Journal of emergency nursing : JEN : official publication of the Emergency Department Nurses Association
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Shared decision making involves both patients and health care professionals working together to choose a certain diagnostic or therapeutic option. To facilitate these decisions, the shared decision-support tools (SDSTs) have been developed to assist in the communication with patients during the hospital process. They have been frequently used in the choice of treatment for chronic diseases. However, in emergency departments, this model has not been as widely implemented. For that reason, this article aims to examine, through a systematic review, the effects of SDSTs on patients' hospital care in emergency departments. ⋯ Nevertheless, its implementation is limited by the belief that patients prefer physicians to decide for them and the pressures due to the limited time available. The development of SDSTs is relevant in urgent care pathways in which treatment has a high level of evidence and a complex risk-benefit balance.
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Nurse scheduling within an emergency department can be a very time-consuming process as nursing leadership works to reach sufficient nurse-staffing levels across every day of the schedule while also working to satisfy nurse preferences. ⋯ The emergency department can use mathematical modeling to improve the nurse-scheduling process.
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The Centers for Disease Control and Prevention (CDC) reports 136.9 million ED visits in 2015, of which 21.4 million (15.6%) were by patients who were 65 or older. This US population demographic is expected to grow by 112% over the next 40 years, becoming just below 25% of the total US population. Emergency nurses will play an increasingly important part in the development of nursing care for geriatric patients. The purpose of this study was to explore emergency nurses' perception of their ability to care for geriatric patients in the emergency setting. ⋯ Emergency departments should develop integrated systems to facilitate appropriate care of older patients. Identified barriers to improved care include a lack of integration between emergency care and community care, deficits in geriatric-specific education, inconsistent use of early screening for frailty, and lack of resources in the emergency care environment to intervene appropriately.