Journal of emergency nursing : JEN : official publication of the Emergency Department Nurses Association
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There are significant and negative psychological effects that can occur in nursing staff caring for pediatric patients experiencing critical incidents. Debriefings can provide relief from the stressors caused by critical incidents. Adapting a pre-existing critical incident stress debriefing (CISD) process to ED staff is 1 way to provide staff debriefing. ⋯ Pediatric ED staff de-stress in a variety of ways, and a nonmandatory, formalized CISD process-open to staff involved and facilitated by an emergency nurse-could provide additional relief from stress. This debriefing process should include positive feedback and critiques to help improve care processes, information about mechanism of injury, and should occur before the end of shift or within 12 to 24 hours of the incident. Staff may deal with personal feelings outside of debriefing.
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For children with autism spectrum disorder (ASD) and sensory-processing disorder (SPD), an unexpected visit to the emergency department can be an overwhelming experience that creates intensifying behaviors and an unsafe clinical interaction for the child, nurses, and providers. Although resources exist to help nurses work with this specialized group, there are limited examples of the challenges and opportunities of modifying an emergency department to be a place where nurses can provide sensory-informed care. ⋯ Integrating current evidence, staff suggestions, community input, and expert advice allowed us to find creative solutions to the unique sensory needs of children who visit our emergency department. Modifying both the patient-care environment and the patient-flow process to accommodate for the needs of children with ASD/SPD created a more peaceful and healing environment for children and their families and gave nurses the support they needed to provide sensory-informed care.
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Nursing burnout and high levels of nursing turnover contribute to negative work environments, diminished patient care, and increased health care costs. There is a gap in literature regarding cost-effective, easily implemented interventions to address burnout and turnover. The purpose of this project was to determine if the implementation of evidence-based interventions would improve the perception of the practice environment, decrease the levels of nursing burnout, and decrease the voluntary nurse turnover rate in the emergency department. ⋯ Nursing burnout and turnover are frequently discussed topics. The results support the use of cost-effective interventions outlined in the Cultural Change Toolkit to address nursing turnover and burnout.