Journal of emergency nursing : JEN : official publication of the Emergency Department Nurses Association
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Medical and technologic developments entail new competence demands in emergency health care, and it follows that head nurses must recognize and create prerequisites, as well as evaluate the competence of registered nurses. The aim of this study is to describe head nurses' conceptions of emergency nursing competence needs and their responsibility for creating prerequisites of competence development in emergency nursing. ⋯ To ensure sufficient nursing competence in emergency health care organizations, there is a need to establish competence demands in emergency nursing and evaluate strategies for competence development. The establishment of a Swedish emergency nurses association would be important for the development of national guidelines of emergency nursing as well as to facilitate the interpretation and concretizing of rules and legislation and to promote questions related to research, development, and education in emergency nursing. With national guidelines and recommendations, the head nurses' responsibilities for the development of nurses' skills would be clarified.
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Multicenter Study
Acute pain assessment and pharmacological management practices for the older adult with a hip fracture: review of ED trends.
This article examines acute pain assessment and pharmacological management in the emergency department that occurred over a period of time after the release of the new pain assessment and management compliance standards of the Joint Commission on Accreditation of Healthcare Organizations (JCAHO) for accredited health care organizations. Data were available from that collected for a large-scale study testing a Translating Research into Practice intervention to promote use of evidence-based practices for acute pain management in older adults. ⋯ Pain assessment and management practices in the emergency departments showed improvements over time following the release of JCAHO standards for pain management. However, the care documented does not consistently represent best practices for all patients.
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Randomized Controlled Trial
The use of topical anesthesia during intravenous catheter insertion in adults: a comparison of pain scores using LMX-4 versus placebo.
Intravenous (IV) catheter placement is an extremely common painful procedure performed in all ages and healthcare settings, more often than not without anesthetics, despite clear research and guidelines demonstrating their effectiveness. This study examined differences in pain scores following topical anesthetic and placebo application, in a sample of healthy adult volunteers experiencing IV catheterization. ⋯ These findings suggest that the topical use of LMX-4 anesthetic cream is a viable option for reducing the pain associated with IV catheter insertion in adults.
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Multicenter Study
The impact of a sexual assault/domestic violence program on ED care.
Examination and management of the sexually assaulted patient comprise a complex task. On-call nurses with advanced training are used in some hospitals, but their impact on patient care and appropriate forensic examination is largely unknown. We evaluated the impact of the introduction of a sexual assault/domestic violence program (SADVP) on ED flow, comprehensive patient care, and collection of forensic evidence. ⋯ The profile of patients observed after SADVP implementation changed to include less stereotypical sexual assaults. Introduction of the SADVP decreased wait times for sexually assaulted patients, despite the need for the on-call nurses to attend the emergency department. This program also showed higher completion on a number of important indicators of quality of care: forensic kits, counseling, and pregnancy and sexually transmitted disease prophylaxis.