Journal of emergency nursing : JEN : official publication of the Emergency Department Nurses Association
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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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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.
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Multicenter Study Comparative Study
Emergency nursing and medical error--a survey of two states.
This study describes issues concerning emergency nurses in 2 states and their experiences and perspectives regarding the recognition, reporting, and resolution of medical error. ⋯ There is a need for a practiced, standardized approach to medical error reporting that includes improved teamwork, conflict resolution, and appropriate reporting methodology education that should be paired with mandatory reporting laws.
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Multicenter Study Clinical Trial
Alcohol screening, brief intervention, and referral in the emergency department: an implementation study.
Alcohol is the single greatest contributor to injury in the United States. Numerous studies have reported that a standardized screening, brief intervention, and referral to treatment (SBIRT) intervention can effectively minimize future alcohol consumption, reduce injury recurrence, and decrease the number of repeat ED visits. To date, SBIRT studies have been conducted in settings in which physicians or research assistants carried out SBIRT. Little is known about ED nurses carrying out SBIRT. The purpose of this study was to examine ED nurse training needs and identify both barriers to, and enablers of, SBIRT implementation in the emergency department. ⋯ The SBIRT process can be conducted successfully by emergency nurses. However, substantial operational barriers to widespread routine implementation exist. These barriers need to be addressed before emergency nurses incorporate SBIRT as routine part of ED care.
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Multicenter Study Comparative Study
Triage tool inter-rater reliability: a comparison of live versus paper case scenarios.
Published studies of triage scale inter-rater reliability assessment have been conducted mostly using paper case scenarios. ⋯ There is moderate to high agreement between live cases and paper case scenarios, and the inter-rater reliabilities, although significantly different, are acceptable in both cases. It is impossible to determine which triage setting provides a more accurate triage score but paper case scenarios generally receive lower triage scores than live cases.