Journal of emergency nursing : JEN : official publication of the Emergency Department Nurses Association
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Emergency and mental health nurses are, in many countries, the designated professionals to conduct acute mental health triage. This review aimed to identify competencies these nurses need in major acute health care services such as emergency and accident departments and mental health crisis services for triage for psychiatric patients in crisis. ⋯ Emergency and mental health nurses require a significant amount of competencies beyond basic nursing education in acute mental health triage. Most described competencies pertain both to knowledge and skills. Less is known about attitude. To integrate the several competencies knowledge, skills, and attitude, clinical reasoning is needed to organize chaos in unpredictable and complex patient situations.
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Accurate triage assessment by emergency nurses is essential for prioritizing patient care and providing appropriate treatment. Undertriage and overtriage remain an ongoing issue in care of patients who present to the emergency department. The purpose of this literature review was to examine factors associated with triage accuracy in the emergency department. ⋯ This review underscores the complex nature of ED triage accuracy. It highlights the importance of nurse experience, training programs, patient characteristics, and the work environment in enhancing triage decision making. Enhanced understanding of these factors can inform strategies to optimize triage accuracy and improve patient outcomes.
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According to the Institute for Safe Medication Practices, unfractionated heparin is a high-risk medication due to the potential for medication errors and adverse events. Unfractionated heparin is often started in the emergency department for patients with acute coronary syndromes or coagulopathies. Risk-mitigation strategies should be implemented to ensure appropriate initiation and monitoring of this high-risk medication. In 2019, an unfractionated heparin calculator was built into the electronic health record at a community medical center. The purpose of this study was to evaluate the impact of the calculator as a risk-mitigation strategy. ⋯ The use of the unfractionated heparin infusion calculator in the emergency department led to decrease in medication administration errors. This is the first study to evaluate the integration of an unfractionated heparin calculator into the electronic health record.