Journal of emergency nursing : JEN : official publication of the Emergency Department Nurses Association
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Emergency nurses could assume a unique role in the screening process and provide patient education regarding the consequences of harmful alcohol use. Screening, brief intervention, and referral to treatment is an evidence-based method used to identify drinking behaviors that may have a negative impact on people's lives and reduce abuse or dependence on alcohol. ⋯ The emergency department is an integral location for the implementation of screening, brief intervention, and referral to treatment because it can decrease injuries and readmissions due to the use of alcohol. Nurses play a key role in implementation because of their unique relationship with their patients. This review of the literature indicated that screening, brief intervention, and referral to treatment can be effective in the emergency department and successfully implemented by emergency nurses.
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Studies show that nurse rounding is an effective means to increase patient satisfaction and quality of care and decrease patient-safety events. There is evidence to support that daily leader rounding improves patients' hospital experience as well. Patients' experience increased confidence in their care providers, and leaders are able to address service concerns proactively. Furthermore, recent studies have addressed patient satisfaction in the ED setting as having an impact on patients' perceptions of the health care institution as a whole. Our objective was to demonstrate the effect of hourly nursing rounds and daily leader rounds on the ED patient experience. ⋯ Through collaboration and a participative approach, nurses and leaders used the current evidence from scholarly nursing literature as well as Lewin's theory of change to guide a successful approach to rounding and improving patients' experiences when receiving emergency care.
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Handoff in the emergency department is considered a high-risk period for medical errors to occur. In response to concerns about the effectiveness of the nursing handoff in the emergency department of a Midwestern trauma center, a practice improvement project was implemented. The process change required nursing handoff at shift changes to be conducted at the bedside, using an adapted situation, background, assessment, recommendation (SBAR) communication tool. ⋯ Results showed that nurses found the SBAR bedside report method easy to use and prevented the loss of patient information more effectively than pre-intervention practice. Despite the strong evidence in the literature supporting bedside handoff, questions remain concerning its sustainability, as some nurses may resist such a change in the process of shift reporting.
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ED boarding is a major issue in many hospitals. ED boarding occurs when there is insufficient hospital capacity to supply inpatient beds for admitted patients. ED boarding is not only a problem because of increased wait times for patients but also because it results in delays in administration of medication, higher rates of complications, and increased mortality. ⋯ We reduced the time to transfer from the emergency department to the SICU significantly by implementing a new protocol to expedite this transfer among level I trauma activations. Our protocol shows that a collaborative effort between the main emergency department and SICU can result in expedited care for injured and critically ill patients that not only increases care for the ill but also creates valuable space in a busy emergency department for better patient flow.