Journal of emergency nursing : JEN : official publication of the Emergency Department Nurses Association
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Comparative Study
Novel Use of a Nurse-Led Telemedicine Team in Acute Stroke: A Retrospective Review of the Impact on a Regional Health Care System.
Despite the increasing incidence of acute ischemic stroke in the United States, many health care facilities remain unprepared to manage patients with acute stroke, including the administration of intravenous alteplase (recombinant tissue plasminogen activator [rTPA]). This has led to an opportunity for telemedicine systems to facilitate these evaluations and acute medical stroke treatment decisions. However, even telemedicine systems can fail to provide timely evaluation and management of the patient with acute stroke. The purpose of this retrospective study was to compare stroke outcome metrics pre- and postimplementation of a hybrid, local nurse-led "stroke-responder" telemedicine system. ⋯ In an acute stroke telemedicine system, implementation of a local nurse-led "stroke responder" system resulted in significantly decreased acute stroke metrics for a community hospital within a regional hospital system.
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Emergency nursing turnover rates are high in the United States. Little is known about the role of personality characteristics in the turnover decisions of emergency nurses. Intent to leave is often measured to determine the likelihood of turnover versus retention of employees. The aim of this study is to examine the relationship among personality characteristics, employment tenure, and intent to leave among emergency nurses. ⋯ This study found similarities in personality characteristics for all 406 study participants, with significant differences related to career tenure for some dimensions. This type of knowledge might provide administrators with details of important characteristics to foster which may have a positive impact on retention.
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Although death is common in emergency departments, there is limited research regarding ED design as an obstacle to end-of-life care. This study identifies emergency nurses' recommendations regarding ways designs have negative or positive impact on care for dying patients and their families. ⋯ Emergency nurses understand the need for family presence during resuscitation, for secure body stowage areas, and for more resuscitation rooms so that families have time to grieve before being removed because of the immediate needs of a second trauma patient. Nurses can evaluate existing facilities to identify areas in which potential change and remodeling could improve care, increase patient privacy, or further utilize space. Understanding ED design's impact on EOL care is crucial. Modifications to ED layout and design may be challenging; however, improvements to space, layout, and privacy need to be considered when planning new emergency departments or remodeling existing departments. Further research is required to determine the impact of ED design on EOL care.