Articles: emergency-services.
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To determine the regular source of care and the relationship between usual provider and use of medical services among ambulatory emergency department patients. ⋯ Our patients rely heavily on emergency departments for ambulatory physician visits, regardless of their reported regular source of care. However, patients who identify an emergency department as their regular source of ambulatory care used physician services less frequently than patients with access to providers in other settings. These issues require further evaluation with population-based surveys.
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To identify existing surveillance initiatives and to seek and reach consensus on a national minimum data set for injury surveillance in public hospital emergency departments in New Zealand. ⋯ Injury data collection will, in time become mandatory. However, the promotion of the minimum data set for injury surveillance by health professionals, national organisations and community groups will be essential to ensure its implementation and utilisation for the prevention and control of injuries.
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To determine whether omitting neuroimaging in the primary assessment of patients with minor head injuries in the emergency department is safe. ⋯ We found it safe to exclude neuroimaging in the primary assessment of patients with minor head injuries in the ED, and to rely instead on clinical criteria.
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Previous studies, conducted mainly in ICUs, have shown low compliance with hand-washing recommendations, with failure rates approaching 60%. Hand washing in the emergency department has not been studied. We examined the frequency and duration of hand washing in one ED and the effects of three variables: level of training, type of patient contact (clean, dirty, or gloved), and years of staff clinical experience. ⋯ Compliance with hand washing recommendations was low in this ED. Nurses washed their hands significantly more often than either staff physicians or resident physicians, but the average hand-washing duration was less than recommended for all groups. Poor compliance in the ED may be due to the large number of patient contacts, simultaneous management of multiple patients, high illness acuity, and severe time constraints. Strategies for improving compliance with this fundamental method of infection control need to be explored because simple educational interventions have been unsuccessful in other health care settings.