International emergency nursing
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Time between emergency department (ED) presentation and treatment onset is an important, but little-researched phase within the revascularization process for ischaemic heart disease (IHD). ⋯ Substantial undertriage of AMI occurred for both sexes, but was worse in women. Incorrect triage led to prolonged treatment times for AMI, with women's treatment delays longer than men's. When triaged correctly, both sexes were treated early for AMI, emphasising the need for all patients to be accurately triaged for this time-sensitive disease.
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Critically ill patients can be subject to prolonged stays in the emergency department following receipt of an order to admit to an intensive care unit. The purpose of this study was to explore patient and organizational influences on the duration of boarding times for intensive care bound patients. ⋯ The study results provide a profile that may assist clinicians in understanding the complex and site-specific interplay of variables contributing to boarding of critically ill patients.
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Observational Study
Effectiveness of Emergency Medicine Wards in reducing length of stay and overcrowding in emergency departments.
This study aims to evaluate the effectiveness of an Emergency Medicine Ward (EMW) in reducing the length of stay (LOS) in the emergency department, length of hospitalization, emergency medical admission rate, and the hospital bed occupancy rate. ⋯ EMWs effectively reduce both the LOS during in-patient hospitalization and the avoidable medical admission rate.
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There are a number of perceived benefits and barriers to family presence during resuscitation (FPDR) in the emergency department, and debate continues among health professionals regarding the practice of family presence. ⋯ In order to ensure that practice of FPDR becomes consistent, emergency personnel need to understand the need for advanced FPDR training and education, the importance of a designated support person role and the evidence of FPDR policy as enablers to implementation.
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Review
Reducing uncertainty in triaging mental health presentations: examining triage decision-making.
Little is known about how emergency department (ED) nurses make decisions and even less is known about triage nurses' decision-making. There is compelling motivation to better understand the processes by which triage nurses make decisions, particularly with complex patient populations such as those with frequently emotive mental health and illness issues. ⋯ In this paper, we review the current research regarding the effectiveness of triage tools particularly with mental health presentations, present a theoretical framework that may guide research in understanding how triage nurses approach decision-making, and apply that framework to thinking about research in mental health-related triage. Developing a better understanding of how triage nurses make decisions, particularly in situations where issues related to mental health and illness may raise the levels of uncertainty, is crucial to ensure that they have the skills and tools they need to provide the most effective, sensitive, and compassionate care possible.