Accident and emergency nursing
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Nurses and paramedics in partnership: perceptions of a new response to low-priority ambulance calls.
To explore patients' and staffs' perceptions of a pilot service which dispatched a nurse and paramedic to low-priority ambulance calls. However, ⋯ Both patients and staff expressed positive views about the pilot service. Patients appreciated being treated at home and staff believed that working together provided more appropriate care for patients and enhanced interprofessional development.
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Comparative Study
Prospective audit of emergency department transit times associated with entonox analgesia for reduction of the acute, traumatic dislocated shoulder.
To establish current UK practice for the management of the acute traumatic shoulder dislocation with respect to analgesia and reduction manoeuvres. To compare the transit times of patients through an emergency department (ED) after the use of intravenous analgesia and/ or sedation compared to entonox +/- simple oral analgesia. ⋯ Entonox +/- simple oral analgesia significantly decreases ED transit times as compared to IV morphine and/or midazolam for the reduction of the acute traumatic dislocated shoulder. Further studies should be done into patient pain scores and into the best combination of oral analgesia and entonox.
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This paper reports the findings of a self-harm audit based on data collected at an A&E department in North Wales. The National Institute for Clinical Excellence (NICE) guidelines on the short term physical and psychological management of self-harm were published in 2004 and the audit was based on technical criteria recommended in the guideline booklet, including standards of psychosocial assessment, staff training and patient satisfaction information. The data in this study related to fifty consecutive self-harm attendances at the A&E department Ysbyty Glan Clwyd in the Spring of 2007. ⋯ Service developments, as a result of the audit, include the proposal to provide mental health and self-harm training to all those staff likely to encounter the behaviour--not just to those who work in mental health. Patients, from the questionnaire, who express a willingness to become part of a mental health planning group are now provided details of the patient participation involvement (PPI) group, where their experiences can often inform service improvement. Meanwhile the case note audit has reinforced the need for a practical self-harm pathway which will ensure consistency.
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Overcrowding in Accident and Emergency Departments (A&E) in Ireland has reached crisis proportions since the dawning of the new millennium. Although this phenomenon is not unique to Ireland and many authors have suggested causes and management strategies to deal with these crises, little appears to have been written regarding the experiences of patients or their families waiting in the A&E. The aim of this qualitative descriptive study was to describe the experiences of patients and/or their relatives/significant others who had spent 12 h or more in A&E awaiting admission to hospital. ⋯ Descriptions portrayed an environment that was overcrowded, dirty and lacking in resources. Participants were generally positive in their attitudes towards the care they received, but some descriptions appeared to suggest that the quality of care was not always ideal. Recommendations from participants included reduced waiting times with a maximum of 6 h from admission to transfer or discharge; better communications systems with perhaps a liaison person who could advise them about the expected duration of stay in A&E and what was happening regarding their care; and better privacy and security within the departments.
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To describe the epidemiology of a leading cause of childhood mortality in Al-Ain, United Arab Emirates (UAE)--injury. To examine trends across types of injury, as well as the mechanisms of injury leading to death, by age groups, gender, citizenship, and explore mortality rates and make global comparisons. ⋯ The present study reveals that the burden of injury deaths among children below 15 years is significant; and injuries exist in every form and affect every age group, and gender. The high burden of injuries on children in the UAE demands the attention of the health community, including policy makers. An understanding of the trends such as those presented in this study, for instance that injuries from road traffic are prominent, will assist in the development of interventions to address this growing concern. Furthermore, similarities in rates of UAE with other developed countries signify the potential for appropriate responses to lower the burden of injuries on children in the future.