Emergency nurse : the journal of the RCN Accident and Emergency Nursing Association
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The Department of Health's four-hour operational standard for waiting times in emergency departments (EDs) was introduced in 2001 to speed up treatment and improve the patient experience. Studies and media reports have shown, however, that the standard has increased pressure on ED staff, particularly nurses. This article refers to an analysis of the literature in an attempt to determine whether the implementation of the standard has been beneficial or detrimental to nurses' work, and offers advice to help nurses meet it with minimum stress.
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Prompt treatment of patients with cardiorespiratory arrest can mean the difference between life and death. This article analyses the use of therapeutic hypothermia and aims to educate practitioners about its advantages and disadvantages as an immediate treatment.
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Enabling triage nurses to request X-rays has a number of benefits for patients and staff. This article describes the development of a protocol and in-house training programme that allows triage nurses to assess patients with hand and wrist injuries, make a differential diagnosis of potential fracture and request X-rays. The protocol not only improves patients' journeys, but also empowers members of the emergency department's nursing team to develop new skills.
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Christmas and New Year festivities notoriously result in increased attendance at emergency departments (EDs). The knock-on effect of this in Solihull, in the West Midlands, is that, when ambulance staff and police accompany patients to hospital, the locality is temporarily under-resourced by these services. To address this problem, a collaborative project was implemented to enable advanced clinical practitioners, with consultant support, to assess, treat and potentially discharge patients from a specially constructed emergency facility situated in Solihull town centre. This has reduced the number of ED admissions and transfers, and resulted in significant cost and time savings for the ambulance service.
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As a result of a merger between NHS Direct in Wales and the Welsh Ambulance Services NHS Trust, an initiative in which nurses assess the presenting symptoms of people who call for emergency services has been launched. This article describes how the initiative has ensured that patients receive the services they need, reduced the number of inappropriate ambulance call-outs and helped the nurses involved to improve their practice.