Journal of emergency nursing : JEN : official publication of the Emergency Department Nurses Association
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Nurses who evaluate patients following sexual assault are often faced with the task of identifying genital injuries and providing legal testimony regarding the nature of the injuries. Following a 2000 Virginia State court decision, sexual assault nurse examiners have had to struggle to answer the questions, "Are the genital injuries consistent with the patient's history?" and "Are the genital injuries consistent with sexual assault?" ⋯ Currently, the presence or absence of genital injury should not be used to render an opinion regarding consent to sexual intercourse. Further research is necessary to determine if injury patterns can indeed distinguish consensual from nonconsensual sex.
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Despite evidence to support efficacy of early goal-directed therapy for resuscitation of patients with severe sepsis and septic shock in the emergency department, implementation remains incomplete. To identify and address specific barriers at our institution and maximize benefits of a planned sepsis treatment initiative, a baseline assessment of knowledge, attitudes, and behaviors regarding detection and treatment of severe sepsis was performed. ⋯ Knowledge gaps and procedural hurdles identified by the survey will inform both educational and process components of an initiative to improve sepsis care in the emergency department.
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Health care workers are more likely than most other occupations to experience work-related injuries, and emergency nurses frequently encounter job-related hazards in their daily routine. Risk factors for non-violence-related workplace injuries among nurses include heavy workloads, aging of the nursing workforce, workplace environmental factors, obesity, and non-standard work schedules. These factors impact nurses' decisions regarding whether or not to return to their job or to stay in their field of practice, thereby exacerbating workforce shortages and hindering recruitment and retention efforts. ⋯ While these results provide only a preliminary understanding of ED non-violence-related workplace injuries, they form the basis of a fundamental model for prevention of workplace injuries among emergency nurses. The model can be used to help establish a culture of ED workplace safety through the integration of safety policies and programs, access to safety equipment and controls, and optimal staffing levels. Support from hospital administrators for ED workplace safety initiatives that address these three components, along with current best practice recommendations from the field of occupational health and safety, have the potential to improve workplace safety for emergency nurses.
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This paper presents a study of prehospital care with particular focus on how ambulance personnel prepare themselves for their everyday assignments. ⋯ Our findings suggest that the outcomes of good prehospital care affect patient security. The seemingly time-consuming dialogue with the patient facilitates understanding and decision-making regarding the patient's medical needs, and it is comforting to the patient. The ambulance personnel need to be well prepared for this task and fully understand that the situation might differ considerably from the information provided by the EMD centers. All objective information is of great value in this care context, but ultimately it is the patient who provides reliable information about her/his own situation.