Articles: emergency-department.
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Observational Study
The status of patient portal use among Emergency Department patients experiencing houselessness: A large-scale single-center observational study.
Patient portal (PP) use has rapidly increased in recent years. However, the PP use status among houseless patients is largely unknown. We aim to determine 1) the PP use status among Emergency Department (ED) patients experiencing houselessness, and 2) whether PP use is linked to the increase in patient clinic visits. ⋯ Houselessness is a potential risk factor preventing patient portal use. In addition, using patient portals could potentially increase clinic visits among the houseless patient population.
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EDs are highly demanding workplaces generating considerable potential for occupational stress experiences. Previous research has been limited by a focus on specific aspects of the working environment and studies focussing on a range of variables are needed. The aim of the present study was to describe the perceptions of occupational stress and coping strategies of ED nurses and doctors and the differences between these two groups. ⋯ The present study found organisational stressors adversely impact the well-being of ED nurses and doctors. Organisational-focused interventions including leadership development, strategic recruitment, adequate staffing and resources may mitigate occupational stress and complement individual coping strategies. Expanding this research to understand broader perspectives and especially the impact of COVID-19 upon ED workers is recommended.
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Observational Study
Factors Associated with a Lack of Healthcare Utilization Among Veterans after a Positive Suicide Screen in the Emergency Department.
Many Veterans at high risk for suicide are identified in Veterans Health Administration (VHA) emergency departments (ED). Little is known about what may predict care utilization in this population. To address this knowledge gap, we explored factors associated with Veterans' lack of VHA care utilization following a positive suicide risk screen in the ED. ⋯ Veterans who do not utilize VHA care after a positive suicide risk screen appear to have fewer documented health and housing concerns than those who do receive care. Yet, Veterans with a positive suicide risk screen who are otherwise healthy may remain at elevated risk for suicide following their ED visit. ED providers may consider enhanced follow-up care to mitigate suicide risk for these Veterans.
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Scand J Trauma Resus · Apr 2023
Clinical TrialPredicting deterioration of patients with early sepsis at the emergency department using continuous heart rate variability analysis: a model-based approach.
Sepsis is a life-threatening disease with an in-hospital mortality rate of approximately 20%. Physicians at the emergency department (ED) have to estimate the risk of deterioration in the coming hours or days and decide whether the patient should be admitted to the general ward, ICU or can be discharged. Current risk stratification tools are based on measurements of vital parameters at a single timepoint. Here, we performed a time, frequency, and trend analysis on continuous electrocardiograms (ECG) at the ED to try and predict deterioration of septic patients. ⋯ We showed that continuous ECG recordings can be automatically analyzed and used to extract HRV features associated with clinical deterioration in sepsis. The predictive accuracy of our current model based on HRV features derived from the ECG only shows the potential of HRV measurements at the ED. Unlike other risk stratification tools employing multiple vital parameters this does not require manual calculation of the score and can be used on continuous data over time. Trial registration The protocol of this study is published by Quinten et al., 2017.
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There is strong evidence for emergency department (ED)-initiated treatment of opioid use disorder (OUD). However, implementation is variable, and ED management of OUD may differ by clinical presentation. Our aim was to use mixed methods to explore variation in ED-based OUD care by patient clinical presentation and understand barriers and facilitators to ED implementation of OUD treatment across scenarios. ⋯ ED-based treatment of OUD differed by clinical presentation. Clinician focus groups identified several areas where targeted guidance or novel approaches may improve current practices. These results highlight the need for tailored clinical guidance and can inform health system and policy interventions seeking to increase ED-initiated treatment for OUD.