Accident and emergency nursing
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This descriptive exploratory study investigated the reported practices and perceptions of emergency nurses related to infection control in the context of the Human Immunodeficiency Virus/Acquired Immune Deficiency Syndrome (HIV/AIDS) pandemic in Botswana. Quantitative and qualitative data were collected using a self-administered questionnaire. Forty questionnaires were distributed to nurses with emergency department experience in Botswana, with a response rate of 55% (n = 22). ⋯ The authors recommend in-service education and practice initiatives to promote sustainable compliance with universal precautions and realistic risk perception among nurses. Further research is required to evaluate nurses' compliance with universal precautions in developing countries using observational methods or in-depth interviews. This would enable exploration of nurses' actions regarding compliance with universal precautions.
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The emergency department is a dynamic environment with a high throughput of patients. The clinical stability of patients varies considerably. In order to provide optimal care for patients a responsive staffing pattern is required. There is a need for a valid and reliable, prospective, emergency department patient classification system to set adequate nurse staffing levels in the UK. ⋯ There are very few patient classification systems developed for use in the ED setting that have demonstrated good validity and reliability. The Jones Dependency Tool is a simple, easy to use prospective, patient classification system that has demonstrated good validity and reliability in the UK.
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Physical child abuse is a significant social and medical problem within the United Kingdom, and elsewhere. This study considers the role of emergency medical services in the detection of non-accidental childhood injury by examining paediatric attendances at a central London Accident and Emergency department over a two year period. There were 183 recorded episodes of non-accidental injury out of 17,582 paediatric attendances to the A&E department over two years. ⋯ This study shows that about 1 in 100 paediatric attendances at A&E are recorded as non-accidental injury. Young children are less likely to be recorded as non-accidentally injured, compared to adolescents. Health professionals need to be vigilant to the possibility of non-accidental injury for all children using emergency health services.
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The Canadian c-spine rule (CCR) allows safe, reproducible use of radiography in alert, stable patients with potential c-spine injury in the emergency setting [Stiell, I., Clement, C., McKnight, R., Brison, R., Schull, M., Lowe, B., Worthington, J., Eisenhauer, M., Cass, D., Greenberg, G., MacPhail, I., Dreyer, J., Lee, J., Bandiera, G., Reardon, M., Holroyd, B., Lesiuk, H., G. Wells, 2003. The Canadian c-spine rule versus the nexus low-risk criteria in patients with trauma. ⋯ The results suggest that UK emergency department nurses were able to use the Canadian c-spine rule to successfully guide selective immobilisation. A 25% reduction in immobilisation rates would have been achieved if the rule had been followed. Further studies are needed to test the reduction in levels of immobilisation that could be achieved in clinical practice.