Emergency medicine Australasia : EMA
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Emerg Med Australas · Feb 2016
ReviewReview article: Staff perception of the emergency department working environment: Integrative review of the literature.
Employees in EDs report increasing role overload because of critical staff shortages, budgetary cuts and increased patient numbers and acuity. Such overload could compromise staff satisfaction with their working environment. This integrative review identifies, synthesises and evaluates current research around staff perceptions of the working conditions in EDs. ⋯ A key finding was that perceptions of working environment varied across clinical staff and study location, but that high levels of autonomy and teamwork offset stress around high pressure and high volume workloads. The large range of tools used to assess staff perception of working environment limits the comparability of the studies. A dearth of intervention studies around enhancing working environments in EDs limits the capacity to recommend evidence-based interventions to improve staff morale.
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Emerg Med Australas · Feb 2016
Multicenter StudyIs a national time target for emergency department stay associated with changes in the quality of care for acute asthma? A multicentre pre-intervention post-intervention study.
There is debate whether targets for ED length of stay introduced to reduce ED overcrowding are helpful or harmful, as focus on a process target may divert attention from clinical care. Our objective was to investigate the effect of a national ED target in Aotearoa New Zealand on the recommended care for acute asthma as this is known to suffer in overcrowded departments. ⋯ Introduction of the target was not associated with a change in times to steroids in ED, although more patients received steroids in ED indicating closer adherence to recommended practice.
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Emerg Med Australas · Feb 2016
Current profile of cycling injuries: A retrospective analysis of a trauma centre level 1 in Queensland.
One out of 50 injury-related presentations to an ED is a transport-related cycling injury. Detailed information about the most frequent mechanism of cycling injuries, sustained injuries and patterns are under-reported. The objective of this research was to examine the pattern of injuries sustained by cyclists at a level 1 trauma centre. ⋯ This current data review reveals that non-collision traffic crashes accounted for the majority of injuries in cyclists treated in this facility, and the upper limb has replaced the head as the most injured body part. With a growing number of cyclists, this information contributes to considerations to improve road safety and trauma management.
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Emerg Med Australas · Feb 2016
Observational StudyThe Royal North Shore Hospital Emergency Department airway registry: Closing the audit loop.
We aim to investigate whether a bundle of changes made to the practice of endotracheal intubation in our ED was associated with an improvement in first pass success rate and a reduction in the incidence of complications. ⋯ We have shown that, through the introduction of a bundle of changes that spans the domains of staff training, equipment and practice standardisation, we have made significant improvements in the safety of patients undergoing endotracheal intubation in our ED.
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Emerg Med Australas · Feb 2016
Reliability of the Abbreviated Westmead Post-traumatic Amnesia Scale in children: Impact of age on test results.
This study aimed to determine the reliability of the Abbreviated Westmead Post-traumatic Amnesia Scale (A-WPTAS) in children by examining the impact of age on A-WPTAS performance. ⋯ The A-WPTAS is reliable for use in children aged 7 years and older, while its use in children aged 6 years and under results in an unsatisfactory high false positive rate, limiting its clinical utility. The adult-level performance of children aged 7 years onwards provides strong support for using the tool in the early management of these children with mild traumatic brain injury in Australian EDs.