Journal of emergency nursing : JEN : official publication of the Emergency Department Nurses Association
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As the largest component of the United States health care workforce, nurses will play a critical role in radiological or nuclear disaster medical response. Despite this, the United States' schools of nursing are not currently providing radiation content (75% teach zero or <1 hour), and much of the current nursing workforce may not have received adequate response education and training. Nurses working in emergency departments and those who work at hospitals within the Radiation Injury Treatment Network will be relied on heavily, but little is known about whether these nurses possess the knowledge and skills needed to care for and protect patients after a radiation emergency. Current federal and state radiological/nuclear preparedness plans may be built on false assumptions of readiness, which would have serious implications for national preparedness and the National Health Security Strategy. The purpose of this study was to assess nurses' knowledge and skill in emergency radiological or nuclear response and determine their willingness to use mobile technology for education and training in response to a large-scale radiation event. ⋯ Key nurses may not possess adequate knowledge or clinical competence to participate in radiation response activities. The results of this assessment identified educational gaps and areas to strengthen nursing education and clinical skills.
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ED crowding is a complex phenomenon that presents many challenges to patients, hospitals, and staff. Using Lewin's change model, we implemented an ED improvement plan, including an innovative bed traffic control and improved flow system. We hypothesized that this plan would reduce door-to-provider time and emergency medical service-offloading time, decrease the length of stay and number of patients leaving without being seen by a physician, and increase overall patient satisfaction. ⋯ Implementing a pod system, with flow and bed placement managed by bed traffic control, reduced door-to-provider time, door-to-discharge time, leaving without being seen by a physician, emergency medical service-offload time, and increased patient satisfaction. Our results may provide a model for other emergency departments to effectively manage the challenges of crowding.
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Disasters of any kind can affect public health severely. A shortage of health care specialists, such as physicians and nurses, during a disaster is a challenge for health care systems. The use of technology is 1 emerging strategy for addressing the continually increasing demand for care. Moreover, nurses may use technology in their roles. Therefore, the purpose of this study was to identify the application of telehealth, and more specifically telenursing care, in incidents and disasters. ⋯ Providing health care during a disaster is essential, and technology is of vital importance for such care. Because of the shortage of specialized nurses in disaster areas, the presence of such a group in the telehealth program will provide a new window for care. Thus, telenursing offers a means of improving health care response.