Articles: hospital-emergency-service.
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JNMA J Nepal Med Assoc · May 2022
Case ReportsEmergency Caesarean Section in a COVID-19 Infected Mother in a Primary Health Care Centre.
People from rural areas of Nepal struggle to have access to adequate medical care on time. Most of the tertiary centres are overburdened by patients, while the peripheral health facilities have been unable to function efficiently due to a lack of infrastructures and skilled manpower needed to run hospitals smoothly. We present a case of a 21-year-old primigravida at 41 weeks and 3 days of gestation with mild COVID-19 symptoms who underwent a Caesarean section for non-progression of labour and foetal distress at a primary health care centre in Nepal; however, both maternal and foetal outcomes were favourable. Therefore, upgrading the quality of care in peripheral health facilities can help in the achievement of accessibility, equity, and quality in health care service in Nepal.
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Observational Study
Impact of Pain Assessment on Canadian Triage and Acuity Scale Prediction of Patient Outcomes.
How does the removal of patient-reported pain from the Canadian Triage Acuity Scale (CTAS) affect the scale's ability to predict admission, ICU consultation, and mortality? ⋯ The removal of the pain scale from CTAS did not reduce its ability to predict hospital admission, ICU consultation, or the 72-hour mortality.
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Agitation, defined as excessive psychomotor activity leading to violent and aggressive behavior, is becoming more prevalent in the emergency department (ED) amidst a strained behavioral health system. Team-based interventions have demonstrated promise in promoting de-escalation, with the hope of minimizing the need for invasive techniques, like physical restraints. This study aimed to evaluate an interprofessional code response team intervention to manage agitation in the ED with the goal of decreasing physical restraint use. ⋯ With the implementation of a structured agitation code response team intervention combined with design and administrative support, a decreased rate of physical restraint use occurred over a 5-year period. Results suggest that investment in organizational change, along with interprofessional collaboration during the management of agitated patients in the ED, can lead to sustained reductions in the use of an invasive and potentially harmful measure on patients.
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Care coordination (CC) interventions involve systematic strategies to address fragmentation and enhance continuity of care. However, it remains unclear whether CC can sufficiently address patient needs and improve outcomes. ⋯ CC interventions have inconsistent effects on reducing hospitalizations and ED visits. Future work should address how they should be adapted to different healthcare settings and which tools or approaches are most helpful for implementation.