ED management : the monthly update on emergency department management
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During on-site surveys in 2001, surveyors will be asking about your use of infusion pumps. The ED is at higher risk for errors and adverse outcomes than other departments because of the types of drugs given and time constraints. Do not use pumps without protection from the free-flow of intravenous fluid/medication into the patient. If your hospital is considering a change in infusion pumps, make sure someone from the ED is involved in the product evaluation.
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Keeping an observation unit operating with current reimbursement might depend on successful implementation of cost-reduction strategies. A "hybrid" model with scheduled-procedure patients in addition to observation patients allows you to staff with fewer nurses per patient. Observe patients with only one specific acute problem who are likely to be discharged within 18 hours. By offering stress testing in close proximity to the observation unit, length of stay is reduced, and the hospital can provide stress testing to inpatients on weekends.
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ED personnel experience the majority of all hospital assaults, and these attacks can have long-term effects on morale and productivity. OSHA regulations require you to provide staff with a safe working environment. You should have a plan to address security personnel issues, responses to specific scenarios, restraint techniques, and violence prevention. Strategies include flagging violence-prone individuals, using patient liaisons in the waiting areas, and ensuring that ED security officers have been trained to work in hospitals.