Journal of emergency nursing : JEN : official publication of the Emergency Department Nurses Association
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Emergency department encounters include an increasing number of patients with limited English proficiency, yet little is known about the impact of interpreter services on unplanned revisits to the emergency department. This study aims to assess interpreters' utilization and unplanned ED revisits, serving as an indicator of care quality. ⋯ This study reveals a higher unplanned ED revisit rate among limited English proficiency patients, potentially linked to varying interpreter modality effectiveness and underutilization of trained interpreters. Emphasizing the critical role of trained interpreters, these findings offer an opportunity to enhance care quality for limited English proficiency patients in the emergency department.
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Identifying factors that enhance the stages of behavior change and nurses' readiness to evacuate patients during disasters can facilitate the proper management of the patient evacuation process in emergencies. This study aimed to identify the factors related to the stages of behavior change and nurses' readiness to evacuate patients during disasters. ⋯ This study revealed factors that enhance nurses' preparedness for evacuating patients in disasters. Training courses and operational maneuvers based on the stages of behavior change in nurses may effectively increase the process of patient evacuation during disasters.
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In hospital-based emergency departments, the national average of left before treatment complete was 2%. In addition, patients may leave without being seen or against medical advice and elope after arriving to the emergency department. When events occurred, they were associated with an increased length of stay for patients who were admitted to the hospital and decreased patient satisfaction. ⋯ Using a continuous improvement framework and nursing caregiver-based countermeasures, the rate of leaving before final disposition was dramatically reduced. Team involvement in action planning and change processes was critical to successful outcomes.
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Cognitive impairment in older adults is underrecognized in emergency departments. Despite emergency nurses' central role in facilitating ED screening for clinical and social needs, little is known about their perspectives on implementing delirium and dementia screenings. Nurses can provide insights to promote the uptake of these screenings. ⋯ Emergency nurses conceptualize screenings in terms of patient safety, which may be the best way to frame initiatives to implement screenings for cognitive impairment. In light of ED crowding and boarding's impacts on patient safety, nurses highlighted screening for cognitive impairment as increasingly relevant. However, they found current working conditions of delivering patient care in waiting rooms and hallways not conducive to implementing screenings. Using the Consolidated Framework for Implementation Research framework helped identify workflow limitations that are barriers to ED screening.