Journal of emergency nursing : JEN : official publication of the Emergency Department Nurses Association
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Mental and behavioral health (MBH) emergencies in children and youth continue to increasingly affect not only the emergency department (ED), but the entire spectrum of emergency medical services for children, from prehospital services to the community. Inadequate community and institutional infrastructure to care for children and youth with MBH conditions makes the ED an essential part of the health care safety net for these patients. As a result, an increasing number of children and youth are referred to the ED for evaluation of a broad spectrum of MBH emergencies, from depression and suicidality to disruptive and aggressive behavior. ⋯ These factors contribute to prolonged ED stays and boarding, which negatively affects patient care and ED operations. Strategies to improve care for MBH emergencies, including systems level coordination of care, is therefore essential. The goal of this policy statement and its companion technical report is to highlight strategies, resources, and recommendations for improving emergency care delivery for pediatric MBH.
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After coronavirus disease 2019, there has been an increase in patients in the emergency department with mental health conditions. They are usually received by professionals who are not specialized in mental health. This study aimed to describe nursing staff's experiences in the emergency department, in the care they provide to people with mental health problems who often feel stigmatized by society and also in health care settings. ⋯ The main study findings were the need to train emergency nurses to be prepared to care for people who experience mental health concerns including bias education and the need for implementation of standardized protocols. Emergency nurses never doubted their ability to care for people experiencing mental health disorders. Still, they recognized that they needed specialized professionals' support at certain critical moments.
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Observational Study
Hemolyzed Laboratory Specimens in the Emergency Department: An Underappreciated, but Frequent Problem.
Hemolysis of blood samples from emergency department (ED) patients leads to delays in treatment and disposition. The aim of this study is to determine the frequency of hemolysis and variables predictive of hemolysis. ⋯ This large observational analysis demonstrates that lab hemolysis of is a frequent occurrence among ED patients. Given the added risk of hemolysis with certain placement variables, clinicians should consider catheter gauge/placement location to avoid hemolysis that may result in patient care delays and prolonged hospital stays.
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Emergency department overcrowding is a concern that predates the recent coronavirus disease pandemic. Overcrowding in the emergency department continues to worsen internationally. There are multiple combined strategies that help to maintain quality and safety by reducing patient wait times, left-without-being-seen rates, and the length of time a patient stays in the emergency department. The objective of the project was to use an interdisciplinary team to strengthen and revise the emergency department overcrowding plan to reduce the patient wait times, length of stay, and the left-without-being-seen rates. ⋯ Emergency department overcrowding is influenced by a multitude of factors. The development and implementation of an efficient and effective overcrowding plan have significant value for patient quality and safety as well as health system planning. An effective response to emergency department overcrowding is a pre-established plan that incrementally uses system-wide resources to support emergency department functions as the census and patient acuity fluctuate.