Journal of emergency nursing : JEN : official publication of the Emergency Department Nurses Association
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Children often present to the emergency department for treatment of abuse-related injuries. ED providers-including emergency nurses-do not consistently screen children for abuse, which may allow abuse to go undetected and increases the risk for reinjury and death. ED providers frequently cite lack of knowledge or confidence in screening for and detecting child abuse. The purpose of this quality improvement project was to implement an evidence-based screening program that included provider education on child physical abuse, a systematic screening protocol, and use of the validated Escape Instrument. ⋯ The results of this project support comprehensive screening programs to improve ED provider knowledge and confidence in screening for and recognizing child physical abuse. Future research should focus on the impact of screening on the diagnosis and treatment of child physical abuse.
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Health care is being challenged both nationally and globally as a result of the significant expansion of human trafficking (HT). Every day, people are being bought, sold, and smuggled like modern-day slaves. Victims are used solely for the purposes of sexual exploitation, labor, and services. ⋯ ED nurses are frequently the front line of defense for those victims who are rarely permitted to interface with the health care system. ED nurses may be the HT victim's only limited contact with the outside world. At the forefront of caring for victims of trafficking, it is integral for ED nurses to be able to recognize the signs of trafficking, have an awareness of where to report any suspicious cases, and to be knowledgeable about the services that are available to victims of HT.
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Active shooter incidents are becoming more common, and although they are still rare compared with other shooting sites, incidents have increased in health care facilities. Agencies such as the Federal Bureau of Investigation, The Joint Commission, and the Emergency Nurses Association have emphasized that an action plan and training are essential for hospital preparedness. ⋯ The active shooter education included a didactic portion, a pre- and postsurvey, and the simulation event. The presentation focused on statistics of active shooters, possible threats, and the concepts of RUN, HIDE, and FIGHT. A Critical Incident Stress Management team member was present to ensure the emotional and psychological health of the participants. The debriefing was a crucial part of the simulation experience so staff could talk about their experience and express their concerns.
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Vital signs can result in an upgrade of patients' Emergency Severity Index (ESI) levels. It is therefore preferable to obtain vital signs early in the triage process, particularly for ESI level 3 patients. Emergency departments have an opportunity to redesign triage processes to meet required protocols while enhancing the quality and experience of care. ⋯ Performing activities in parallel reduces flow time with no additional resources. Staff involvement in process planning, redesign, and control ensures engagement and early buy-in. One should anticipate how changes to one process might affect other processes.