International emergency nursing
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This study has a health care science approach and explores pre-hospital emergency care with emphasis on assessment. Health care science is focused on the patient with the general aim to describe care that strengthens and supports health. Assessment in the ambulance services has not been explored earlier from this perspective, despite the emphasis on 'coming close' to the acute suffering patient. ⋯ It seems that assessments that focus solely on a patient's medical condition can be an obstacle to a full understanding of the individual, and thereby the illness per se. A caring assessment based on an encounter and a dialogue between patient and carer, characterised by inviting the patient to participate, adds further dimensions to the objective data. Therefore, the inclusion of the patient perspective relieves suffering and enables more safe decisions.
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Unified Modelling Language (UML) models of the patient journey in a regional Australian emergency department (ED) were used to develop an accurate, complete representation of ED processes and drive the collection of comprehensive quantitative and qualitative service delivery and patient treatment data as an evidence base for hospital service planning. The focus was to identify bottle-necks that contribute to over-crowding. Data was collected entirely independently of the routine hospital data collection system. ⋯ The physical layout of the triage area was identified as counterproductive to efficient triaging, and the results of investigations were often observed to be available for some time before clinical staff became aware. The use of independent primary data to construct UML models of the patient journey was effective in identifying sources of delay in patient flow, and aspects of ED activity that could be improved. The findings contributed to recent department re-design and informed an initiative to develop a business intelligence system for predicting impending occurrence of access block.
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The focus of this research study was to ascertain the impact of crime on individuals, who presented with an injury to the emergency department. Given the high prevalence of crime in our society today, victims of crime are identified as a growing patient population seeking help in emergency departments. To maximise holistic care for these patients it is important that healthcare professionals gain insight into the experience of being a victim of crime. ⋯ Unseen is the potential psychological sequelae of the assault. Pivotal to these findings is the absence of psychological follow-up support for these victims of crime. This study affords healthcare professionals working in the emergency department, the opportunity to reflect upon current practice and highlight the value of their role in the provision of optimal care for this patient population.
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We conducted a validation study on use of the Canadian C-Spine Rule (CCR) by emergency department (ED) nurses to clear the c-spine in alert and stable trauma patients (N=3633). This survey sought to identify potential facilitators and barriers to an implementation policy that would allow nurses to clinically clear the c-spine of minor trauma patients. ⋯ This survey was an important step towards the goal of empowering ED nurses to clinically clear the c-spine of alert and stable trauma patients. There was a high rate of endorsement of facilitators and a low rate of endorsement of barriers. We found variation between hospitals, emphasizing the importance of understanding local beliefs when seeking to change clinical practice. We are conducting an implementation trial based on this feedback.