Journal of emergency nursing : JEN : official publication of the Emergency Department Nurses Association
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Triage, as it is understood in the context of the emergency department, is the first and perhaps the most formal stage of the initial patient encounter. Bottlenecks during intake and long waiting room times have been linked to higher rates of patients leaving without being seen. The solution in many emergency departments has been to collect less information at triage or use an "immediate bedding" or "pull until full" approach, in which patients are placed in treatment areas as they become available without previous screening. The purpose of this study was to explore emergency nurses' understanding of-and experience with-the triage process, and to identify facilitators and barriers to accurate acuity assignation. ⋯ Our participants described processes that were unit- and/or nurse-dependent and were manipulations of the triage system to "fix" problems in ED flow, rather than a standard application of a triage system. Our participants reported that, in practice, the use of triage scales to determine acuity and route patients to appropriate resources varies in accuracy and application among emergency nurses and in their respective emergency departments. Nurses in this sample reported a prevalence of "quick look" triage approaches that do not rely on physiologic data to make acuity decisions. Future research should focus on intervention and comparison studies examining the effect of staffing, nurse experience, hospital policies, and length of shift on the accuracy of triage decision making. Contribution to Emergency Nursing Practice.
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More than 9,000 children die annually from various causes of unintentional injury. Of all the pediatric unintentional injuries occurring in the United States, 8.7 million are treated in emergency departments, and 225,000 require hospitalization annually. Health education programs are available to address these injuries. The objective of this research was to examine the distribution of self-reported high priority injury risks in an urban Midwestern pediatric level 1 trauma center and investigate the relationship between parental perceptions and injury-prevention behaviors. Prevalence rates for 3 data sources are compared. ⋯ Because parental perceptions are significantly related to risks of injury, prevention programs aiming to decrease injuries could focus on the perceptions. Not only can perceptions be used to tailor health communication materials, these perceptions can be the targets of change. Further work might investigate the extent to which changes in perceptions result in increased adoption of safety practices.