Emergency medicine Australasia : EMA
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Emerg Med Australas · Jun 2023
Impact of alcohol policy changes on substance-affected patients attending an emergency department in the Northern Territory with police.
Assess the impact of Northern Territory alcohol policy changes to ED utilisation at Royal Darwin-Palmerston Regional Hospitals. ⋯ The sequential introduction of broad sweeping alcohol policy changes introduced by the Northern Territory government was associated with significant reductions in ED utilisation. The proximity of the introduction of interventions creates difficulties identifying individual policy influence.
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Emerg Med Australas · Jun 2023
CommentModified Sequential Organ Failure Assessment score for predicting mortality in emergency department patients with sepsis.
Several scoring systems have been proposed for EDs to identify patients at increased risk of mortality from sepsis. The modified Sequential Organ Failure Assessment (mSOFA) score, proposed in 2019, demonstrated a high negative predictive value. We aimed to validate mSOFA and compare its accuracy for predicting 30-day mortality to the simple bedside score, quick SOFA (qSOFA). ⋯ In the present study, neither mSOFA nor qSOFA was adequately sensitive for predicting 30-day mortality, although both scores were highly specific and their overall accuracy was similar. The added complexity of the mSOFA without a significant increase in discriminative ability makes it unlikely to replace qSOFA in the ED setting.
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Emerg Med Australas · Jun 2023
What factors help and hinder efforts to address incivility in Australasian emergency departments? A modified Delphi study of FACEM perspectives.
Workplace incivility is a global challenge for healthcare and a major leadership challenge facing emergency physicians. However, little is known about emergency physicians' understanding of the factors that help and hinder attempts to address incivility, or what emergency physicians believe are the priority factors to address. The present study makes a novel contribution to research in this area by examining the perceived enablers of, and barriers to, efforts to address incivility in Australian and Aotearoa New Zealand EDs. ⋯ The causes of incivility in Australian and Aotearoa New Zealand EDs are complex and highlight incivility in EDs as a key adaptive leadership challenge of emergency physicians. Fundamentally, the results underscore the need to foster a workplace culture of respect, inclusion and civility in Australasian hospitals.
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Emerg Med Australas · Jun 2023
Impact of art and reflective practice on medical education in the emergency department.
There is heightened intrigue surrounding the application of arts-based pedagogy in medical education. Art encompasses multiple forms of expression and is used to convey specific meaning and emotion, whereas provoking critical reflection. Our aim was to explore the effectiveness of art and reflective practice in medical education, in the context of the ED. ⋯ The combination of art and reflection in medical education enhances reflective learning and can lead to transformative change, including the development of core doctoring values of service, empathy and respect for patient. There are clear benefits to medical education incorporating more arts-based pedagogy that promotes reflective exploration and interpretation of the psychosocial context of health and illness, delivery of more holistic models of care and their role as doctors.
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Emerg Med Australas · Jun 2023
What can coronial cases tell us about the quality of emergency healthcare for prisoners in Australia?
This research aimed to examine the legal and regulatory obligations of authorities and healthcare professionals in the provision of prison emergency health services and to identify problems in the provision of emergency care to prisoners by using case examples from coronial findings. ⋯ Coronial findings and royal commissions have repeatedly identified deficiencies in the emergency healthcare provided to prisoners in Australia. These deficiencies are operational, clinical and stigmatic and not limited to a single prison or jurisdiction. Applying a health quality of care framework focussed on prevention and chronic health management, appropriate assessment and escalation when urgent medical assistance is requested, and a structured audit framework could avoid future preventable deaths in prisons.