Journal of emergency nursing : JEN : official publication of the Emergency Department Nurses Association
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Adherence to aftercare instructions following an emergency department visit may be essential for facilitating recovery and avoiding complications, but conditions for teaching and learning are less than ideal in the ED. The objective of this study was to identify and describe areas of patient confusion about ED discharge instructions. ⋯ This study demonstrated that patients commonly remain confused about aftercare information following treatment in an ED. Follow-up telephone calls may be useful for identifying and addressing ongoing learning needs.
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Randomized Controlled Trial Multicenter Study
Initial ECG acquisition within 10 minutes of arrival at the emergency department in persons with chest pain: time and gender differences.
The American Heart Association recommends all patients presenting to the emergency department with complaints of chest pain/anginal equivalent symptoms receive an initial ECG within 10 minutes of presentation. The Synthesized Twelve-lead ST Monitoring & Real-time Tele-electrocardiography (ST SMART) study is a prospective randomized clinical trial that enrolls all subjects who call 911 for ischemic complaints in Santa Cruz County, California. ST SMART is a 5-year study ending in 2008. The primary aim of the ST SMART study is to determine whether subjects who receive prehospital ECG have more timely hospital intervention and better outcomes. ⋯ In this analysis, the majority of patients with ischemic symptoms did not receive an ECG within 10 minutes of hospital presentation as recommended in evidence-based guidelines. There is a significant delay in door to time-to-ECG for women. ED nurses are in a unique position to initiate efforts to establish processes to decrease time to initial ECG for patients with ischemic symptoms. Attention to timely ECG acquisition in women may improve treatment of acute coronary syndromes in this group.
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Randomized Controlled Trial
Alcohol screening, brief intervention, and referral to treatment conducted by emergency nurses: an impact evaluation.
In a quasi-experimental study, control and intervention group outcomes were compared following implementation of alcohol screening, brief intervention, and referral to treatment (SBIRT) by emergency nurses. The primary hypothesis was: Trauma patients who participate in nurse-delivered ED SBIRT will have greater reductions in alcohol consumption and fewer alcohol-related incidents than those who do not. ⋯ The SBIRT procedure can impact alcohol consumption and potentially reduce injuries and ED visits when successfully implemented by staff nurses in the emergency department environment. Further research is needed to improve follow-up methods in this hard to reach, mobile patient population.
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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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Randomized Controlled Trial Comparative Study
Nursing blood specimen collection techniques and hemolysis rates in an emergency department: analysis of venipuncture versus intravenous catheter collection techniques.
Re-collection of hemolyzed blood specimens delays patient care in overcrowded emergency departments. Our emergency department was unable to meet a benchmark of a 2% hemolysis rate for the collection of blood samples. Our hypothesis was that hemolysis rates of blood specimens differ dependent on the blood collection technique by venipuncture or intravenous catheter draw. ⋯ Total samples by nurse were affected by EMS patients arriving with existing intravenous lines, and nurse schedules affected total samples per nurse.