Journal of emergency nursing : JEN : official publication of the Emergency Department Nurses Association
-
Multicenter Study
Implementing clinical research in the high acuity setting of the emergency department.
Clinical research in the emergency department provides supporting evidence needed for the development of practice guidelines, such as door-to-needle and door-to-balloon times for treatment of acute coronary syndromes, and is vital to improvements in patient outcomes. The purpose of this article is to describe barriers and lessons learned in launching a multisite clinical research study of symptoms of acute coronary syndromes in the emergency department. ⋯ Important strategies to overcome barriers were developed, including identification and support of unit champions in emergency nursing and medicine; minor protocol modifications to improve enrollment goals; development of specific written expectations, roles, research protocols, and algorithms; and sharing successes among sites.
-
The Surviving Sepsis Campaign outlines the elements of early goal-directed therapy when treating patients with sepsis in the emergency department. The success of these guidelines relies on their implementation in order to attain optimal patient outcomes. The purpose of this article is to review the literature regarding the implementation of the sepsis guidelines in emergency departments. ⋯ This review provides some factors important for the successful implementation of the Surviving Sepsis Campaign guidelines. Operational and system issues significantly influenced the success of implementing sepsis protocols or bundles. More research is needed to overcome barriers to implementing early goal-directed therapy and to uncover which elements of the guidelines are most important and feasible to achieve optimal patient outcomes.
-
Ten percent to 15% of urinary catheterizations involve complications. New techniques to reduce risks and pain are indicated. This study examines the feasibility and safety of male urinary catheterization by nursing personnel using a visually guided device in a clinical setting. ⋯ The success rate for placement of a Foley catheter with the visually guided device was 100%, indicating its safety, accuracy, and feasibility in a clinical setting. Minimal pain was associated with the procedure.
-
Comparative Study
Comparing subcutaneous fluid infusion with intravenous fluid infusion in children.
This study examined subcutaneous (SC) infusion as a parenteral alternative for children with mild to moderate illness. The purpose was to compare the difference in infusion start time of parenteral fluid between an initial SC order and an initial intravenous (IV) order. In addition, the number of needlesticks a child received for each method was evaluated. This study also sought to address the following question: If SC fluids were given and an IV attempt was made later, did the administration of SC fluids enhance the success of venous cannulation? ⋯ In a child who is not seriously ill, SC infusions appear to facilitate the initiation of parenteral rehydration. SC infusions minimized the number of needlesticks a child endured. More study is needed to determine if SC fluids enhance success of subsequent venous cannulation.