Accident and emergency nursing
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Patient triage in Accident and Emergency departments requires emergency nurses to make rapid decisions based on their knowledge and experiences. The development of triage decision-making skills can be addressed through the use of simulations, 'thinking aloud' technique, reflection and the decision rules of experienced emergency nurses. Clinical educators and experienced emergency nurse mentors are encouraged to recognize that skill acquisition in triage decision making requires practice before registered nurses can engage fully in the process of triaging patients in the emergency department. ⋯ By using triage simulations developed from 'real triage cases' the process of decision making can be experienced by nurses. Further, if these simulations are accompanied by the collection of verbal protocols, nurses have opportunities retrospectively to explore their decision making with reflection. In addition, the presentation and use of decision rules used by experienced triage nurses can enhance the development of skills in novice triage nurses.
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Comparative Study
Ambulance services: could the UK learn from the French?
Ambulance services, as part of Accident and Emergency provision, are once again under scrutiny. This article reflects on a recent visit to a SAMU (Service d'Aide Medicale Urgente) unit in France, and considers those issues that could be explored in terms of effective UK provision. Recommendations will be proposed for future provision.
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The recent problems and pressures felt by Accident and Emergency departments around the country led a team at Newham Hospital, London, to develop a scheme to prevent frail elderly and vulnerable younger patients being unnecessarily admitted, thus blocking acute hospital beds. This paper outlines the creation of the scheme, its aims and practice, and early results.