né ; Pédiatrie ; Présentations de casMots-clés : Tachypnée Résumé : Neonatal cardiac emergencies are often considered masters of disguise. There is inherent difficulty in recognizing and managing congenital heart disease (CHD) in neonates. The incidence of CHD is about 8 per 1000 live births, and the defects are generally classified into cyanotic and acyanotic CHD. According to the Centers for Disease and Control and Prevention, CHDs are a leading cause of birth defect–associated infant illness and death.1 Infant deaths due to CHDs often occur when the baby is younger than 28 days old. Disponible en ligne : Non Permalink : https://bib.vinci.be/opac_css/index.php?lvl=notice_display&id=81260
in Journal of Emergency Nursing > Vol. 43, n°4 (July 2017) . - p. 370-372[article]Exemplaires (1)
Cote Support Localisation Section Disponibilité REV Périodique papier Woluwe périodiques Consultation sur place uniquement
Exclu du prêt
Exemplaires (1)
| Cote | Support | Localisation | Section | Disponibilité |
|---|---|---|---|---|
| REV | Périodique papier | Woluwe | périodiques | Consultation sur place uniquement Exclu du prêt |
Paru le : 01/05/2017
|
Dépouillements
Ajouter le résultat dans votre panier
Titre : Nurse Participation in Continuing Education in Disaster Nursing in Taiwan Type de document : Article Auteurs : I-Hui Chen ; Shu-Chuan Chang ; Jui-Ying Feng ; [et al.] Année de publication : 2017 Article en page(s) : p. 197-201 Langues : Anglais (eng) Descripteurs : HE Vinci
Education ; Infirmières et infirmiers ; Pratique professionnelle ; TaïwanRésumé : The country of Taiwan is extremely vulnerable to natural disasters. A global risk analysis of natural disaster hot spots identified Taiwan as the number one country with the greatest risk of exposure to at least 4 natural disasters, and it ranks among the top 10 countries at relatively high mortality risk from multiple hazards as well.1 In the past 2 decades alone, the country has experienced a number of devastating disasters including earthquakes, typhoons, floods, infectious diseases outbreaks, and aircraft accidents. DOI : http://dx.doi.org/10.1016/j.jen.2016.10.009|1 Disponible en ligne : Non Permalink : https://bib.vinci.be/opac_css/index.php?lvl=notice_display&id=80079
in Journal of Emergency Nursing > Vol. 43, n°3 (May 2017) . - p. 197-201[article]Exemplaires (1)
Cote Support Localisation Section Disponibilité REV Périodique papier Woluwe périodiques Consultation sur place uniquement
Exclu du prêt
Titre : Improvement of Patient- and Family-Specific Care for Children with Special Behavioral Needs in the Emergency Setting : A Behavioral Needs Education Type de document : Article Auteurs : Nicole Brynes ; Heeyoung Lee ; Dianxu Ren ; [et al.] Année de publication : 2017 Article en page(s) : p. 202-207 Langues : Anglais (eng) Descripteurs : HE Vinci
Besoin ; Enfant (6-12 ans) ; Famille ; Recherche ; Relations entre professionnels de santé et patients ; Soins d'urgence ; Soins infirmiers auprès des famillesRésumé : Improvements in staff training, identification, and treatment planning for children with special health care needs who have behavioral issues are routinely recommended, but a literature review revealed no coherent plans targeted specifically toward pediatric ED staff.
Methods
An educational module was delivered to emergency staff along with a survey before and after and 1 month after the intervention to examine comfort in working with children with behavioral special needs and the ability to deliver specialized care. Child life consultations in the pediatric emergency department were measured 3 months before and 3 months after the education was provided.
Results
A total of 122 staff participated and reported clinically significant improvements across all areas of care that were maintained at 1 month.
Implications for practice
To the best of our knowledge, this project represents the first quality improvement project offering behavioral needs education to emergency staff at a large pediatric hospital with an examination of its impact on staff competence, comfort, and outcomes. A large-scale educational module is a practical option for improvement in pediatric ED staff competence in caring for patients with behavioral special needs.DOI : http://dx.doi.org/10.1016/j.jen.2016.07.010|1 Disponible en ligne : Non Permalink : https://bib.vinci.be/opac_css/index.php?lvl=notice_display&id=80080
in Journal of Emergency Nursing > Vol. 43, n°3 (May 2017) . - p. 202-207[article]Exemplaires (1)
Cote Support Localisation Section Disponibilité REV Périodique papier Woluwe périodiques Consultation sur place uniquement
Exclu du prêt
Titre : Improving the Quality of Nasal Specimen Collection for Influenza A and B Screening Type de document : Article Auteurs : Joan Catherine Widmer ; Pamela P. DiNapoli Année de publication : 2017 Article en page(s) : p. 208-213 Langues : Anglais (eng) Descripteurs : HE Vinci
Confort ; Dépistage systématique ; Echantillon ; Grippe humaine ; Pratique professionnelle ; VirusRésumé : Problem
Rapid diagnosis of seasonal influenza leads to optimized clinical care and reduces the spread of infection. The collection of adequate cellular material can be facilitated by the presence of moisture in the nares. The specific aim of this project was to determine if the installation of sterile saline into the nares prior to specimen collection would improve the quality of the specimen.
Methods
This quasi-experimental single group design tested an initial “dry swab” specimen against a second swab after instillation of sterile saline solution using a nasal atomizer, a “wet swab.”
Results
A total of 80 paired specimens were collected and analyzed between December 7, 2015, and April 21, 2016, with an 11.25% infection rate in those tested. Of 9 positive tests, 6 subjects tested positive for influenza A or B for both the dry swab and the wet swab. Three subjects tested positive for influenza A or B for only the wet swab, and these subjects had experienced their symptoms longer than did subjects who tested positive for both methods (mean symptom onset of 72 hours vs 66 hours). We found an important inconsistency between manufacturers’ recommendations and typical hospital practice.
Implications for Practice
The results appear somewhat equivocal. Because viral shedding declines after the first 48 to 72 hours in adults, the wet swab method may be clinically superior for detecting influenza in adults presenting later in the course of their illness. Hospital policy was revised for consistency in using the gel medium before sampling in accordance with manufacturer recommendations.DOI : http://dx.doi.org/10.1016/j.jen.2016.09.008|1 Disponible en ligne : Non Permalink : https://bib.vinci.be/opac_css/index.php?lvl=notice_display&id=80081
in Journal of Emergency Nursing > Vol. 43, n°3 (May 2017) . - p. 208-213[article]Exemplaires (1)
Cote Support Localisation Section Disponibilité REV Périodique papier Woluwe périodiques Consultation sur place uniquement
Exclu du prêt
Titre : Rural Emergency Nurses’ Suggestions for Improving End-of-Life Care Type de document : Article Auteurs : Renea L. Beckstrand ; Kelly E. Smith ; Karlen E. Luthy ; [et al.] Année de publication : 2017 Article en page(s) : p. 214-220 Langues : Anglais (eng) Descripteurs : HE Vinci
Démarche qualité ; Infirmiere d'urgence ; Malades en phase terminale ; Milieu rural ; Pratique professionnelle ; Recherche ; Recommandations ; Soins palliatifsRésumé : Many patient visits to emergency departments result in the patient dying or being pronounced dead on arrival. The numbers of deaths in emergency departments are likely to increase as a significant portion of the U.S. population ages. Consequently, emergency nurses face many obstacles to providing quality end-of-life (EOL) care when death occurs. The purpose of this study was to identify suggestions that emergency nurses have to improve EOL care, specifically in rural emergency departments.
Methods
A 57-item questionnaire was sent to 53 rural hospitals in 4 states in the Intermountain West, plus Alaska. One item asked nurses to identify the one aspect of EOL care they would change for dying patients in rural emergency departments. Each qualitative response was individually reviewed by a research team and then coded into a theme.
Results
Four major themes and three minor themes were identified. The major themes were providing greater privacy during EOL care for patients and family members, increasing availability of support services, additional staffing, and improved staff and community education.
Discussion
Providing adequate privacy for patients and family members was a major obstacle to providing EOL care in the emergency department, largely because of poor department design, especially in rural emergency departments where space is limited. Lack of support services and adequate staffing were also obstacles to providing quality EOL care in rural emergency departments. Consequently, rural nurses are commonly pulled away from EOL care to perform ancillary duties because additional support personnel are lacking. Providing EOL care in rural emergency departments is a challenging task given the limited staffing and resources, and thus it is imperative that nurses’ suggestions for improvement of EOL care be acknowledged. Because of the current lack of research in rural EOL care, additional research is needed.DOI : http://dx.doi.org/10.1016/j.jen.2017.03.012|1 Disponible en ligne : Non Permalink : https://bib.vinci.be/opac_css/index.php?lvl=notice_display&id=80082
in Journal of Emergency Nursing > Vol. 43, n°3 (May 2017) . - p. 214-220[article]Exemplaires (1)
Cote Support Localisation Section Disponibilité REV Périodique papier Woluwe périodiques Consultation sur place uniquement
Exclu du prêt
Titre : National Institutes of Health Stroke Scale in Plain English Is Reliable for Novice Nurse Users with Minimal Training Type de document : Article Auteurs : Sandy Dancer ; Alleen J. Brown ; Lisa Rietz Yanase Année de publication : 2017 Article en page(s) : p. 221-227 Langues : Anglais (eng) Descripteurs : HE Vinci
Douleur ; Echelle d'évaluation ; Infirmières et infirmiers ; Institution médico-pédagogique (IMP) ; Recherche ; Santé ; Unité de soins ; UrgencesRésumé : The National Institutes of Health Stroke Scale (NIHSS) is commonly used in Comprehensive Stroke Centers, but it has not been easily implemented in smaller centers. The aim of this study was to assess whether nurse providers who were naive to stroke assessment scales could obtain accurate stroke severity scores using our previously validated NIH Stroke Scale in Plain English (NIHSS-PE) with minimal or no training.
Methods
We randomly assigned 122 nursing students who were naive to stroke assessment scales to 1 of 4 groups: trained on the NIHSS, untrained on the NIHSS, trained on the NIHSS-PE, or untrained on the NIHSS-PE. The Trained/NIHSS and Trained/NIHSS-PE groups watched assessment scale-specific training DVDs. All 4 study groups scored the same 3 patients from the National Institute of Neurological Disorders and Stroke certification DVD, in randomly assigned order. Two-way repeated measures analysis of variance was used to compare group scores with those obtained by a consensus panel of NIHSS-certified expert users, and with each other.
Results
NIHSS-PE users had scores significantly closer to the expert scores compared with NIHSS users (F(1,118) = 4.656, P = .033). Trained users had scores significantly closer to the expert scores than untrained users (F(1,118) = 6.607, P = .011). Scores from untrained users of the NIHSS-PE did not differ from those of trained users of the NIHSS (F(1,59) = 0.08, P = .780).
Discussion
With minimal or no training, novice nurse users of the NIHSS-PE can do as well as, if not better than, novice users of the NIHSS, making this tool useful for facilities pursuing Acute Stroke-Ready certification.DOI : http://dx.doi.org/10.1016/j.jen.2016.09.002|1 Disponible en ligne : Non Permalink : https://bib.vinci.be/opac_css/index.php?lvl=notice_display&id=80083
in Journal of Emergency Nursing > Vol. 43, n°3 (May 2017) . - p. 221-227[article]Exemplaires (1)
Cote Support Localisation Section Disponibilité REV Périodique papier Woluwe périodiques Consultation sur place uniquement
Exclu du prêt
Titre : Painful Discrimination in the Emergency Department: Risk Factors for Underassessment of Patients’ Pain by Nurses Type de document : Article Auteurs : Jorien G.J. Pierik ; Maarten J. IJzerman ; Menno I. Gaakeer ; [et al.] Année de publication : 2017 Article en page(s) : p. 228-238 Langues : Anglais (eng) Descripteurs : HE Vinci
Douleur ; Evaluation ; Facteurs de risque ; Infirmières et infirmiers ; Recherche ; UrgencesMots-clés : Sous-évaluation de la douleur Service hospitalier d'urgence Résumé : Introduction
Unrelieved acute musculoskeletal pain continues to be a reality of major clinical importance, despite advancements in pain management. Accurate pain assessment by nurses is crucial for effective pain management. Yet inaccurate pain assessment is a consistent finding worldwide in various clinical settings, including the emergency department. In this study, pain assessments between nurses and patients with acute musculoskeletal pain after extremity injury will be compared to assess discrepancies. A second aim is to identify patients at high risk for underassessment by emergency nurses.
Methods
The prospective PROTACT study included 539 adult patients who were admitted to the emergency department with musculoskeletal pain. Data on pain assessment and characteristics of patients including demographics, pain, and injury, psychosocial, and clinical factors were collected using questionnaires and hospital registry.
Results
Nurses significantly underestimated patients’ pain with a mean difference of 2.4 and a 95% confidence interval of 2.2-2.6 on an 11-points numerical rating scale. Agreement between nurses’ documented and patients’ self-reported pain was only 27%, and 63% of the pain was underassessed. Pain was particularly underassessed in women, in persons with a lower educational level, in patients who used prehospital analgesics, in smokers, in patients with injury to the lower extremities, in anxious patients, and in patients with a lower urgency level.
Discussion
Underassessment of pain by emergency nurses is still a major problem and might result in undertreatment of pain if the emergency nurses rely on their assessment to provide further pain treatment. Strategies that focus on awareness among nurses of which patients are at high risk of underassessment of pain are needed.DOI : http://dx.doi.org/10.1016/j.jen.2016.10.007|1 Disponible en ligne : Non Permalink : https://bib.vinci.be/opac_css/index.php?lvl=notice_display&id=80084
in Journal of Emergency Nursing > Vol. 43, n°3 (May 2017) . - p. 228-238[article]Exemplaires (1)
Cote Support Localisation Section Disponibilité REV Périodique papier Woluwe périodiques Consultation sur place uniquement
Exclu du prêt
Titre : Child Passenger Safety: An Assessment of Emergency Nurses’ Knowledge and Provision of Information in the Emergency Department Type de document : Article Auteurs : Thelma C. Kuska ; Mark R. Zonfrillo ; Palos Heights Année de publication : 2017 Article en page(s) : p. 239-245 Langues : Anglais (eng) Descripteurs : HE Vinci
Conduite automobile ; Enfant (6-12 ans) ; Enquête ; Infirmiere d'urgence ; Recherche ; SécuritéMots-clés : Service hospitalier d'urgence Résumé : Introduction
Each year, more than 130,000 children younger than 13 years are treated in the emergency department after evaluation of injuries sustained from motor vehicle crashes (MVCs). Many of these injuries can be prevented with use of child restraints. In this study we sought to assess emergency nurses’ knowledge of child passenger safety (CPS) and its use to keep children safe while traveling in motor vehicles.
Methods
A cross-sectional anonymous study was distributed electronically to 530 emergency nurses who were asked to forward the survey link to other emergency nurses through snowball sampling. The target population included full-time and part-time emergency nurses, including nurse practitioners caring for pediatric patients. Emergency nurses’ CPS knowledge, attitudes, and practices were ascertained.
Results
Nine hundred eighty-four emergency nurses completed a Web-based survey. All 6 CPS knowledge and scenario-based items were answered correctly by only 18.8% of the sample; these respondents were identified as the “high knowledge” group. Similarly, ED nurses rarely addressed CPS during ED visits in the prior 6 months. Those with high knowledge were more likely to be confident about providing recommendations for CPS topics.
Discussion
Emergency nurses can improve their knowledge and provision of CPS in the emergency department, particularly for children presenting for care following MVCs. These results identify opportunities to increase the knowledge and confidence of emergency nurses in providing CPS information to parents seen in the emergency department, especially those involved in MVCs. The gap in knowledge can be overcome by providing the nurses with increased CPS-focused educational opportunities.DOI : http://dx.doi.org/10.1016/j.jen.2016.06.016|1 Disponible en ligne : Non Permalink : https://bib.vinci.be/opac_css/index.php?lvl=notice_display&id=80085
in Journal of Emergency Nursing > Vol. 43, n°3 (May 2017) . - p. 239-245[article]Exemplaires (1)
Cote Support Localisation Section Disponibilité REV Périodique papier Woluwe périodiques Consultation sur place uniquement
Exclu du prêt
Titre : Voluntary Medication Error Reporting by ED Nurses: Examining the Association With Work Environment and Social Capital Type de document : Article Auteurs : Amany Farag ; Mary Blegen ; Amalia Gedney-Lose ; [et al.] Année de publication : 2017 Article en page(s) : p. 246-254 Langues : Anglais (eng) Descripteurs : HE Vinci
Autorité ; Erreurs médicales ; Infirmiere d'urgence ; Recherche ; SécuritéMots-clés : Erreurs de médication volontaires Service hospitalier d'urgence Déclaration obligatoire Résumé : Introduction
Medication errors are one of the most frequently occurring errors in health care settings. The complexity of the ED work environment places patients at risk for medication errors. Most hospitals rely on nurses’ voluntary medication error reporting, but these errors are under-reported. The purpose of this study was to examine the relationship among work environment (nurse manager leadership style and safety climate), social capital (warmth and belonging relationships and organizational trust), and nurses’ willingness to report medication errors.
Methods
A cross-sectional descriptive design using a questionnaire with a convenience sample of emergency nurses was used. Data were analyzed using descriptive, correlation, Mann-Whitney U, and Kruskal-Wallis statistics.
Results
A total of 71 emergency nurses were included in the study. Emergency nurses’ willingness to report errors decreased as the nurses’ years of experience increased (r = –0.25, P = .03). Their willingness to report errors increased when they received more feedback about errors (r = 0.25, P = .03) and when their managers used a transactional leadership style (r = 0.28, P = .01).
Discussion
ED nurse managers can modify their leadership style to encourage error reporting. Timely feedback after an error report is particularly important. Engaging experienced nurses to understand error root causes could increase voluntary error reporting.DOI : http://dx.doi.org/10.1016/j.jen.2016.10.015|1 Disponible en ligne : Non Permalink : https://bib.vinci.be/opac_css/index.php?lvl=notice_display&id=80086
in Journal of Emergency Nursing > Vol. 43, n°3 (May 2017) . - p. 246-254[article]Exemplaires (1)
Cote Support Localisation Section Disponibilité REV Périodique papier Woluwe périodiques Consultation sur place uniquement
Exclu du prêt
Titre : The Effect of Pneumatic Tube Systems on the Hemolysis of Biochemistry Blood Samples Type de document : Article Auteurs : Gokhan Cakirca ; Huseyin Erdal Année de publication : 2017 Article en page(s) : p. 255-258 Langues : Anglais (eng) Descripteurs : HE Vinci
Biochimie ; Hemolyse ; RechercheMots-clés : Système de tube pneumatique Échantillons sanguins Résumé : Pneumatic tube systems (PTSs) are widely used in many hospitals because they lead to reduced turnaround times and cost efficiency. However, PTSs may affect the quality of the blood samples transported to the laboratory. The aim of this study was to investigate the effect of the PTS used in our hospital on the hemolysis of the biochemical blood samples transported to the laboratory.
Methods
A total of 148 samples were manually transported to the laboratory by hospital staff, 148 samples were transported with the PTS, and 113 were transported with the PTS without use of sponge-rubber inserts (PTSws). Hemolysis rates and the levels of biochemical analytes for the different transportation methods were compared.
Results
No significant difference was found between the samples transported manually and with the PTS with regard to hemolysis rate and the levels of biochemical analytes. However, the samples transported with the PTSws showed a significant difference compared with the samples transported manually and with the PTS with regard to hemolysis rate and potassium and lactate dehydrogenase levels. The percentages of the samples that exceeded the permissible threshold for the hemolysis among the samples transported manually, with the PTS, and with the PTSws were 10%, 8%, and 47%, respectively.
Discussion
A PTS can be used safely for transporting biochemistry blood samples to the laboratory. However, a sponge-rubber insert that holds sample tubes must be used with the PTS to prevent the hemolysis of blood samples.DOI : http://dx.doi.org/10.1016/j.jen.2016.09.007|1 Disponible en ligne : Non Permalink : https://bib.vinci.be/opac_css/index.php?lvl=notice_display&id=80087
in Journal of Emergency Nursing > Vol. 43, n°3 (May 2017) . - p. 255-258[article]Exemplaires (1)
Cote Support Localisation Section Disponibilité REV Périodique papier Woluwe périodiques Consultation sur place uniquement
Exclu du prêt
Exemplaires (1)
| Cote | Support | Localisation | Section | Disponibilité |
|---|---|---|---|---|
| REV | Périodique papier | Woluwe | périodiques | Consultation sur place uniquement Exclu du prêt |
Paru le : 01/03/2017
|
Dépouillements
Ajouter le résultat dans votre panier
Titre : Caring for Patients with Totally Endoscopic Coronary Artery Bypass : Special Considerations for the ED Nurse Type de document : Article Auteurs : Ameera Chakravarthy ; Eric J. Lehr ; Susan L. Bindon Année de publication : 2017 Article en page(s) : p. 100-105 Langues : Anglais (eng) Descripteurs : HE Vinci
Endoprothèses ; Endoscopie ; Infirmiere d'urgence ; Soins d'urgence ; Soins postopératoiresDOI : http://dx.doi.org/10.1016/j.jen.2016.04.009|1 Disponible en ligne : Non Permalink : https://bib.vinci.be/opac_css/index.php?lvl=notice_display&id=79728
in Journal of Emergency Nursing > Vol. 43, n°2 (March 2017) . - p. 100-105[article]Exemplaires (1)
Cote Support Localisation Section Disponibilité REV Périodique papier Woluwe périodiques Consultation sur place uniquement
Exclu du prêt
Titre : Epidemiology of Opioid Abuse and Addiction Type de document : Article Auteurs : Jonathan Green Année de publication : 2017 Article en page(s) : p. 106-113 Langues : Anglais (eng) Descripteurs : HE Vinci
Addiction ; Drogue ; Épidémiologie ; Infirmiere d'urgence ; RisqueMots-clés : Opioïdes Surdose DOI : http://dx.doi.org/10.1016/j.jen.2016.09.004|1 Disponible en ligne : Non Permalink : https://bib.vinci.be/opac_css/index.php?lvl=notice_display&id=79729
in Journal of Emergency Nursing > Vol. 43, n°2 (March 2017) . - p. 106-113[article]Exemplaires (1)
Cote Support Localisation Section Disponibilité REV Périodique papier Woluwe périodiques Consultation sur place uniquement
Exclu du prêt
Titre : Impact of a Planned Workflow Change : Super Track Improves Quality and Service for Low-Acuity Patients at an Inner-City Hospital Type de document : Article Auteurs : Nancy Mannion Bonalumi ; A Bhattacharya ; Christopher Edwards ; [et al.] Année de publication : 2017 Article en page(s) : p. 114-125 Langues : Anglais (eng) Descripteurs : HE Vinci
Bien-être ; Hôpitaux ; Patients ; ProgrammeMots-clés : Service hospitalier d'urgence Résumé : Problem
ED volume and acuity were anticipated to increase at an inner-city hospital. A strategy to mitigate the impact was needed.
Methods
A multidisciplinary team facilitated a workflow modification project implementing a Super Track to treat low-acuity patients. A literature review led to the creation of an evidence-based framework. Staff education regarding the change process and the results of an analysis in the strengths, weaknesses, opportunities, and threat format, along with simulation exercises and a pilot project, supported implementation of this strategy.
Results
Simulation exercises demonstrated that the proposed workflow with a Super Track had the potential to reduce the length of stay among level 4 and 5 patients coming to the emergency department. Implementing a Super Track reduced the patient arrival-to-provider time for low-acuity patients, but length of stay was not affected. After implementation, the number of patients who left without being seen decreased by 40%, and patient satisfaction increased by 36%.
Implications for practice
A modified front-end workflow process produced a statistically significant, sustainable improvement in patient flow of low-acuity patients in our emergency department. Use of an evidence-based, multidisciplinary team approach supported the change process.DOI : http://dx.doi.org/10.1016/j.jen.2016.03.029|1 Disponible en ligne : Non Permalink : https://bib.vinci.be/opac_css/index.php?lvl=notice_display&id=79730
in Journal of Emergency Nursing > Vol. 43, n°2 (March 2017) . - p. 114-125[article]Exemplaires (1)
Cote Support Localisation Section Disponibilité REV Périodique papier Woluwe périodiques Consultation sur place uniquement
Exclu du prêt
Titre : Eliminating Blood Culture False Positives : Harnessing the Power of Nursing Shared Governance Type de document : Article Auteurs : Dawn Moeller Année de publication : 2017 Article en page(s) : p. 126-132 Langues : Anglais (eng) Descripteurs : HE Vinci
Autorité ; Contamination ; Démarche qualité ; Hemoculture ; RechercheRésumé : Problem
Our emergency department struggled with unacceptable blood culture contamination rates for several years. The objective of this project was to create a self-governing culture within nursing that would generate and sustain the achievement of monthly blood culture contamination rates below the national benchmark of 3% and the hospital laboratory acceptable threshold of 2.3%.
Methods
The ED shared governance council partnered with the laboratory team to review the monthly epidemiology reports for all adult and pediatric ED patients having blood cultures performed from January 2010 through December 2015. A written competency assessment test completed by ED personnel performing phlebotomy showed opportunity for improvement. After a review of the literature, a blood culture collection education tool was created and implemented. The final step was to design a monthly monitoring and peer-review process to perform ongoing causal analysis with those individuals who were linked with contaminated specimens.
Results
The evidence shows that the new process decreased the blood culture contamination rate from a baseline rate of 5.37% to 1.76%.
Implications for Practice
The chief recommendation is to engage staff through clinical leadership. This quality-improvement project translates to improved patient care and a reduction in unnecessary treatment and costs.DOI : http://dx.doi.org/10.1016/j.jen.2016.07.001|1 Disponible en ligne : Non Permalink : https://bib.vinci.be/opac_css/index.php?lvl=notice_display&id=79731
in Journal of Emergency Nursing > Vol. 43, n°2 (March 2017) . - p. 126-132[article]Exemplaires (1)
Cote Support Localisation Section Disponibilité REV Périodique papier Woluwe périodiques Consultation sur place uniquement
Exclu du prêt
Titre : Nurse Staffing and Hospital Characteristics Predictive of Time to Diagnostic Evaluation for Patients in the Emergency Department Type de document : Article Auteurs : Judith Shindul-Rothschild ; Catherine Y. Read ; Kelly D. Stamp ; [et al.] Année de publication : 2017 Article en page(s) : p. 138-144 Langues : Anglais (eng) Descripteurs : HE Vinci
Condition de travail ; Diagnostic ; Evaluation ; Infirmiere d'urgence ; Performance ; RechercheMots-clés : Service hospitalier d'urgence Résumé : Introduction
In the 2014 Emergency Department Benchmarking Alliance Summit, for the first time, participants recommended tracking nursing and advanced practice nurse hours. Performance data from the Centers for Medicare and Medicaid Services provides an opportunity to analyze factors associated with delays in emergency care. The purpose of this study was to investigate hospital characteristics associated with time to a diagnostic evaluation in 67 Massachusetts emergency departments from 2013 to 2014.
Methods
Covariates significantly correlated with time to diagnostic evaluation, and factors associated with timely care in emergency departments were included in the stepwise linear regression analysis. Differences in nurse staffing and performance measures in trauma and nontrauma emergency departments were examined with analysis of variance and t tests.
Results
Two predictors explained 38% of the variance in time a diagnostic evaluation (1): nurse staffing (P
Discussion
Efforts to improve patient flow often focus on process interventions such as improved utilization of observation beds or transfers of patients to inpatient units. In this study, time to diagnostic evaluation significantly increased when emergency nurses care for higher numbers of patients. The findings present new evidence identifying the relationship of specific nurse to patient ratios to wait time in emergency departments.DOI : http://dx.doi.org/10.1016/j.jen.2016.07.003|1 Disponible en ligne : Non Permalink : https://bib.vinci.be/opac_css/index.php?lvl=notice_display&id=79733
in Journal of Emergency Nursing > Vol. 43, n°2 (March 2017) . - p. 138-144[article]Exemplaires (1)
Cote Support Localisation Section Disponibilité REV Périodique papier Woluwe périodiques Consultation sur place uniquement
Exclu du prêt
Titre : Active Intervention Can Decrease Burnout In Ed Nurses Type de document : Article Auteurs : Rong Wei ; Hong Ji ; Jianxin Li ; [et al.] Année de publication : 2017 Article en page(s) : p. 145-149 Langues : Anglais (eng) Descripteurs : HE Vinci
Équipe ; Infirmiere d'urgence ; Recherche ; Syndrome d'épuisement professionnel
Autres descripteurs
project & people managementRésumé : Introduction
The aim of this study was to evaluate whether active intervention can decrease job burnout and improve performance among ED nurses.
Methods
This study was carried out in the emergency departments of 3 hospitals randomly selected from 8 comprehensive high-level hospitals in Jinan, China. A total of 102 nurses were enrolled and randomly divided into control and intervention groups. For 6 months, nurses in intervention groups were treated with ordinary treatment plus comprehensive management, whereas nurses in the control group were treated with ordinary management, respectively. Questionnaires were sent and collected at baseline and at the end of the study. The Student t test was used to evaluate the effect of comprehensive management in decreasing burnout.
Results
All ED nurses showed symptoms of job burnout at different levels. Our data indicated that comprehensive management significantly decreased emotional exhaustion and depersonalization (P
Discussion
The findings suggest that active intervention with comprehensive management may effectively reduce job burnout in ED nurses and contribute to relieving work-related stress and may further protect against potential mental health problems.DOI : http://dx.doi.org/10.1016/j.jen.2016.07.011|1 Disponible en ligne : Non Permalink : https://bib.vinci.be/opac_css/index.php?lvl=notice_display&id=79734
in Journal of Emergency Nursing > Vol. 43, n°2 (March 2017) . - p. 145-149[article]Exemplaires (1)
Cote Support Localisation Section Disponibilité REV Périodique papier Woluwe périodiques Consultation sur place uniquement
Exclu du prêt
Titre : On the Threshold of Safety : A Qualitative Exploration of Nurses’ Perceptions of Factors Involved in Safe Staffing Levels in Emergency Departments Type de document : Article Auteurs : Lisa A. Wolf ; Cydne Perhats ; Altair M. Delao ; [et al.] Année de publication : 2017 Article en page(s) : p. 150-157 Langues : Anglais (eng) Descripteurs : HE Vinci
Infirmiere d'urgence ; Recherche qualitative ; Sécurité ; Soins d'urgenceMots-clés : Service hospitalier d'urgence Résumé : Introduction
The emergency department is a unique practice environment in that the Emergency Medical Treatment and Active Labor Act (EMTALA), which mandates a medical screening examination for all presenting patients, effectively precludes any sort of patient volume control; staffing needs are therefore fluid and unpredictable. The purpose of this study is to explore emergency nurses’ perceptions of factors involved in safe staffing levels and to identify factors that negatively and positively influence staffing levels and might lend themselves to more effective interventions and evaluations.
Methods
We used a qualitative exploratory design with focus group data from a sample of 26 emergency nurses. Themes were identified using a constructivist perspective and an inductive approach to content analysis.
Results
Five themes were identified: (1) unsafe environment of care, (2) components of safety, (3) patient outcomes: risky care, (4) nursing outcomes: leaving the profession, and (5) possible solutions. Participants reported that staffing levels are determined by the number of beds in the department (as in inpatient units) but not by patient acuity or the number of patients waiting for treatment. Participants identified both absolute numbers of staff, as well as experience mix, as components of safe staffing. Inability to predict the acuity of patients waiting to be seen was a major component of nurses’ perceptions of unsafe staffing.
Discussion
Emergency nurses perceive staffing to be inadequate, and therefore unsafe, because of the potential for poor patient outcomes, including missed or delayed care, missed deterioration (failure to rescue), and additional ED visits resulting from ineffective discharge teaching. Both absolute numbers of staff, as well as skill and experience mix, should be considered to provide staffing levels that promote optimal patient and nurse outcomes.DOI : http://dx.doi.org/10.1016/j.jen.2016.09.003|1 Disponible en ligne : Non Permalink : https://bib.vinci.be/opac_css/index.php?lvl=notice_display&id=79735
in Journal of Emergency Nursing > Vol. 43, n°2 (March 2017) . - p. 150-157[article]Exemplaires (1)
Cote Support Localisation Section Disponibilité REV Périodique papier Woluwe périodiques Consultation sur place uniquement
Exclu du prêt
Exemplaires (1)
| Cote | Support | Localisation | Section | Disponibilité |
|---|---|---|---|---|
| REV | Périodique papier | Woluwe | périodiques | Consultation sur place uniquement Exclu du prêt |
Paru le : 01/01/2017
|
Dépouillements
Ajouter le résultat dans votre panier
Titre : Nursing Self-perceptions of Emergency Preparedness at a Rural Hospital Type de document : Article Auteurs : Angela J. Hodge ; Elaine L. Miller ; Mary Kate Dilts Skaggs Année de publication : 2017 Article en page(s) : p. 10-14 Langues : Anglais (eng) Descripteurs : HE Vinci
Enquête ; Hôpitaux ; Milieu rural ; Perception ; Recherche ; UrgencesDOI : http://dx.doi.org/10.1016/j.jen.2015.07.012|1 Disponible en ligne : Non Permalink : https://bib.vinci.be/opac_css/index.php?lvl=notice_display&id=78907
in Journal of Emergency Nursing > Vol. 43, n°1 (January 2017) . - p. 10-14[article]Exemplaires (1)
Cote Support Localisation Section Disponibilité REV Périodique papier Woluwe périodiques Consultation sur place uniquement
Exclu du prêt
Titre : Obstetric Hemorrhage in the Rural Emergency Department: Rapid Response Type de document : Article Auteurs : Anne C. Dillard Année de publication : 2017 Article en page(s) : p. 15-20 Langues : Anglais (eng) Descripteurs : HE Vinci
Grossesse ; Hémorragie ; Hémorragie de la délivrance ; Hôpitaux ; Milieu rural ; Mortalité ; Obstétrique ; RechercheDOI : http://dx.doi.org/10.1016/j.jen.2016.10.002|1 Disponible en ligne : Non Permalink : https://bib.vinci.be/opac_css/index.php?lvl=notice_display&id=78908
in Journal of Emergency Nursing > Vol. 43, n°1 (January 2017) . - p. 15-20[article]Exemplaires (1)
Cote Support Localisation Section Disponibilité REV Périodique papier Woluwe périodiques Consultation sur place uniquement
Exclu du prêt
Titre : Safe Handling of Snakes in an ED Setting Type de document : Article Auteurs : Melanie Cockrell ; Christopher Swanson ; April Sanders ; [et al.] Année de publication : 2017 Article en page(s) : p. 21-23 Langues : Anglais (eng) Descripteurs : HE Vinci
Morsure ; Recherche ; Sécurité ; Soins d'urgence ; Unité de soinsMots-clés : Reptiles Résumé : Efforts to improve consistency in management of snakes and venomous snake bites in the emergency department (ED) can improve patient and staff safety and outcomes, as well as improve surveillance data accuracy. The emergency department at a large academic medical center identified an opportunity to implement a standardized process for snake disposal and identification to reduce staff risk exposure to snake venom from snakes patients brought with them to the ED.
Methods
A local snake consultation vendor and zoo Herpetologist assisted with development of a process for snake identification and disposal.
Results
All snakes have been identified and securely disposed of using the newly implemented process and no safety incidents have been reported.
Implications for Practice
Other emergency department settings may consider developing a standardized process for snake disposal using listed specialized consultants combined with local resources and suppliers to promote employee and patient safety.DOI : http://dx.doi.org/10.1016/j.jen.2016.07.009|1 Disponible en ligne : Non Permalink : https://bib.vinci.be/opac_css/index.php?lvl=notice_display&id=78909
in Journal of Emergency Nursing > Vol. 43, n°1 (January 2017) . - p. 21-23[article]Exemplaires (1)
Cote Support Localisation Section Disponibilité REV Périodique papier Woluwe périodiques Consultation sur place uniquement
Exclu du prêt
Titre : Improving Access to Stroke Care in the Rural Setting : The Journey to Acute Stroke Ready Designation Type de document : Article Auteurs : Andrea Slivinski ; Robin Jones ; Hollis Whitehead ; [et al.] Année de publication : 2017 Article en page(s) : p. 24-32 Langues : Anglais (eng) Descripteurs : HE Vinci
Accessibilité ; Accident vasculaire cérébral (AVC) ; Milieu rural ; Recherche ; SoinsMots-clés : Accessibilité des services de santé Résumé : Stroke is the fifth highest cause of death and the leading cause of long-term disability in the United States. North Carolina has one of the highest death rates from stroke in the nation. Access to acute stroke care in rural western North Carolina is limited, with only one primary stroke center within an 18-county region. Angel Medical Center, located in rural western North Carolina, sought to pursue The Joint Commission’s disease-specific certification as an Acute Stroke Ready Hospital in an effort to improve stroke care and outcomes across the region.
Methods
A multidisciplinary team of ED clinicians, hospital leadership, and community participants was formed to develop a structured care algorithm and intensive process improvement initiatives to guide the Acute Stroke Ready Hospital application process.
Results
In the 7 months since implementation, door-to-laboratory results have improved by an average of 12 minutes, door-to-computed tomography interpretation has improved by 3 minutes, time to intravenous thrombolytics has improved to less than 60 minutes, and patient transfer within 2 hours of arrival has also improved. ED provider average response time has been reduced by 5 minutes, and time to neurology via telemedicine has been reduced by almost 10 minutes.
Implications for Practice
By driving best practices in the delivery of stroke care, Angel Medical Center enhanced stroke care in a rural community, allowing patients and families to receive evaluation and treatment in a timely and efficient manner close to home.DOI : http://dx.doi.org/10.1016/j.jen.2016.10.006|1 Disponible en ligne : Non Permalink : https://bib.vinci.be/opac_css/index.php?lvl=notice_display&id=78910
in Journal of Emergency Nursing > Vol. 43, n°1 (January 2017) . - p. 24-32[article]Exemplaires (1)
Cote Support Localisation Section Disponibilité REV Périodique papier Woluwe périodiques Consultation sur place uniquement
Exclu du prêt
Titre : A Rural Hospital’s Journey to Becoming a Certified Acute Stroke–Ready Hospital Type de document : Article Auteurs : Denise C. Rhew ; Susan H. Owen ; Jessica B. Buckner ; [et al.] Année de publication : 2017 Article en page(s) : p. 33-39 Langues : Anglais (eng) Descripteurs : HE Vinci
Accident vasculaire cérébral (AVC) ; Certification ; Hôpitaux ; Interdisciplinarité ; Management ; Milieu rural ; RechercheRésumé : Problem
For many stroke patients, rural emergency departments are the first point of medical care to stop brain cell death. We identified a need to meet standards to improve outcomes for stroke care.
Methods
An interdisciplinary Stroke Continuous Process Improvement Committee was formed. We conducted a gap analysis to address current stroke care processes. Chart audits were performed, and strategies to meet the requirements for recognition as an Acute Stroke Ready Hospital (ASRH) were implemented. The ASRH guidelines guided our certification journey.
Results
ASRH certification was achieved. In addition, stroke care outcomes such as door-to-computed tomography results, door-to-international normalized ratio results, door teleneurology consultation, and door-to-needle time have improved.
Implications for Practice
Achieving certification makes a strong statement to the community about a hospital’s efforts to provide the highest quality in stroke care services. Becoming a certified ASRH promotes quality of patient care by reducing variation in clinical processes.DOI : http://dx.doi.org/10.1016/j.jen.2016.10.016|1 Disponible en ligne : Non Permalink : https://bib.vinci.be/opac_css/index.php?lvl=notice_display&id=78911
in Journal of Emergency Nursing > Vol. 43, n°1 (January 2017) . - p. 33-39[article]Exemplaires (1)
Cote Support Localisation Section Disponibilité REV Périodique papier Woluwe périodiques Consultation sur place uniquement
Exclu du prêt
Titre : Rural Emergency Nurses’ End-of-Life Care Obstacle Experiences : Stories from the Last Frontier Type de document : Article Auteurs : Renea L. Beckstrand ; Jonathan Rohwer ; Karlen E. Luthy ; [et al.] Année de publication : 2017 Article en page(s) : p. 40-48 Langues : Anglais (eng) Descripteurs : HE Vinci
Malades en phase terminale ; Milieu rural ; Recherche ; Soins d'urgence ; Unité de soinsRésumé : Rural emergency nurses face unique obstacles to providing quality end-of-life (EOL) care. Stories provided by emergency nurses embody their most difficult EOL care obstacles.
Methods
A questionnaire was sent to 53 rural hospitals. Respondents were asked to share stories that epitomized the obstacles faced while providing EOL care in the rural emergency setting.
Results
The lack of an ideal death (eg, the nurse personally knows the patient, issues with family members, and unknown patient wishes) was the top obstacle. Other reported obstacles were insufficient ED staff and power struggles between nurses and physicians.
Discussion
Rural emergency nurses often provide EOL care to friends and family members, whereas their urban counterparts are likely to transfer care to nurses with no relation to the dying patient. Not only does caring for patients whom the nurse knows or is related to cause great distress to rural emergency nurses, but this unfortunately common situation also may prevent patients from receiving the highest quality EOL care.DOI : http://dx.doi.org/10.1016/j.jen.2015.08.017|1 Disponible en ligne : Non Permalink : https://bib.vinci.be/opac_css/index.php?lvl=notice_display&id=78912
in Journal of Emergency Nursing > Vol. 43, n°1 (January 2017) . - p. 40-48[article]Exemplaires (1)
Cote Support Localisation Section Disponibilité REV Périodique papier Woluwe périodiques Consultation sur place uniquement
Exclu du prêt
Titre : Pediatric Readiness in Indian Health Service and Tribal Emergency Departments : Results from the National Pediatric Readiness Project Type de document : Article Auteurs : Juliana Sadovich ; Terry Adirim ; Russell Telford ; [et al.] Année de publication : 2017 Article en page(s) : p. 49-56 Langues : Anglais (eng) Descripteurs : HE Vinci
Milieu rural ; Recherche ; Soins d'urgence ; Soins de l'enfant ; Unité de soinsMots-clés : Indiens (USA) Résumé : Introduction
In 2014, 45 Indian Health Service (IHS)/Tribal emergency departments serving American Indian and Alaskan Native communities treated approximately 650,000 patients of which, 185,000 (28%) were children and youth younger than 19 years. This study presents the results of the National Pediatric Readiness Project (NPRP) assessment of the 45 IHS/Tribal emergency departments.
Methods
Data were obtained from the 2013 NPRP national assessment, which is a 55-question Web-based questionnaire based on previously published 2009 national consensus guidelines. The main measure of readiness is the weighted pediatric readiness score (WPRS), with the highest score being 100.
Results
The overall mean WPRS for all emergency departments is 60.9. Of the IHS/Tribal emergency departments that had pediatric emergency care coordinators, scores across all domains were higher than those of emergency departments without pediatric emergency care coordinators. All 45 emergency departments have readily available a pediatric medication dosing chart, length-based tape, medical software, or other system to ensure proper sizing of resuscitation equipment and proper dosing of medication. Of the 45 IHS/Tribal 37% report having 100% of the equipment items, and 78% report having at least 80% of these items.
Discussion
This article reports the results of the NPRP assessment in IHS/Tribal emergency departments that, despite serving a historically vulnerable population, scored favorably when compared with national data. The survey identified areas for improvement, including implementation of QI processes, stocking of pediatric specific equipment, implementation of policies and procedures on interfacility transport, and maintaining staff pediatric competencies.DOI : http://dx.doi.org/10.1016/j.jen.2015.09.004|1 Disponible en ligne : Non Permalink : https://bib.vinci.be/opac_css/index.php?lvl=notice_display&id=78913
in Journal of Emergency Nursing > Vol. 43, n°1 (January 2017) . - p. 49-56[article]Exemplaires (1)
Cote Support Localisation Section Disponibilité REV Périodique papier Woluwe périodiques Consultation sur place uniquement
Exclu du prêt
Titre : ED Utilization and Self-Reported Symptoms in Community-Dwelling Older Adults Type de document : Article Auteurs : Gordana Dermody ; Patricia Sawyer ; Richard Kennedy ; [et al.] Année de publication : 2017 Article en page(s) : p. 57-69 Langues : Anglais (eng) Descripteurs : HE Vinci
Groupe ; Locomotion ; Recherche ; Soins d'urgence ; Sujet âgé ; Unité de soinsRésumé : The rise in ED utilization among older adults is a nursing concern, because emergency nurses are uniquely positioned to have a positive impact on the care of older adults. Symptoms have been associated with ED utilization; however, it remains unclear whether symptoms are the primary reason for ED utilization. The purpose of this study was to describe the self-reported symptoms of community-dwelling older adults prior to accessing the emergency department and to examine the differences in self-reported symptoms among those who did and did not utilize the emergency department.
Methods
A prospective longitudinal design was used. The sample included 403 community-dwelling older adults aged 75 years and older. Baseline in-home interviews were conducted followed by monthly telephone interviews over 15 months.
Results
Commonly reported symptoms at baseline included pain, feeling tired, and having shortness of breath. In univariate analysis, pain, shortness of breath, fair/poor well-being, and feeling tired were significantly correlated with ED utilization. In multivariable models, problems with balance and fair/poor well-being were significantly associated with ED utilization.
Discussion
Several symptoms were common among this cohort of older adults. However, no significant differences were found in the types of symptoms reported by older adults who utilized the emergency department compared with those who did not utilize the emergency department. Based on these findings, it appears that symptoms among community-dwelling older adults may not be the primary reason for ED utilization.DOI : http://dx.doi.org/10.1016/j.jen.2016.10.001|1 Disponible en ligne : Non Permalink : https://bib.vinci.be/opac_css/index.php?lvl=notice_display&id=78914
in Journal of Emergency Nursing > Vol. 43, n°1 (January 2017) . - p. 57-69[article]Exemplaires (1)
Cote Support Localisation Section Disponibilité REV Périodique papier Woluwe périodiques Consultation sur place uniquement
Exclu du prêt
Titre : Case Studies Demonstrating Stroke Telemedicine in the Rural Emergency Department Type de document : Article Auteurs : Debra L. Bowman Année de publication : 2017 Article en page(s) : p. 70-71 Langues : Anglais (eng) Descripteurs : HE Vinci
Accident vasculaire cérébral (AVC) ; Présentations de cas ; Recherche ; Soins d'urgence ; Sujet âgé ; Télémédecine ; Unité de soinsDOI : http://dx.doi.org/10.1016/j.jen.2016.10.008|1 Disponible en ligne : Non Permalink : https://bib.vinci.be/opac_css/index.php?lvl=notice_display&id=78915
in Journal of Emergency Nursing > Vol. 43, n°1 (January 2017) . - p. 70-71[article]Exemplaires (1)
Cote Support Localisation Section Disponibilité REV Périodique papier Woluwe périodiques Consultation sur place uniquement
Exclu du prêt
Titre : Optimizing care of the mechanically ventilated patient in the emergency department through the utilization of validated sedation scoring scales Type de document : Article Auteurs : Chelsie L. Sanders ; Kristin H. Eginger Année de publication : 2017 Article en page(s) : p. 84-86 Langues : Anglais (eng) Descripteurs : HE Vinci
Echelle d'évaluation ; Recherche ; Sédation ; Soins ; Soins d'urgence ; Unité de soins ; Ventilation artificielleDOI : http://dx.doi.org/10.1016/j.jen.2016.12.005|1 Disponible en ligne : Non Permalink : https://bib.vinci.be/opac_css/index.php?lvl=notice_display&id=78918
in Journal of Emergency Nursing > Vol. 43, n°1 (January 2017) . - p. 84-86[article]Exemplaires (1)
Cote Support Localisation Section Disponibilité REV Périodique papier Woluwe périodiques Consultation sur place uniquement
Exclu du prêt
Exemplaires (1)
| Cote | Support | Localisation | Section | Disponibilité |
|---|---|---|---|---|
| REV | Périodique papier | Woluwe | périodiques | Consultation sur place uniquement Exclu du prêt |
