Journal of emergency nursing : JEN : official publication of the Emergency Department Nurses Association
-
The death of a child in the emergency department (ED) is one of the most challenging problems facing ED clinicians. This revised technical report and accompanying policy statement reaffirm principles of patient- and family-centered care. Recent literature is examined regarding family presence, termination of resuscitation, bereavement responsibilities of ED clinicians, support of child fatality review efforts, and other issues inherent in caring for the patient, family, and staff when a child dies in the ED. Appendices are provided that offer an approach to bereavement activities in the ED, carrying out forensic responsibilities while providing compassionate care, communicating the news of the death of a child in the acute setting, providing a closing ritual at the time of terminating resuscitation efforts, and managing the child with a terminal condition who presents near death in the ED.
-
Hematologic cancers comprise an aggregate of several different cancers, such as leukemia, lymphoma, and multiple myeloma. There are more than 100,000 new cases of these hematologic cancers in the United States annually, and more than 50,000 children and adults die from these cancers., Hematologic cancers affect the body’s blood, bone marrow, and lymphatic system, leaving these patients more susceptible to infections. A newly diagnosed patient with acute leukemia receives aggressive chemotherapy treatment and is closely monitored in the hospital for at least 3 to 4 weeks. Treatment-related signs and symptoms including fever, pain, nausea and vomiting, and respiratory distress may bring the patient to the emergency department before his or her next scheduled clinic appointment., In this article a case study of a patient with acute lymphoblastic leukemia who enters the emergency department will be used to illustrate a common clinical scenario and provide clinical implications for emergency nurses who care for patients with hematologic cancers.
-
Lack of specific guidelines regarding collection of blood for culture from central venous catheters (CVCs) has led to inconsistencies in policies among hospitals. Currently, no specific professional or regulatory recommendations exist in relation to using, reinfusing, or discarding blood drawn from CVCs before drawing blood for a culture. Repeated wasting of blood may harm immunocompromised pediatric oncology patients. The purpose of this comparative study was to determine whether differences exist between blood cultures obtained from the first 5 mL of blood drawn from a CVC line when compared with the second 5 mL drawn. ⋯ These findings support the accuracy of the specimen that is normally discarded and suggest the need to reconsider its use for blood culture testing.
-
Comparative Study
A Comparison of Patient and Nurse Expectations Regarding Nursing Care in the Emergency Department.
Patient satisfaction, an important measurable outcome, allows nurses to assess what can be improved in nursing practice. The purpose of this study is to compare expectations of patients and nurses using 3 nursing care attributes: 1) friendliness, courtesy, and respectfulness; 2) comfort measures; and 3) degree of information sharing. ⋯ The unexpected highly positive patient rating did not identify specific areas for practice improvement; it did provide positive feedback for excellent care, reinforcing good nursing practice.