Journal of emergency nursing : JEN : official publication of the Emergency Department Nurses Association
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Evaluation of a Nurse-Initiated Acute Gastroenteritis Pathway in the Pediatric Emergency Department.
Acute gastroenteritis (AGE) is a common illness treated in the emergency department. Delays in initiating rehydration for children with mild or moderate dehydration from AGE can lead to prolonged ED visits and increased resource utilization that do not provide prognostic value or support family-centered care. The purpose of this quality improvement project was to promote early oral rehydration therapy (ORT) for persons with AGE in an attempt to reduce unnecessary resource utilization and length of stay (LOS). ⋯ Nurse autonomy in using an AGE pathway facilitates evidence-based practice, improves ED efficiency, and decreases resource utilization and LOS. Future research should focus on family satisfaction and ED revisits within 72 hours of discharge.
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Little information has been published regarding the actual practice, training, and validation of basic skills and competencies needed by the advanced practice registered nurse (APRN) in the emergency care setting. The purpose of this study was to (1) identify skills being performed by APRNs practicing in emergency care settings (2); explore types of training; and (3) describe competency validation. Additionally, we explored frequency of skill use and facilitators and barriers to performing a skill to the full extent of training and education. ⋯ Integrated educational and orientation programs are needed that address high-acuity patients across the life span. Additionally, a more nuanced approach to assessing APRN capabilities as a combination of hard (clinical emergency) and soft (communication and organizational) skills may be an appropriate framework within which to examine the advanced practice role. Future research should continue to evaluate training, competency assessment, and outcomes for APRNs in the emergency care setting.
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Our hospital was encountering problems with ED crowding. We sought to determine the impact of implementing a full-capacity protocol to respond to anticipated or actual crowding conditions. Our full-capacity protocol is based on collaboration among multiple hospital units. ⋯ The collaborative full-capacity protocol was effective in reducing LWBS and ambulance diversion, while accommodating a significant increase in ED volume and increased hospital admission rates at our institution.
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ABSTRACT INTRODUCTION: Increasing numbers of behavioral patients are presenting to emergency departments, where competency of staff to care for this group is unknown. ⋯ This study provides needed research demonstrating improved perceived competency of nurses and allied health professionals to care for BH patients in emergency departments after brief concentrated education. Improvements occurred despite the fact that participants had initial baseline competencies that were higher than those of general hospital nurses from a historical sample.