Journal of emergency nursing : JEN : official publication of the Emergency Department Nurses Association
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Heart failure is a progressive disease that affects more than 6.7 million people in the United States and has a 50% mortality rate. A left ventricular assist device provides an option to many patients with heart failure as a bridge to either transplantation or destination therapy. Patients are becoming more prevalent with improved survival rates. Emergency nurses must have a basic understanding and skills to provide high-quality care. The competency program aims to elevate the confidence of emergency nurses caring for left ventricular assist device patients and reduce the reliance on the circulatory support technician through quarterly skills assessment and simulation. ⋯ The quality improvement project identified a need to provide additional support to emergency nurses to increase their skills and confidence. Replication is needed to assess further the efficacy of more frequent simulation-based learning and the implementation of readily available resource books and left ventricular assist device nurse champions.
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Patient fall risk assessment in the emergency department poses a unique challenge as fall risk is often associated with risk factors other than inpatient falls. While there are many inpatient fall risk assessment tools, few have been used or validated in the ED environment. Therefore, this study examined the predictive performance of the KINDER 1 Fall Risk Assessment Tool in 10 emergency departments. ⋯ KINDER 1 exhibited a sufficiently high degree of sensitivity and specificity, supporting an acceptable level of predictive performance. Additional research is recommended to compare the reliability and predictive validity of KINDER 1 to the emergency Hester Davis Scale and the Memorial Emergency Department Fall Risk Assessment Tool, as well as to compare the usability of the tools for nurses in a triage setting.