ED management : the monthly update on emergency department management
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An algorithm can help convey basic EMTALA compliance information to ED staff. An algorithm can instruct staff to perform duties in the correct order. Every ED staff member needs to understand EMTALA requirements, because all employees have the potential for violations. Complex EMTALA issues call for personal consultation with the hospital's EMTALA coordinator or risk manager.
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Programs that address the needs of indigent patients benefit the community, boost staff morale, and decrease return visits to the ED. By giving "starter" packs of prescriptions to patients, you can reduce return visits caused by the inability to fill a prescription. ⋯ Donate car seats for infants and young children. Provide a range of social services that address specific needs of patients, such as shelter referrals and substance abuse interventions.
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Three organizations recently published reports on medication errors--the Institute for Healthcare Improvement, the Institute of Medicine, and the Joint Commission on Accreditation of Healthcare Organizations. The ED is at higher risk for medication errors than other areas of the hospital because of extreme time pressure, high patient volumes, verbal orders, and multiple staff caring for patients. Medication errors often are caused by unclear labeling, lack of a check system for medication dosages, and similar drugs kept in close proximity to each other. Recommended strategies include a check system in which one nurse prepares a dose and another nurse reviews it, and avoiding look-alike and sound-alike medications.