Journal of emergency nursing : JEN : official publication of the Emergency Department Nurses Association
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More than 5.5 million patients present to emergency departments in the United States annually for potential acute coronary syndrome (ACS); however, diagnosing ACS remains a challenge in emergency departments. Our aim was to describe the quality of symptoms (chest discomfort/description of pain, location/radiation, and overall symptom distress) reported by women and men ruled-in and ruled-out for ACS in emergency departments. ⋯ Higher levels of symptom distress may help ED personnel in making a decision to evaluate a patient for ACS, and the presence of chest pressure may aid in making a differential diagnosis of ACS.
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Shared decision making involves both patients and health care professionals working together to choose a certain diagnostic or therapeutic option. To facilitate these decisions, the shared decision-support tools (SDSTs) have been developed to assist in the communication with patients during the hospital process. They have been frequently used in the choice of treatment for chronic diseases. However, in emergency departments, this model has not been as widely implemented. For that reason, this article aims to examine, through a systematic review, the effects of SDSTs on patients' hospital care in emergency departments. ⋯ Nevertheless, its implementation is limited by the belief that patients prefer physicians to decide for them and the pressures due to the limited time available. The development of SDSTs is relevant in urgent care pathways in which treatment has a high level of evidence and a complex risk-benefit balance.
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Nurse scheduling within an emergency department can be a very time-consuming process as nursing leadership works to reach sufficient nurse-staffing levels across every day of the schedule while also working to satisfy nurse preferences. ⋯ The emergency department can use mathematical modeling to improve the nurse-scheduling process.