Journal of emergency nursing : JEN : official publication of the Emergency Department Nurses Association
-
Clinical alarms promote patient safety by alerting clinicians when there is an indication or change in a condition requiring a response. An excessive volume of alarm fires, however, contributes to sensory overload and desensitization, referred to as alarm fatigue, which has significant implications when alarms are missed. This evidence-based, practice project aimed to implement and evaluate a program that reduces the number of clinically nonactionable, physiologic alarms in an emergency department. Although alarm fatigue is an important negative consequence, the focus of this project is not on alarm fatigue but on measures to reduce the volume of clinically nonactionable alarms that lead to alarm fatigue. The Iowa Model was used as a conceptual framework. ⋯ A reduction in nonactionable, physiologic alarms was attained after implementing multimodal strategies inclusive of adjusting default settings, staff education on managing alarms, and emphasis on staff accountability.
-
Although certain critically ill patients in emergency departments-such as those experiencing trauma, stroke, and myocardial infarction-often receive care through coordinated team responses, resource allocation and care delivery can vary widely for other high-acuity patients. The absence of a well-defined response process for these patients may result in delays in care, suboptimal outcomes, and staff dissatisfaction. The purpose of this quality improvement project was to develop, implement, and evaluate an ED-specific alert team response for critically ill medical adult and pediatric patients not meeting criteria for other medical alerts. ⋯ Emergency nurses and providers see the value of coordinated team response in the delivery of patient care. Team responses to critical medical alerts can improve care delivery substantially and sustainably.
-
For decades, health inequalities have persisted among Indigenous peoples. As the Indigenous population is growing in the cities, health care delivery in urban areas can be challenging. Emergency nurses are often the first contact in the health system, and they play a key role in the patient's experience. This study aims to describe the transcultural health practices of Canadian emergency nurses working with Indigenous peoples. ⋯ In summary, emergency nurses had more confidence in their ability to provide technical care than in their knowledge regarding the cultural aspects of providing care. As Indigenous populations face challenges regarding access to health care, specific interventions should be implemented to support better-quality cultural care from emergency nurses.
-
Although evidence supports the addition of video discharge instructions to improve caregiver knowledge among English-speaking caregivers of children in the pediatric emergency department, there is no evidence about the effectiveness of videos for Spanish-speaking caregivers. The purpose of this study was to test whether Spanish video discharge instructions added to standard written and oral discharge instructions would result in improved knowledge and satisfaction among caregivers compared with written and oral instructions alone. ⋯ Study results demonstrate that when tailored to reflect diagnosis-specific education, video discharge instructions can improve Spanish-speaking caregiver knowledge about discharge education compared with written and oral instructions alone. Videos can be integrated to standardize the ED discharge process as an adjunct to nurse-provided written and oral instructions with an interpreter for Spanish-speaking families.