Journal of emergency nursing : JEN : official publication of the Emergency Department Nurses Association
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Comparative Study
Five-level triage system more effective than three-level in tertiary emergency department.
The study objectives were to compare reliability and validity of a 3-level (3L) triage system with a new 5-level (5L) triage system and determine the effect of nursing experience on triage reliability. ⋯ The 5L triage system is safer and provides greater discrimination, better reliability, and improved sensitivity and specificity than the 3L triage system.
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Health care workers have long been recognized as having a high risk of work-related assault. In response to a growing threat of violence in hospitals, California implemented the Hospital Security Act (AB508) in 1993. This study compares surveys of emergency nurses before and after implementation of AB508. ⋯ Although results reported here cannot be directly attributed to AB508, the increase in security program components suggests that hospitals are responding positively to reduce violence. The high prevalence of threats and violent events reported indicates a persistent risk of violence against health care workers.
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The observation unit at The Children's hospital in Denver is a care delivery system which provides expanded ED services to patients. The purposes of this study of the observation unit included: constructing a demographic profile; determining the distribution of admissions by diagnosis and related disposition; and evaluating staffing patterns and nursing workload. Issues related to safety, length of stay, and appropriate utilization were raised as well as the need to accurately identify the most effective nursing staff requirements to provide safe, quality care. ⋯ Study findings inform clinical staffing and formulate guidelines for the ED observation unit usage.
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The purpose of this study was to describe characteristics, insights, and decision making of expert emergency nurses practicing in a triage environment. ⋯ Expert triage nurses discussed the characteristics that they deemed important in themselves and in those they worked with, such as intuition, assessment abilities, good communication, and critical thinking. The participants strongly verbalized the need for more formal education and emergency nursing experience for new triage nurses. Positive reinforcement from management for timely and accurate decision making was also an important topic.