Journal of emergency nursing : JEN : official publication of the Emergency Department Nurses Association
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Pulmonary embolism has extremely varied clinical presentations and can be difficult to diagnose. Clinical decision rules can help determine the probability of pulmonary embolism by assessment of the clinical presentation. After the diagnosis, several prognostic rules can be used to risk-stratify and facilitate outpatient treatment of pulmonary embolism. This review addresses the utility of clinical decision rules, biomarkers in the diagnosis of pulmonary emoblism, high-risk patient phenotypes, the use of this data to make disposition decisions for patients with a diagnosis of PE, and recent shifts in the management of pulmonary embolism in the clinical setting.
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Multicenter Study
Predictors of Nonurgent Emergency Visits at a Midsize Community-Based Hospital System: Secondary Analysis of Administrative Health Care Data.
Nonurgent visits to the emergency department compromise efficiency in treating patients with urgent conditions and inversely influence the satisfaction of patients and staff. There is inconclusive evidence of the factors associated with nonurgent ED visits. Therefore, the purpose of this study was to explore the independent factors associated with nonurgent ED visits in a midsize community-based Canadian hospital system. ⋯ The findings of this study may assist health care providers and stakeholders in developing strategies to minimize nonurgent ED visits.
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Respiratory rate is the first sign of patient decline. Monitoring and recording respiratory rate are essential nursing competencies. However, health care system emergency nurses' ability to differentiate normal from abnormal respiratory rates was unknown. We conducted a health care improvement project to assess emergency nurses' accuracy in "spot" and "formal" assessments, understand assessment practices, and determine competency and training needs. ⋯ Respiratory rate assessment may be best assessed formally, particularly for bradypnea, where formal checks may outperform spot checks. The results present areas for improving respiratory rate assessment training and clinical practice.