International emergency nursing
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This study investigates possible differences in the perception of quality of care at an emergency department, as related to patient background and visit characteristics. ⋯ There are differences in the perception of quality of care related to patient background and visit characteristics at the emergency department. Clinical guidelines for different patient groups could facilitate the quality improvement work. However, to improve the quality of care at the emergency department there should be a balance between standardized care and individualized patient care. In addition, there has to be a changed attitude and behaviour towards the ED patients to improve their perception of the emergency care.
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Severe sepsis and septic shock are syndromes resulting in a systemic inflammatory response and the dysfunction of one or more organs following infection. The Surviving Sepsis Campaign is an international effort to reduce mortality in severe sepsis and septic shock by 25% by 2009 using a care bundle approach. It comprises evidenced-based interventions to be carried out within 6h of onset of sepsis. ⋯ Administration of an antibiotic was also very slow. Local recommendations include improvements to the track and trigger scoring system in A&E to improve recognition of sick patients, ensuring the doctor responsible for prescribing the antibiotic will administer it, and increasing awareness of the surviving sepsis campaign via education and training of all A&E staff. Given current evidence greater compliance to the care bundle may well improve patient outcomes for this client group.