International emergency nursing
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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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To describe the numbers and length of stay (LOS) of patients with mental health (MH) problems at a Dutch emergency department (ED) and the effect of a psychiatric intervention team (PIT) on patient flow. ⋯ The number of MH presentations increased over the three years while LOS remained similar. In the before and after intervention study, number of presentations increased even more while LOS decreased significantly. Specialist psychiatric input reduces ED LOS.
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To compare the reliability, validity and resource utilization of the Emergency Severity Index (ESI) and Patient Acuity Category Scale (PACS) triage scales. ⋯ Both triage systems demonstrated moderate interrater reliability and construct validity in triaging actual patients. The ESI has better resource discrimination ability than the PACS and can improve resource management in the ED.
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Randomized Controlled Trial
Nurse-initiated radiographic-test protocol for ankle injuries: A randomized controlled trial.
Nurse-initiated radiographic-test protocol was compared with usual practice in reducing unnecessary ankle and foot radiographic-test requests and shortening patients' length of stay (LOS) in an emergency department (ED) by reducing their waiting time for physician reassessment. ⋯ Implementing the nurse-initiated radiographic-test protocol reduced unnecessary ankle and foot radiographic-test requests and shortened patients' LOS in the ED by reducing their waiting time for physician reassessment.
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This paper reports a systematic literature review evaluating the impact and quality of pain management associated with nurse initiated analgesia in patients presenting to the emergency department (ED). ⋯ Nurse-initiated analgesia was associated with safe, timely and effective pain relief.