Articles: emergency-department.
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Randomized Controlled Trial
Disparities in Emergency Department and Urgent Care Opioid Prescribing Before and After Randomized Clinician Feedback Interventions.
Racial and ethnic minorities receive opioid prescriptions at lower rates and dosages than White patients. Though opioid stewardship interventions can improve or exacerbate these disparities, there is little evidence about these effects. We conducted a secondary analysis of a cluster-randomized controlled trial conducted among 438 clinicians from 21 emergency departments and 27 urgent care clinics. Our objective was to determine whether randomly allocated opioid stewardship clinician feedback interventions that were designed to reduce opioid prescriptions had unintended effects on disparities in prescribing by patient race and ethnicity. ⋯ Combined individual audit and peer comparison feedback was associated with fewer opioid pills per prescription equally by patient race and ethnicity. However, the intervention did not significantly close the baseline disparity in prescribing by race.
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Most unintentional injuries among children occur in the home environment. Tip-overs, defined as incidents where heavy objects fall on children due to some type of interaction, are one of the reasons for injuries inside the home. This study aims to determine injury patterns and outcomes for child injuries resulting from tip-overs in the home environment as reported in the emergency department. ⋯ Most tip-over injuries among children were caused by TV, furniture, and TV trolleys. These injuries can be prevented with public education around home safety measures, such as mounting them on the wall.
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Pediatric emergency care · Aug 2023
Multicenter StudyPredicting Delayed Shock in Multisystem Inflammatory Disease in Children: A Multicenter Analysis From the New York City Tri-State Region.
Patients with multisystem inflammatory disease in children (MIS-C) are at risk of developing shock. Our objectives were to determine independent predictors associated with development of delayed shock (≥3 hours from emergency department [ED] arrival) in patients with MIS-C and to derive a model predicting those at low risk for delayed shock. ⋯ Serum CRP, lymphocyte percent, and platelet count differentiated children at higher and lower risk for developing delayed shock. Use of these data can stratify the risk of progression to shock in patients with MIS-C, providing situational awareness and helping guide their level of care.
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Patient safety in emergency departments: a problem for health care systems? An international survey.
Patient safety in healthcare is one of the cornerstones of quality of care. The emergency department (ED) is by its very nature a place where errors and safety issues are liable to occur. ⋯ This survey highlighted that most health professionals identify the ED as an environment with specific safety issues. The main factors appeared to be a shortage of personnel during busy periods, overcrowding due to boarding, and a perceived lack of support from hospital management.
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Emerg Med Australas · Aug 2023
Multicenter StudyUnderstanding experiences of Aboriginal and/or Torres Strait Islander patients at the emergency departments in Australia.
The present study describes the experiences of Aboriginal and/or Torres Strait Islander patients and the factors that shaped their experiences of ED visits in regional settings. ⋯ A holistic approach and a robust hospital commitment to address cultural needs while considering overall health, social and emotional wellbeing, will enhance Aboriginal and/or Torres Strait Islander patients' satisfaction for ED visits.