Journal of Emergency Nursing最新文献

{"title":"Predictive Performance of the KINDER 1 Fall Risk Assessment Tool in a Regional Health System","authors":"Vallire Hooper PhD, RN, CPAN, FASPAN, FAAN,&nbsp;Cynthia M. LaFond PhD, RN, CCRN-K, FAAN,&nbsp;Kristi Stephenson BSN, RN, CEN,&nbsp;Angela Wright PhD, RN, MBA, NEA-BC","doi":"10.1016/j.jen.2024.12.013","DOIUrl":"10.1016/j.jen.2024.12.013","url":null,"abstract":"<div><h3>Introduction</h3><div>Patient fall risk assessment in the emergency department poses a unique challenge as fall risk is often associated with risk factors other than inpatient falls. While there are many inpatient fall risk assessment tools, few have been used or validated in the ED environment. Therefore, this study examined the predictive performance of the KINDER 1 Fall Risk Assessment Tool in 10 emergency departments.</div></div><div><h3>Methods</h3><div>A retrospective cohort design was used. Data were collected from November 15, 2023, to April 30, 2024, as a part of an electronic pilot of the KINDER 1 Fall Risk Assessment tool. Inclusion criteria encompassed all adult (≥18 years) ED visits during which a KINDER 1 fall risk assessment was completed. Descriptive statistics were used to describe overall sample characteristics. Predictive performance was calculated via multiple accuracy measurements.</div></div><div><h3>Results</h3><div>KINDER 1 assessments were completed on 64,811 patients, of which 40 patient falls met inclusion criteria for final analysis. The mean age of the patients who fell was 58.46 years (±18.38). Final sensitivity was 77.5%, and the specificity was 75.8%. Fall prevalence was 0.06%.</div></div><div><h3>Discussion</h3><div>KINDER 1 exhibited a sufficiently high degree of sensitivity and specificity, supporting an acceptable level of predictive performance. Additional research is recommended to compare the reliability and predictive validity of KINDER 1 to the emergency Hester Davis Scale and the Memorial Emergency Department Fall Risk Assessment Tool, as well as to compare the usability of the tools for nurses in a triage setting.</div></div>","PeriodicalId":51082,"journal":{"name":"Journal of Emergency Nursing","volume":"51 4","pages":"Pages 636-643"},"PeriodicalIF":1.8,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143076379","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Information for Readers","authors":"","doi":"10.1016/S0099-1767(25)00180-1","DOIUrl":"10.1016/S0099-1767(25)00180-1","url":null,"abstract":"","PeriodicalId":51082,"journal":{"name":"Journal of Emergency Nursing","volume":"51 4","pages":"Page A8"},"PeriodicalIF":1.8,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144517314","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Expanding the Discussion on Emergency Nurse Retention: Insights and Global Perspectives","authors":"","doi":"10.1016/j.jen.2025.01.008","DOIUrl":"10.1016/j.jen.2025.01.008","url":null,"abstract":"","PeriodicalId":51082,"journal":{"name":"Journal of Emergency Nursing","volume":"51 4","pages":"Page 513"},"PeriodicalIF":1.8,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144517317","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"International Day on the Hill: Taking it Home to Parliament 2024","authors":"Dawn Peta BN, RN, ENC(C)","doi":"10.1016/j.jen.2025.01.010","DOIUrl":"10.1016/j.jen.2025.01.010","url":null,"abstract":"","PeriodicalId":51082,"journal":{"name":"Journal of Emergency Nursing","volume":"51 4","pages":"Pages 530-536"},"PeriodicalIF":1.8,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144517321","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Case Report: Care of the Agitated Emergency Department Patient With Alzheimer’s Disease","authors":"Ines Luciani McGillivray RN, BSN, CEN,&nbsp;Anderson Chen MD,&nbsp;Patricia A. Normandin DNP, RN, CEN, CPN, CPEN, FAEN","doi":"10.1016/j.jen.2025.04.002","DOIUrl":"10.1016/j.jen.2025.04.002","url":null,"abstract":"<div><div>Global estimates of persons in various stages of Alzheimer’s disease, a form of dementia, were estimated to be at 416 million. It is estimated that 22% of people who are 50 years of age or older have Alzheimer’s disease. According to the National Institute on Aging, millions of families took care of loved ones at home who had serious chronic diseases, which included Alzheimer’s disease. It is important that these statistics are understood by emergency nurses because their assigned emergency patient may be in any stage of Alzheimer’s disease.</div><div>This case report is about a patient with advanced Alzheimer’s disease being cared for at home by her daughter, an experienced emergency nurse. The patient developed uncontrollable agitation owing to Alzheimer’s disease dementia that necessitated multiple emergency department visits. A gap in emergency nurses’ knowledge of available resources to help family members navigate home care of loved ones with Alzheimer’s disease was identified.</div><div>Tools that empower emergency nurses during care of patients with uncontrolled Alzheimer’s disease agitation are provided. Palliative and hospice services available for loved ones with Alzheimer’s disease are discussed. Emergency nurses are encouraged to share information with families to facilitate dignity during a loved one’s end of life.</div></div>","PeriodicalId":51082,"journal":{"name":"Journal of Emergency Nursing","volume":"51 4","pages":"Pages 553-569"},"PeriodicalIF":1.8,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144517323","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of Individualized Versus Weight-Based Pain Protocols on Patient Satisfaction for Patients With Sickle Cell Disease Experiencing a Vaso-Occlusive Episode","authors":"Stephanie O. Ibemere PhD, MSN, RN,&nbsp;Huiman Barnhart PhD,&nbsp;John Myers PhD, MSPH,&nbsp;Joseph Miller MD,&nbsp;Ifeyinwa Osunkwo MD,&nbsp;Hayden B. Bosworth PhD,&nbsp;Caroline E. Freiermuth MD,&nbsp;Robert Hughes DO, MS,&nbsp;Patricia L. Kavanagh MD,&nbsp;Judith A. Paice PhD, RN,&nbsp;James Paxton MD,&nbsp;Ava Pierce MD,&nbsp;Michael S. Runyon MD, MPH,&nbsp;John J. Strouse MD, PhD,&nbsp;Padmaja Veeramreddy MD,&nbsp;R. Gentry Wilkerson MD,&nbsp;Paula Tanabe PhD, RN, FAEN, FAAN","doi":"10.1016/j.jen.2024.12.014","DOIUrl":"10.1016/j.jen.2024.12.014","url":null,"abstract":"<div><h3>Introduction</h3><div>National guidelines for the acute management of sickle cell disease vaso-occlusive episodes recommend the use of a patient-specific or a weight-based protocol. The authors compared patient satisfaction with pain management between those randomized to receive either a patient-specific or weight-based pain protocol in the COMPARE-VOE randomized control trial.</div></div><div><h3>Methods</h3><div>Participants with sickle cell disease were pre-enrolled and patient satisfaction with pain management was assessed at the time of discharge from the 6 participating emergency departments. Patients were randomized to receive a patient-specific or weight-based pain protocol. The authors compared continuous variables between the patient-specific and weight-based protocols with the 2-sample <em>t</em> test and categorical variables by the chi-square test.</div></div><div><h3>Results</h3><div>The authors enrolled 104 participants. Compared with satisfaction with pain management on previous ED visits, more participants in the patient-specific protocol group than the weight-based group (57.1% vs 31.8%; <em>P =</em> .02) were satisfied with pain management. Most who were discharged home (91.2%) felt their pain was sufficiently relieved to be discharged home.</div></div><div><h3>Discussion</h3><div>These findings support evidence-based guidelines to manage vaso-occlusive episodes in emergency departments. Patient-specific protocols can be implemented by partnering with local sickle cell disease providers to make protocols available in the emergency department.</div></div>","PeriodicalId":51082,"journal":{"name":"Journal of Emergency Nursing","volume":"51 4","pages":"Pages 626-635"},"PeriodicalIF":1.8,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143525110","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Burnout Among Physicians and Nurses Working in Intensive Care Units and Emergency Departments: A Systematic Review and Meta-Analysis","authors":"Kuan-Han Lin PhD,&nbsp;Nandhini Selvanayagam BSc,&nbsp;Sneha Patnaik MD,&nbsp;Chun-Ya Kuo MD","doi":"10.1016/j.jen.2025.02.007","DOIUrl":"10.1016/j.jen.2025.02.007","url":null,"abstract":"<div><h3>Introduction</h3><div>This study aimed to discover the prevalence and risk factors of burnout among physicians and nurses working in intensive care units and emergency departments.</div></div><div><h3>Methods</h3><div>This systematic review followed the reporting guidance from the Preferred Reporting Items for Systematic Reviews and Meta-Analyses. A literature search was conducted using the following databases: PubMed, MEDLINE, CINAHL, and Embase. The search was conducted in November 2023. English-language studies reporting burnout prevalence and risk factors among intensive care units and emergency physicians and nurses, with primary outcomes, were identified. Quantitative studies with observational designs underwent review, with 2 independent reviewers screening titles, abstracts, and full texts for inclusion. Quality assessment used Joanna Briggs Institute critical appraisal tools. A meta-analysis was conducted if data were sufficient.</div></div><div><h3>Results</h3><div>This review included 17 studies. The pooled prevalence rates for burnout, high emotional exhaustion, high depersonalization, and low personal accomplishment were 46%, 48%, 30%, and 47%, respectively. Factors such as age, sex, smoking/tobacco use, education level, years of experience, workload, and the impact of coronavirus disease 2019 were identified as significant determinants of burnout in this population.</div></div><div><h3>Discussion</h3><div>The results assisted in determining preventive strategies and identified areas for future research.</div></div>","PeriodicalId":51082,"journal":{"name":"Journal of Emergency Nursing","volume":"51 4","pages":"Pages 702-720"},"PeriodicalIF":1.8,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143634958","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Implementing “ER is for Emergencies” Practice Guideline to Reduce Nonemergent Emergency Department Visits","authors":"Shannon Etheridge Whitten DNP, MPH, MS, APRN, NP-C, APRN-BC, CCRN, AACC,&nbsp;Shelli Kitchens BSN, RN, TNCC, ENPC,&nbsp;Cecilia Tomori PhD, MA","doi":"10.1016/j.jen.2025.03.015","DOIUrl":"10.1016/j.jen.2025.03.015","url":null,"abstract":"<div><h3>Introduction</h3><div>More than half of all health care visits in the United States occur in the emergency department. These visits are the result of systems and policies that reduce primary care access. Patient linkage to primary care services is essential for improved health outcomes and effective emergency department care. This project aimed to implement a patient education and navigation program in a rural emergency department to reduce nonemergent emergency department visits and nurse workload and to improve patient enrollment in primary care patient-centered medical homes.</div></div><div><h3>Methods</h3><div>The project used a pretest-posttest design to determine the impact of the “ER is for Emergencies” clinical guideline on nonemergent emergency department visits and patient enrollment. The modified Need for Recovery Survey used a paired group analysis to assess the project’s impact on nurse workload and job satisfaction.</div></div><div><h3>Results</h3><div>A convenience sample of 38 primarily Black/African American (N = 35) and Medicaid-insured patients (N = 16) received nurse-led education and a referral to a patient-centered medical home. A comparison of pre- and postintervention chart reviews demonstrated a significant reduction in nonemergent emergency department visits after the intervention (<em>P</em> &lt; .01) and improved participant enrollment in the patient-centered medical home (<em>P</em> = .04). Furthermore, the intervention was associated with reduced nurse-reported workload and stress (N = 7; <em>P</em> &lt; .007).</div></div><div><h3>Conclusion</h3><div>The results of this quality improvement project are consistent with the broader literature that multimodal interventions can effectively reduce nonemergent emergency department visits and link patients to primary care. Multimodal interventions and policy solutions targeting structural inequities are urgently needed to support access to primary care and reduce nonemergent ED use.</div></div>","PeriodicalId":51082,"journal":{"name":"Journal of Emergency Nursing","volume":"51 4","pages":"Pages 597-606"},"PeriodicalIF":1.8,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144056540","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Implementation of a Naloxone Vending Machine in the Public Space of an Emergency Department: A Feasibility and Acceptability Study","authors":"Chin Hwa (Gina) Dahlem PhD, FNP-C, FAANP,&nbsp;Elizabeth English BS,&nbsp;Mary Dwan BA,&nbsp;Christian Carlson PharmD, MBA,&nbsp;Aaron Dora-Laskey MD MS,&nbsp;Keith E. Kocher MD, MPH,&nbsp;Eve D. Losman MD, MHSA","doi":"10.1016/j.jen.2025.03.009","DOIUrl":"10.1016/j.jen.2025.03.009","url":null,"abstract":"<div><h3>Introduction</h3><div>Naloxone is a lifesaving medication to prevent opioid overdose deaths. Emergency departments can provide important access points for individuals to receive naloxone. Vending machines are 1 low-barrier method of distributing naloxone. We describe the implementation of an emergency department-based naloxone vending machine and demonstrate its feasibility and acceptability among participants.</div></div><div><h3>Methods</h3><div>A naloxone vending machine, supplying free naloxone and educational resources via a Quick Response code affixed to the box in addition to brochures, was installed in a public hallway next to other vending machines in the emergency department. A 12-item paper survey attached to the machine queried reasons for obtaining naloxone, acceptability of emergency department-based naloxone vending machines, and an open-ended question about their experiences with the machine.</div></div><div><h3>Results</h3><div>From October 2023 to May 2024, 1470 boxes of naloxone were dispensed. Survey results (N = 54) indicated that nearly half of respondents (46.2%) would not have otherwise had access to naloxone. Also, 75.9% obtained naloxone to be prepared for an overdose emergency, 42.6% because it was free, and 35.2% out of concern for a family or friend. High acceptability was reported for all survey items. Qualitative themes were predominantly positive, including gratitude, desire to help others, need for increased distribution, and the personal impact of naloxone in their lives.</div></div><div><h3>Discussion</h3><div>Emergency department-based naloxone vending machines are an impactful, low-barrier strategy that is acceptable to the public. They provide continuous access to a life-saving medication and should be replicated widely.</div></div>","PeriodicalId":51082,"journal":{"name":"Journal of Emergency Nursing","volume":"51 4","pages":"Pages 607-615"},"PeriodicalIF":1.8,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144042405","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Outpatient Follow-Up After Rural Emergency Department Discharge: A Quality Improvement Initiative","authors":"Madeline Boyce DNP, FNP-BC,&nbsp;Kelly Snyder DNP, FNP-BC,&nbsp;Kristen Slabaugh DNP, FNP-BC, CNE,&nbsp;Anne Woods PhD, RN","doi":"10.1016/j.jen.2025.03.008","DOIUrl":"10.1016/j.jen.2025.03.008","url":null,"abstract":"<div><h3>Introduction</h3><div>Patients residing in rural communities experience a gap in health care access, leading to increased emergency department usage and returns. Outpatient follow-up with primary care providers or specialists is instrumental in transitioning from the emergency department to home. Evidence supports the use of post-discharge phone calls to increase adherence with follow-up outpatient appointments and potentially reduce negative sequelae for health care systems and patients.</div></div><div><h3>Methods</h3><div>This quality improvement project used a convenience sample of patients aged 18 years and older presenting to a critical-access rural emergency department and discharged home with recommended outpatient follow-up. Two scripted post-discharge phone calls were conducted: initial contact within 72 hours of discharge and second contact between 7 and 10 days after discharge. Resources were provided during phone calls if barriers to timely follow-up were identified.</div></div><div><h3>Results</h3><div>Implementation of post-discharge phone calls significantly increased outpatient follow-up but had no impact on unplanned emergency department revisits.</div></div><div><h3>Discussion</h3><div>Post-discharge phone calls addressed potential barriers and effectively increased outpatient follow-up. Implementation of post-emergency department discharge phone calls is recommended to improve primary care or specialist follow-up. Continued tracking of follow-up appointments and emergency department revisits are required.</div></div>","PeriodicalId":51082,"journal":{"name":"Journal of Emergency Nursing","volume":"51 4","pages":"Pages 616-625"},"PeriodicalIF":1.8,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144042582","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}