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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Former paediatric nurse, health visitor and bank nurse Paula Chell is now the manager of an urgent care unit in Stoke-on-Trent, where she has developed a 'nurse navigator' system to ensure that nurse practitioners and emergency care triage nurses can identify the appropriate forms of treatment for a wide range of patients
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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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The emergency department (ED) education team at the Queen's Medical Centre, Nottingham, has developed a process to promote effective teamwork in major trauma management. To introduce this process to ED staff, the team developed a multiprofessional education and training programme. This article describes the development process, explains how and why it was undertaken, and provides details of the education and training programme. It also highlights the challenges met by the education team during implementation.
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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.