ED management : the monthly update on emergency department management
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To address the higher risks of violence to ED staff, you'll need to implement strategies for prevention and security response. Instead of waiting for an assault to occur, have security respond to potentially violent patients. Include abuse by co-workers in your violence prevention policies. Consider using a security dog as a deterrent.
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A just-released General Accounting Office report identified holding inpatients in the ED as the No. 1 reason for overcrowding. Have inpatient nurses care for admitted patients in the ED, including paperwork. Use a "bed control" office to get admitted patients discharged or transported more quickly, freeing ED beds. Consider adding an admissions nurse to handle inpatient documentation or a second ED charge nurse to track inpatients.
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You'll need strategies to improve care of patients who request pain medications frequently. Use care plans to ensure that patients with conditions such as sickle cell disease will have medications given immediately. Use written agreements to discourage drug-seeking patients. Have a system to alert ED staff to a patient's existing pain management plan.
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Significant reductions in delays and diversion hours are reported by an ED that has implemented changes as part of the GE Medical Systems Six Sigma for Healthcare process. Triage protocols for blood draws, urine, and intravenous lines are used. Nurses are paired with a technician or paramedic and work as a team. Technicians are assigned specific tasks, such as triage, electrocardiograms, or performing repeat vital signs.