Journal of emergency nursing : JEN : official publication of the Emergency Department Nurses Association
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Vital signs are an important component of the nursing assessment and are used as early warning signs of changes in a patient's condition; however, little research has been conducted to determine how often vital signs are monitored in the emergency department. Additionally, it has not been determined what personal, social, and environmental factors affect the frequency of vital sign monitoring. The purpose of this study was to examine what factors may influence the time between recording vital signs in the emergency department. ⋯ These findings are clinically important because greater time between vital sign recordings can lead to errors of omission by not detecting changes in vital signs that could reveal changes in the patient's condition. The findings of this study provide direction for future research focusing on determining whether higher frequency of vital signs surveillance contributes to higher quality care and linking quality of care to missing vital signs/inadequate monitoring.
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As hospitals compete for patients and their healthcare dollars, the emergency nurse is being asked to provide excellent nursing care to "customers" rather than patients. This has changed the approach in delivering quality care and has created favorable conditions for conflict as the nurse tries to achieve specific patient satisfaction goals. ⋯ The core conflict of conflicting priorities was based on the emergency nurses' perception that while patient satisfaction is important, it is not necessarily an indicator of quality of care. Interacting sub-themes reflect the way in which conflict priorities were influenced by patient satisfaction and the nurses' ability to provide quality care. Avoidant conflict management style was used to resolve conflicting priorities because nurses perceive that there is not enough time to address conflict even though it could impact on work stress and patient care.
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This study examined the accuracy of temporal artery and axillary temperatures compared with rectal temperatures in pediatric ED patients younger than 4 years. ⋯ Bias and precision values for the temporal artery, but not the axillary temperature, were within the acceptable range set by experts to use as a noninvasive substitute for core body temperature measurements. If properly used by ED staff, temporal artery thermometers could be used to obtain temperature in pediatric patients younger than 4 years, thus avoiding physical and psychological discomfort for the child and parent associated with obtaining rectal thermometers.