Journal of emergency nursing : JEN : official publication of the Emergency Department Nurses Association
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Heart failure is a progressive disease that affects more than 6.7 million people in the United States and has a 50% mortality rate. A left ventricular assist device provides an option to many patients with heart failure as a bridge to either transplantation or destination therapy. Patients are becoming more prevalent with improved survival rates. Emergency nurses must have a basic understanding and skills to provide high-quality care. The competency program aims to elevate the confidence of emergency nurses caring for left ventricular assist device patients and reduce the reliance on the circulatory support technician through quarterly skills assessment and simulation. ⋯ The quality improvement project identified a need to provide additional support to emergency nurses to increase their skills and confidence. Replication is needed to assess further the efficacy of more frequent simulation-based learning and the implementation of readily available resource books and left ventricular assist device nurse champions.
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Patient fall risk assessment in the emergency department poses a unique challenge as fall risk is often associated with risk factors other than inpatient falls. While there are many inpatient fall risk assessment tools, few have been used or validated in the ED environment. Therefore, this study examined the predictive performance of the KINDER 1 Fall Risk Assessment Tool in 10 emergency departments. ⋯ KINDER 1 exhibited a sufficiently high degree of sensitivity and specificity, supporting an acceptable level of predictive performance. Additional research is recommended to compare the reliability and predictive validity of KINDER 1 to the emergency Hester Davis Scale and the Memorial Emergency Department Fall Risk Assessment Tool, as well as to compare the usability of the tools for nurses in a triage setting.
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Strong evidence demonstrated that working in a healthy environment has been associated with high-quality patient care. However, the mechanism underlying this relationship requires further investigation. This study aimed to examine the role of structural empowerment in mediating the relationship between nursing practice environment and quality of care among emergency nurses. ⋯ Nurse leaders can enhance care quality in emergency departments by improving the work environment through engaging nurses in quality activities, ensuring adequate staffing and resources, and providing robust leadership support, which collectively empower nurses and improve patient outcomes.
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The management of patients with major trauma is complex and encompasses the entire clinical pathway. The trauma coordinator role has been introduced to enhance communication and coordination. Despite the clinical benefits of trauma coordinators, their implementation in Italy is currently limited. ⋯ This survey highlights the need for a more structured integration of trauma coordinators into trauma care teams. Emphasizing clear role descriptions, formal recognition, and appropriate compensation is essential to maximize the impact of trauma coordinators on patient outcomes.
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This study aimed to compare the time spent on episodes seen by primary care emergency departments before (2017) and after (2019) the inclusion of an advanced practice nurse in patient classification. ⋯ The inclusion of nurses with advanced nursing practice roles reduces the waiting time and length of stay in the emergency department, but increases the classification time, which could be linked to early interventions.