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 · Feb 2015
ReviewThe validity, reliability, responsiveness and applicability of observation sedation-scoring instruments for use with adult patients in the emergency department: a systematic literature review.
This paper reports a systematic literature review examining the range of published observational sedation-scoring instruments available in the assessment, monitoring and titration of continuous intravenous sedation to critically ill adult patients in the Emergency Department, and the extent to which validity, reliability, responsiveness and applicability of the instruments has been addressed. ⋯ None of the 27 observational sedation-scoring instruments were designed or trialled within ED. The Richmond Agitation and Assessment Scale was identified as most suitable to be trialled prospectively within an Australian ED.
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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 · Feb 2015
Unreported clinical deterioration in emergency department patients: a point prevalence study.
Formal processes for recognising and responding to deteriorating emergency department (ED) patients are variable despite features of the ED context that may increase the risk of unrecognised or unreported clinical deterioration. The aim of this study was to determine the frequency and nature of unreported clinical deterioration in emergency care. ⋯ Unreported clinical deterioration is an important quality indicator of emergency care. The effect of the collective ED patient group on the frequency and nature of adverse events for individual ED patients is poorly understood and warrants further investigation.
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Australas Emerg Nurs J · Feb 2015
Observational StudyIs the Modified Early Warning Score able to enhance clinical observation to detect deteriorating patients earlier in an Accident & Emergency Department?
Currently there is no study to prove the accuracy of any early warning system on a group of patients who are waiting for in-patient beds in emergency department (ED). The study objective is to compare the performances of detecting patient deterioration with and without using the Modified Early Warning Score for a group of patients who are waiting for in-patient beds in a public ED. ⋯ Using the MEWS for patient monitoring did not significantly enhance the performance in detecting patient deterioration for a group of patients who are waiting for in-patient beds in a public ED. However, the MEWS may be beneficial to less experienced nurses who have less clinical experience to identify patient deterioration.