Australasian Emergency Care最新文献

Patient acceptability and satisfaction with the rural emergency department nurse practitioner model of care (RED-NP MoC). 患者对农村急诊科护士执业模式（RED-NP MoC）的接受程度和满意度。

IF 2.1 4区医学

Australasian Emergency Care Pub Date : 2025-05-26 DOI: 10.1016/j.auec.2025.05.002

Sophie Dilworth, Jean Ball, Michelle Giles, Lynette Lackay, Candice Dahlstrom, Michael Fahy, Peter Massey, Gena Lieschke

{"title":"Patient acceptability and satisfaction with the rural emergency department nurse practitioner model of care (RED-NP MoC).","authors":"Sophie Dilworth, Jean Ball, Michelle Giles, Lynette Lackay, Candice Dahlstrom, Michael Fahy, Peter Massey, Gena Lieschke","doi":"10.1016/j.auec.2025.05.002","DOIUrl":"https://doi.org/10.1016/j.auec.2025.05.002","url":null,"abstract":"In Australia emergency department (ED) workflows have traditionally been reliant on a medical workforce. Ongoing and critical medical workforce shortages in rural areas have resulted in sub-optimal access to emergency department services. Nurse Practitioners (NP) have been proposed as one solution to the crisis. This study aimed to examine patient experiences and satisfaction with a newly implemented rural emergency department nurse practitioner model of care (RED-NP MoC). Between November 2023 to June 2024, patients seen by NPs in one of five participating emergency departments were invited to complete an anonymous online or telephone survey. A total 382 participants responded to the survey (22 % response rate). Over 90 % of patients agreed or strongly agreed that the NP listened to them, had time to talk to them, explained in a way that could be understood, was thorough, provided high quality care, was trustworthy and gave good advice. Similarly, over 90 % of patients were satisfied with the care they received from the NP and would be happy to see the NP in the ED again. Most additional comments about the RED-NP MoC supported the quantitative findings, expressing positive experiences. The RED-NP-MoC was highly acceptable to surveyed patients attending five rural hospital EDs.","PeriodicalId":55979,"journal":{"name":"Australasian Emergency Care","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-05-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144163775","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}

引用次数: 0

Reducing pathology testing in emergency departments: A scoping review. 减少急诊科的病理检查：范围审查。

IF 2.1 4区医学

Australasian Emergency Care Pub Date : 2025-05-26 DOI: 10.1016/j.auec.2025.05.006

Luise Kazda, Kristen Pickles, Philomena Colagiuri, Katy Bell, Brian O'Connell, Erin Mathieu

{"title":"Reducing pathology testing in emergency departments: A scoping review.","authors":"Luise Kazda, Kristen Pickles, Philomena Colagiuri, Katy Bell, Brian O'Connell, Erin Mathieu","doi":"10.1016/j.auec.2025.05.006","DOIUrl":"https://doi.org/10.1016/j.auec.2025.05.006","url":null,"abstract":"Background: Pathology testing in emergency departments (EDs) is often unnecessary, leading to avoidable financial and environmental costs without improving clinical care. This overview summarises interventions to reduce pathology testing in EDs, their effectiveness, and any resulting financial, environmental, patient, or staff impacts.Methods: We searched multiple databases up to February 2025 and conducted citation searches. Eligible studies included intervention and aetiological observational studies of pathology tests in EDs. Secondary studies and conference abstracts were excluded.Results: Of 1,755 records, 34 studies met inclusion criteria: 32 quality improvement studies, one cohort study, and one randomised controlled trial. Interventions included ordering system changes, education, audit & feedback, guideline development, penalties, and alternative care models. Significant reductions ranging from 1.5% to 99% (median: 29%) in targeted pathology tests were reported in 33 of 34 studies. All 25 studies reporting financial impacts found cost reductions, with potential savings up to AUS$1 million in one Australian ED over 18 months (median:US$247,000 per year for nine studies reporting annual savings in US$). No adverse patient or staff impacts were found. No studies reported on environmental impacts.Conclusion: Nearly all interventions reduced test frequency with beneficial or no impacts on patient care and staff efficiency, along with notable cost savings. Future studies should include environmental impacts and assess clinical care co-benefits of reducing unnecessary pathology testing.","PeriodicalId":55979,"journal":{"name":"Australasian Emergency Care","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-05-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144163777","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}

引用次数: 0

Mild and moderate traumatic brain injury: Screening, documentation and referral to concussion services. 轻度和中度创伤性脑损伤：筛选，文件和转介到脑震荡服务。

IF 2.1 4区医学

Australasian Emergency Care Pub Date : 2025-05-24 DOI: 10.1016/j.auec.2025.05.005

Syed Aaraiz Ul Hassan, Noor Ul Huda, Maryam Maheen

引用次数: 0

The T2 nurse - A novel role to reduce time to treatment for critically ill patients in a metropolitan emergency department. T2护士——在城市急诊科减少危重病人治疗时间的新角色。

IF 2.1 4区医学

Australasian Emergency Care Pub Date : 2025-05-16 DOI: 10.1016/j.auec.2025.05.001

Helen Zaouk, Michael Piza, Sabrina Naz, Aaron de Los Santos, Jordan Fenech, Kelly Bivona, Robbie Cruceanu, Sarah Kourouche

{"title":"The T2 nurse - A novel role to reduce time to treatment for critically ill patients in a metropolitan emergency department.","authors":"Helen Zaouk, Michael Piza, Sabrina Naz, Aaron de Los Santos, Jordan Fenech, Kelly Bivona, Robbie Cruceanu, Sarah Kourouche","doi":"10.1016/j.auec.2025.05.001","DOIUrl":"https://doi.org/10.1016/j.auec.2025.05.001","url":null,"abstract":"Background: Delayed access to treatment in the Emergency Department for patients presenting with time-critical presentations leads to increased morbidity and mortality. This study aimed to determine if the introduction of a novel 'T2 Nurse' nursing role to initiate assessment and treatment for time-critical (category 2) patients reduces time to treatment (TTT).Methods: This pre/post-implementation pilot study used routinely collected performance data from all category 2 patients presenting to an emergency department in NSW, Australia from January 2023 to July 2024 using regression analysis.Results: 17,332 pre-implementation records and 16,989 post-implementation records were examined. The mean average TTT pre-implementation was 27 min compared to 12 min during the program, with a mean daily average TTT reduced by 15.4 min post-implementation. After adjusting for seasonal variation, the T2 program significantly reduced average waiting time by approximately 8 min. There was a sustained increase in performance targets with over 80 % of category 2 patients seen within the recommended time post-implementation (a 42 % increase).Conclusion: The implementation of a T2 nurse role led to statistically and clinically significant sustained improvements in TTT particularly when the T2 Nurse initiates treatment, which may lead to improved health outcomes.","PeriodicalId":55979,"journal":{"name":"Australasian Emergency Care","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144095877","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}

引用次数: 0

A cross-sectional survey reporting nurses' perspectives of person-centred care at emergency department triage and waiting room in Australia. 横断面调查报告护士的观点，以人为本的护理在急诊科分诊和候诊室在澳大利亚。

IF 2.1 4区医学

Australasian Emergency Care Pub Date : 2025-05-15 DOI: 10.1016/j.auec.2025.05.004

Carrie Janerka, Gavin D Leslie, Fenella J Gill

{"title":"A cross-sectional survey reporting nurses' perspectives of person-centred care at emergency department triage and waiting room in Australia.","authors":"Carrie Janerka, Gavin D Leslie, Fenella J Gill","doi":"10.1016/j.auec.2025.05.004","DOIUrl":"https://doi.org/10.1016/j.auec.2025.05.004","url":null,"abstract":"Background: A person-centred care approach is widely considered a standard for quality healthcare and has been adopted in various acute care settings. However, emergency department (ED) triage presents unique challenges to operationalising person-centred care and provision in this setting is unclear. This study aimed to explore nurses' perspectives of person-centred care at ED triage and waiting room.Methods: A cross-sectional study of triage nurses across Australia was conducted to understand nurses' knowledge, attitudes and provision of person-centred care. Quantitative data were analysed using descriptive statistics. Responses to open-ended questions were analysed inductively and deductively using the Picker principles of person-centred care.Results: 176 survey responses from nurses across a range of EDs were received. Nurses reported they understood concepts and benefits of person-centred care, yet provision of it varied. Time constraints, high volumes of patients, inadequate staffing and environmental constraints were common barriers. Nurses reported using communication and interpersonal skills, patient involvement and nurse-initiated interventions as strategies for person-centred care.Conclusions: System and organisational-level factors challenge the provision of person-centred care, despite individual efforts by triage nurses. To facilitate person-centred care at ED triage and in the waiting room, consideration of the ED triage context, processes and outcomes is necessary.","PeriodicalId":55979,"journal":{"name":"Australasian Emergency Care","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144086932","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}

引用次数: 0

PISTACHIO (Primary Trauma Care Course Impact & Outcome): A prospective before and after intervention study of the Primary Trauma Care course effect on road trauma morbidity and mortality in two Vietnamese hospitals. 开心果（初级创伤护理过程的影响和结果）：一项前瞻性的干预前后研究初级创伤护理过程对两家越南医院道路创伤发病率和死亡率的影响。

IF 2.1 4区医学

Australasian Emergency Care Pub Date : 2025-05-09 DOI: 10.1016/j.auec.2025.05.003

Ba Tuan Nguyen, C Leigh Blizzard, Andrew Palmer, Huu Tu Nguyen, Quyet Thang Cong, Viet Tran, Toi Lam Phung, Marcus Skinner, Haydn Perndt, Mark R Nelson

{"title":"PISTACHIO (Primary Trauma Care Course Impact & Outcome): A prospective before and after intervention study of the Primary Trauma Care course effect on road trauma morbidity and mortality in two Vietnamese hospitals.","authors":"Ba Tuan Nguyen, C Leigh Blizzard, Andrew Palmer, Huu Tu Nguyen, Quyet Thang Cong, Viet Tran, Toi Lam Phung, Marcus Skinner, Haydn Perndt, Mark R Nelson","doi":"10.1016/j.auec.2025.05.003","DOIUrl":"https://doi.org/10.1016/j.auec.2025.05.003","url":null,"abstract":"Background: Road trauma is a major public health problem in Vietnam. The Vietnamese medical education system is deficient in providing education to address this. The Primary Trauma Care (PTC) course has been used but not yet been evaluated for its impact on patient outcomes'. We conducted this study to assess the impact of the PTC course on patient outcomes in 2 local hospitals in Vietnam.Methods: The research was a prospective before and after intervention study. The intervention (PTC course) was run over 2 days in 2021. The outcomes reported here are mortality at 24 hours, 30 days, and length of hospital stay. Univariate analyses were conducted using χ2 to investigate the effectiveness of the course. Multivariate analysis was also taken to control for confounding factors. Fisher's exact test was used to discern statistical significance.Result: The PTC course halved 24-hour and 30-day mortality from 2.9 % and 4.6 % in the pre-course to 1.0 % and 2.4 % in the post-course period respectively (p < 0.01). However, it failed to shorten the length of hospital stay from 9.0 ± 7.8-8.2 ± 7.1 days (p = 0.458).Conclusion: The PTC course was effective in two Vietnamese hospitals in improving road trauma survival without reducing the length of hospital stay.","PeriodicalId":55979,"journal":{"name":"Australasian Emergency Care","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144040913","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}

引用次数: 0

Emergency department staff perceptions of representation through an observational documentary series. 通过观察纪录片系列急诊科员工的代表性的看法。

IF 2.1 4区医学

Australasian Emergency Care Pub Date : 2025-04-30 DOI: 10.1016/j.auec.2025.04.001

Felicity Moon, Angela Dean, Mark J Putland

{"title":"Emergency department staff perceptions of representation through an observational documentary series.","authors":"Felicity Moon, Angela Dean, Mark J Putland","doi":"10.1016/j.auec.2025.04.001","DOIUrl":"https://doi.org/10.1016/j.auec.2025.04.001","url":null,"abstract":"Background: The representation of healthcare professionals in television has been subject to critique due to the depictions of stereotypical tropes between professional disciplines. Production of factual television programs requires healthcare professionals to perform their roles for a diverse audience, and ideally presents an accurate portrayal of patient care.Methods: We used an anonymous mixed-method survey framed by symbolic interactionism and Goffman's theory of presentation of self to explore how staff negotiate representation during the filming of an observational documentary in an Emergency Department. Quantitative data were analysed using descriptive statistics and qualitative data using thematic analysis.Results: In total 105 staff completed the survey, predominantly nurses and physicians. They reported mixed responses to the impact of filming on professional performance and clinical care. Two themes from the qualitative data revealed that staff sought ideal representation through television production, while also being required to engage in additional work to adjust to the filming team, manage team dynamics, and provide appropriate patient care.Conclusion: Filming of documentaries provides the opportunity for healthcare professionals to engage in representation. However, there is a need to challenge dominant depictions of medical-nursing hierarchies, and present a broader variety of clinical presentations.","PeriodicalId":55979,"journal":{"name":"Australasian Emergency Care","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144034366","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}

引用次数: 0

Refresher training for emergency department triage nurses - A scoping review. 急诊科分诊护士的进修培训-范围审查。

IF 2.1 4区医学

Australasian Emergency Care Pub Date : 2025-04-16 DOI: 10.1016/j.auec.2025.03.006

Amanda Hinds, Susan Kay, Kiah Evans

{"title":"Refresher training for emergency department triage nurses - A scoping review.","authors":"Amanda Hinds, Susan Kay, Kiah Evans","doi":"10.1016/j.auec.2025.03.006","DOIUrl":"https://doi.org/10.1016/j.auec.2025.03.006","url":null,"abstract":"Background: Triage nurses have under five minutes to assess patients; prioritise urgency and assign wait times. Triage accuracy is vital for patient safety and Emergency Department (ED) efficiency. Guidelines for triage nurse refresher training are unclear. This review aimed to describe the evidence on ED triage nurse refresher training.Methods: This scoping review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR), searching Medline, Embase and CINAHL databases from 2007 to 2024.Results: Eighteen studies were included. Problem-based learning, lectures, simulation, and project learning were identified as effective education strategies, with multiple teaching methods frequently used. Cost and delivery mode affected refresher training. Tiredness, patient context, and nurses' forming personal rules over time negatively impacted accuracy, while clear guidelines and flowcharts helped maintain it.Conclusions: Triage refresher training enhances nurses' accuracy. Clear guidance on minimum standards along with visible resources, guidelines and flowcharts further improve triage accuracy. Further research is needed to understand the long-term effects on patient safety and ED patient flow.","PeriodicalId":55979,"journal":{"name":"Australasian Emergency Care","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-04-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144011174","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}

引用次数: 0

A scoping review of randomised controlled trials in vascular access devices in emergency departments. 急诊科血管通路装置随机对照试验的范围综述

IF 2.1 4区医学

Australasian Emergency Care Pub Date : 2025-04-14 DOI: 10.1016/j.auec.2025.03.004

Hui Grace Xu, Yang Camila Zhao, Jed Duff, Nicole Marsh

{"title":"A scoping review of randomised controlled trials in vascular access devices in emergency departments.","authors":"Hui Grace Xu, Yang Camila Zhao, Jed Duff, Nicole Marsh","doi":"10.1016/j.auec.2025.03.004","DOIUrl":"https://doi.org/10.1016/j.auec.2025.03.004","url":null,"abstract":"Aims: To synthesise findings from randomised controlled trials (RCTs) on vascular access devices (VADs) in emergency departments (EDs).Background: VADs play a critical role in EDs, enabling rapid delivery of supportive therapies to address urgent medical needs. This scoping review will map current evidence and determine areas to focus future research priorities.Methods: Following Arksey and O'Malley's scoping review framework, a comprehensive search was conducted (2012-2024) across four databases. RCTs that focused on peripheral intravenous catheters, central venous catheters, arterial catheters, or intraosseous catheters in an ED setting were included.Results: 48 RCTs were included, a majority focused on peripheral intravenous catheters (n = 41, 85 %), followed by central venous catheters (n = 4, 8 %), arterial catheters (n = 2, 4 %), and intraosseous catheters (n = 1, 3 %). The findings were categorised by intervention type, including vessel visualisation technology, catheter design, dressing and securement design, distraction techniques, topical anaesthetics, inserter models, and other related techniques. The top three most frequently reported outcomes were insertion success (n = 21), time to successful insertion (n = 20), and catheter-related complications (n = 19).Conclusion: This review provides ED clinicians with current evidence on VAD technologies and techniques, enabling them to select and implement the most effective options into daily practice reduce costs and improve patient satisfaction.","PeriodicalId":55979,"journal":{"name":"Australasian Emergency Care","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-04-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143996588","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}

引用次数: 0

Self-referral trends to a virtual emergency department following initial presentation: A retrospective exploratory analysis. 自我转诊到虚拟急诊科的趋势：回顾性探索性分析。

IF 2.1 4区医学

Australasian Emergency Care Pub Date : 2025-04-10 DOI: 10.1016/j.auec.2025.03.008

Belinda L Baines, Joanna Lawrence, Jennie Hutton, Loren Sher, Adam I Semciw, James H Boyd, Rebecca L Jessup, Suzanne M Miller, Jason Talevski

{"title":"Self-referral trends to a virtual emergency department following initial presentation: A retrospective exploratory analysis.","authors":"Belinda L Baines, Joanna Lawrence, Jennie Hutton, Loren Sher, Adam I Semciw, James H Boyd, Rebecca L Jessup, Suzanne M Miller, Jason Talevski","doi":"10.1016/j.auec.2025.03.008","DOIUrl":"https://doi.org/10.1016/j.auec.2025.03.008","url":null,"abstract":"Objective: The Victorian Virtual Emergency Department (VVED) provides emergency care for patients across Victoria, Australia with non-life-threatening concerns. This study aims to explore subsequent self-referral patterns of patients after initial presentation to the VVED.Methods: A retrospective cohort study was conducted in 42,921 VVED patients between October 2020 and June 2024. Subsequent self-referral rates among VVED patients who were initially referred through a health care provider (HCP) referral pathway were compared to those who self-referred upon their first presentation. Descriptive statistics and multivariable logistic regression modelling were used.Results: Patients were more likely to self-refer on their second presentation if they self-referred on their first presentation (88 % vs 40 %; p < 0.001). Multivariable logistic regression analyses showed significantly lower odds of subsequent self-referral in all HCP referral pathways compared to the self-referral group. Patients referred through pathways without an HCP present had higher odds of subsequent self-referral than those referred via pathways with a HCP present (OR=1.19, 95 % CI: 1.10-1.28).Conclusions: Patients who self-refer to the VVED initially are more likely to continue self-referring to the service. Further research is needed to explore factors that may enhance the likelihood of self-referral to virtual emergency care services.","PeriodicalId":55979,"journal":{"name":"Australasian Emergency Care","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144043236","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}

引用次数: 0