Australasian emergency care
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Australas Emerg Care · Jun 2019
A survey of sepsis knowledge among Canadian emergency department registered nurses.
With the rise of patients with sepsis presenting to emergency departments, emergency nurses, as frontline healthcare workers, require current clinical knowledge of sepsis. The aim of this study was to assess emergency department registered nurses' knowledge of sepsis and their perspectives of caring for patients with sepsis. ⋯ Educational programs and coaching approaches that maximize nurses' abilities to enhance their decision-making with regards to early assessment and appropriate intervention for persons with sepsis are needed. Such multifaceted approaches would acknowledge nurses' existing knowledge and provide practical supports to help nurses extend and mobilize their knowledge for everyday decision-making within the complex clinical environment of the emergency department.
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Australas Emerg Care · Jun 2019
The management of patients with acute abdominal pain in the emergency department: A qualitative study of nurse perceptions.
Acute abdominal pain is a common reason for presentation to the emergency department. Understanding the role of nurses involved in management of acute abdominal pain is important for improving patient care and outcomes. The aim of this study was to understand the perceptions of emergency nurses in the management of acute abdominal pain. ⋯ The management of patients with acute abdominal pain is influenced by how nurses participate in the diagnostic process. Nurses identified their role in this process and described how this role impacted their delivery of fundamental care. Further studies of the nursing contribution to diagnosis, communication, and the systems that affect care delivery in the emergency department are required.
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Australas Emerg Care · Jun 2019
Triage in Australian emergency departments: Results of a New South Wales survey.
To describe current models of triage, the preparation and education of triage nurses, and methods of auditing triage practice in New South Wales emergency departments. ⋯ The purpose of triage is to ensure that the level of emergency care provided is commensurate with clinical urgency. Variability in the preparation, education and evaluation of triage nurses may in and of itself, contribute to poor patient outcomes. Further, workforce size and geography may impede auditing and the provision of feedback, which are critical to improving triage practice and triage nurse performance. It is imperative that the Emergency Triage Education Kit be revised and maintained in tandem with future revisions of the Australasian Triage Scale.
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Australas Emerg Care · Jun 2019
Prehospital and hospital delays for stroke patients treated with thrombolysis: A retrospective study from mixed rural-urban area in Northern Finland.
Thrombolysis improves stroke outcome, but efficacy of the treatment is limited by time. Therefore, recognition of stroke symptoms by dispatch centres and by emergency medical services (EMS) is crucial, as is minimization of pre-hospital delays. We investigated the pre-hospital delays in patients with stroke treated with thrombolysis and compared the delays between rural and urban patients. ⋯ Positive FAST findings and the use of priority dispatch code and priority transport code were associated with shorter transport delays. There is room for improvement in door-to-needle time and in stroke recognition by the dispatch centre and EMS providers. For the rural population, helicopter transportation could reduce the long pre-hospital time.
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Australas Emerg Care · Mar 2019
The impact of simulated multidisciplinary Trauma Team Training on team performance: A qualitative study.
Effective teamwork is imperative in the emergency trauma setting as trauma teams work in the uncertain and complex context of resuscitating critically injured patients. Poorly performing teams have the potential to contribute to adverse events. Efforts to improve teamwork in trauma include simulation-based multidisciplinary team training with a non-technical skills (NTS) focus. However, there is a lack of evidence linking teamwork training programs with the uptake of NTS in real life trauma resuscitations. The aim of this study was to understand trauma team members' perspectives and experiences of teamwork in real world trauma resuscitations at a Level 1 Trauma Hospital, following completion of a simulated multidisciplinary Trauma Team Training (TTT) program. ⋯ A quickly constructed specialty team with unstable membership, will not transform naturally into an expert trauma team. The creation and maintenance of effective trauma teams requires training strategies such as multidisciplinary simulation that target team training and team interaction. Specifically, training should focus on developing non-technical skills for resuscitation trauma teams that have to form quickly and function effectively, often having never met before. As participants were overwhelmingly female, the data generated by this study are not necessarily generalisable to male members of trauma teams.