International emergency nursing
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Emergency department (ED) crowding and prolonged waiting times have been associated with adverse consequences towards quality and patient safety. ⋯ The number of patients simultaneously present is a moderate indicator of unsafe waiting times. Future initiatives to improve safe waiting times should not focus solely on occupancy, and expand their focus towards other factors affecting waiting time.
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To determine the frequency, duration and type of audible monitor alarms in an ED, utilising the standard manufacturer's classification. ⋯ Whilst high level monitoring is desired from a patient safety perspective, it contributes to a significant ambient noise level, which is recognised by all who pass through an ED, and can be detrimental to patients, relatives and staff. We have demonstrated that there is a high probability of near-continuous alarm noise from patient monitoring in a 10-bedded Majors area. We make suggestions for methods of noise reduction and intend to implement some of these within our own ED.
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This study investigated the inter-observer agreement (IOA) between doctors and nurses on triaging adult ED dyspneic patients. ⋯ Trained ED nurses were safe and managed adult dyspneic patients as well as doctors at triage.
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Cultural awareness of emergency department staff is important to ensure delivery of appropriate health care to people from all ethnic groups. Cultural awareness training has been found to increase knowledge about other cultures and is widely used as a means of educating staff, however, debate continues as to the effectiveness of these programs. ⋯ Future strategies to improve staff cultural awareness need to be investigated, developed, implemented and evaluated.
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Nursing is evolving into new fields of health care including ambulance care, where a branch of specialist nursing is growing. Various views exist on the desired competence for the ambulance nurse and valid guidelines are lacking in Sweden. To increase knowledge of the field, professionals were asked to describe what competences an ambulance nurse should possess. ⋯ A modified Delphi technique was used, where a panel of professional experts expressed their views on the desired competence of the ambulance nurse. This study reports, at a high level of agreement among the panel experts, that the desired competence of the specialist ambulance nurse consist of forty-four separate competences creating ten areas of competences: execute leadership, generic abilities, interpersonal communication, institutional collaboration, pedagogic skills, possession of relevant knowledge, professional judgement, professional skills, research activities, and technical skills. The high level of agreement among the professionals as well as the large number of competences reflects the high demands placed on the ambulance nurse by the professionals themselves.