International emergency nursing
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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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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.
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Multicenter Study
Knowing what to expect, forecasting monthly emergency department visits: A time-series analysis.
To evaluate an automatic forecasting algorithm in order to predict the number of monthly emergency department (ED) visits one year ahead. ⋯ The applied automated exponential smoothing approach provided useful predictions of the number of monthly visits a year in advance.
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Multicenter Study
The emergency department "carousel": an ethnographically-derived model of the dynamics of patient flow.
Emergency department (ED) overcrowding reduces efficiency and increases the risk of medical error leading to adverse events. Technical solutions and models have done little to redress this. A full year's worth of ethnographic observations of patient flow were undertaken, which involved making hand-written field-notes of the communication and activities of emergency clinicians (doctors and nurses), in two EDs in Sydney, Australia. ⋯ The carousel model uniquely integrates diagnosis, treatment and transfer of individual patients with the intellectual labour of leading and coordinating the department. The latter involves managing staff skill mix and the allocation of patients to particular ED sub-departments. The model extends traditional patient flow representations and underlines the importance of valuing ethnographic methods in health services research, in order to foster organisational learning, and generate creative practical and policy alternatives that may, for example, reduce or ameliorate access block and ED overcrowding.
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Multicenter Study
Emergency nurses: procedures performed and competence in practice.
Emergency nurses play an important role in identifying and managing critical illness. Thus, nurses' competence in performing a range of functions is important. This study aimed to identify the procedures performed and associated competencies of emergency nurses. ⋯ Emergency nurses in Ireland engage in a wide range of activities, many of which are described in other countries as advanced practice. Recognition needs to be given and education prioritised in deficit areas.