International emergency nursing
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Observational Study
Recognition, response and outcomes of sepsis: A dual site retrospective observational study.
To describe clinical recognition, response and outcomes of patients with sepsis. ⋯ Sepsis can develop at various stages throughout the patient's journey. In this small sample, ED recognition was associated with longer ED stay, likely due to more interventions. Whilst guidelines recommend antibiotics be administered within 60 min of triage, this was not achieved for most patients. Given the dynamic nature of sepsis, future indicators may focus on time from recognition rather than time from triage.
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Observational Study
Workload Indicators of Staffing Need as a tool to determine nurse staffing for a high volume academic Emergency Department: An observational study.
Determination of staffing requirement for an Emergency Department (ED) is often difficult due to random arrivals of a complex mix of cases, fluctuating volumes and lengths of stay. Most staffing strategies are based on patient census, lengths of stay, patient dependency or patient classification systems. However, the actual quantity of workload is seldom employed as a basis to calculate staffing. ⋯ The Workload Indicators of Staffing Need is a simple, easy to use method that can prospectively measure direct and indirect nursing activities and translate workload into nursing full time equivalents for the ED. This method is also useful to identify activities that do not require nursing professional skills and prescribe the skill mix of staff.
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Multicenter Study
Emergency clinician perceptions of occupational stressors and coping strategies: A multi-site study.
Research exploring multi-disciplinary emergency department (ED) clinicians' perceptions of their working environment is limited, although exposure to occupational stressors is frequent. This study describes ED clinicians' perceptions of their working environment, occupational stressors and their use of coping strategies. ⋯ While stressors were similarly rated among the diverse group of clinicians, the ways in which they reported coping varied. Further research is required to facilitate design of staff support strategies.
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The combined use of the Manchester Triage System (MTS) with the Early Warning Score (EWS) may be useful in ensuring both appropriate prioritisation and continued monitoring in the Emergency Department (ED) leading to early intervention for deteriorating patients thus improving patient outcomes especially in overcrowded EDs. ⋯ Although positive in terms of patient outcomes, the effective and sustained combined use of the MTS and EWS requires increased bed capacity and experienced clinical staff to ensure that the ED journey time reduced rather than increased.
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Presentation rates to Emergency Departments (ED) for people with mental health, drug health and behavioural problems are increasing. This necessitates a reorientation of health services and resources to meet this change in demand. ⋯ Implementing new models of care that require a change in thinking and practice can challenge power relations which subsequently impact on individual willingness to support proposed change. Therefore, even with demonstrated effectiveness, extensive consultation and high level support the cooperation of key local stakeholders is not always assured.