Australasian emergency nursing journal : AENJ
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Australas Emerg Nurs J · May 2015
Multicenter Study Observational StudyUnderstanding the patient journey to the Emergency Department - A South Australian study.
To determine patients' points of contact prior to or decision making processes before presenting to an Emergency Department for treatment. To obtain data that may inform future exploration of targeted Emergency Department avoidance strategies. ⋯ The study showed 39.8% had sought advice from other health care professionals prior to presenting to the Emergency Department and that 60.2% of patients were self-referred. This study has not revealed any new pathways that warrant targeting for Emergency Department avoidance strategies. The focus still needs to target primary care referrals, ambulance service transports and smaller hospital transfers.
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Australas Emerg Nurs J · May 2015
Multicenter StudyFamily presence during resuscitation (FPDR): A survey of emergency personnel in Victoria, Australia.
Family presence during resuscitation (FPDR) has been endorsed internationally by resuscitation councils since the year 2000; however, the extent to which FPDR is practiced in emergency settings requires further investigation. ⋯ A family support person was highlighted as essential to the successful implementation of FPDR, together with the development of a comprehensive training the education program for emergency personnel. FPDR continues to be a significant issue and further investigation into FPDR practice and implementation in the ED is warranted.
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Australas Emerg Nurs J · Feb 2015
Multicenter StudyRatios and nurse staffing: the vexed case of emergency departments.
Within Australia nursing unions are pursuing mandated nurse-patient ratios to safeguard patient outcomes and protect their members in healthcare systems where demand perpetually exceeds supply. Establishing ratios for an emergency department is more contentious than for hospital wards. The study's aim was to estimate average staffing levels, skill mix and patient presentations in all New South Wales (NSW) Emergency Departments (EDs). ⋯ The study adds to the limited literature on ED staffing and demonstrates the utility in the simplicity of ratios in flagging potential staffing problems. The audit revealed wide variation in staffing levels which was not always linked to patient activity. Of particular concern were the regional EDs (Level 5) which have the capacity to deal with all types of emergencies but where ratios as high as 7 beds per nurse were found during the day. Ratios cannot be used to determine the optimal staffing levels in every clinical situation; their purpose is to force an increase in nursing supply and to prevent individual units from becoming understaffed.
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Australas Emerg Nurs J · Nov 2014
Multicenter Study Comparative StudyA comparison of emergency triage scales in triaging poisoned patients.
Triage of toxicology patients presents a challenge due to their complexity, underlying psychosocial issues, and additional pharmacological considerations. Two emergency department triage systems used in Australia, the Australasian Triage Scale (ATS) and the Manchester Triage System (MTS), were compared in triaging patients presenting with poisoning and envenoming. ⋯ When compared to the ATS, MTS gave a lower acuity triage score for all common and rarely encountered poisoning scenario groups, which included highly toxic ingestions that appear well at triage but may progress to severe poisoning. Triage nurses should refer to information on highly toxic exposures and envenomation guidelines during their triage risk assessment.
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Australas Emerg Nurs J · Nov 2014
Multicenter StudyManagement of patients on chemotherapeutic treatment for advanced cancer with acute conditions in the emergency department.
Chemotherapy is increasingly used in people with advanced cancer to palliate symptoms and improve survival. New Zealand provides medical oncology services in a Hub and Spoke model, with an increasing emphasis on delivering treatment at out-patient spoke services, where after hours and urgent care is provided by the Emergency Department (ED). This study sought to describe the factors that influenced the care and clinical decision-making of this group of patients in the ED. ⋯ A more collaborative relationship between Oncology and ED nurses may support the provision of emergency care within the context of active cancer treatment.