Australasian Emergency Care最新文献

From triage to departure: Older adults' ED journey. A mixed methods study.

IF 2.1 4区医学

Australasian Emergency Care Pub Date : 2025-03-25 DOI: 10.1016/j.auec.2025.03.005

Melinda Williamson, Kristie J Harper, Sarah Bernard, Courtenay Harris

{"title":"From triage to departure: Older adults' ED journey. A mixed methods study.","authors":"Melinda Williamson, Kristie J Harper, Sarah Bernard, Courtenay Harris","doi":"10.1016/j.auec.2025.03.005","DOIUrl":"https://doi.org/10.1016/j.auec.2025.03.005","url":null,"abstract":"Background: Rising Emergency Department (ED) demand strains resources to assess and manage frail older adults. Allied health supports comprehensive care, disposition planning and patient safety in the ED but often intervenes late. This study investigated factors affecting allied health referrals and co-designed an early allied health frailty service.Methods: An explanatory sequential mixed-methods approach was used. Patient journey mapping of low acuity older ED patients was followed by stakeholder focus groups.Results: From triage, 20 older ED patients waited a mean of 110 minutes (SD 83 minutes) for doctor assessment, 123 minutes (SD 116 minutes) for an ED bed and 355 minutes (SD 297 minutes) for allied health assessment with a mean ED length of stay (LOS) of 685 minutes (SD 444 minutes). Qualitative analysis of focus group discussions identified perceived benefits of an early allied health service including shorter LOS, earlier disposition planning, increased staff confidence and streamlined decision making. Perceived barriers were lack of space, competing assessments with doctors and incomplete investigations. Perceived solutions were refining the inclusion criteria and staff education.Conclusion: Allied health assessment occurred six hours post presentation, outside national targets. Opportunities and barriers identified supported the development of an earlier allied health frailty service.","PeriodicalId":55979,"journal":{"name":"Australasian Emergency Care","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143722674","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 clinical nurse specialist practice in Victoria and New South Wales: A cross-sectional study.

IF 2.1 4区医学

Australasian Emergency Care Pub Date : 2025-03-20 DOI: 10.1016/j.auec.2025.03.002

Sarah Wiggs, Abra Osborne, Julia Morphet

{"title":"Emergency clinical nurse specialist practice in Victoria and New South Wales: A cross-sectional study.","authors":"Sarah Wiggs, Abra Osborne, Julia Morphet","doi":"10.1016/j.auec.2025.03.002","DOIUrl":"https://doi.org/10.1016/j.auec.2025.03.002","url":null,"abstract":"Background: Emergency Clinical Nurse Specialists (CNS) are experts in treating patients across the lifespan in the dynamic, unpredictable and busy Emergency Department (ED). The aim of this paper was to create a profile of the Emergency CNS role and practice, and assess work satisfaction.Methods: An online cross-sectional survey based on the College of Emergency Nursing Australasia's Practice Standards for the Specialist Emergency Nurse was conducted in the Australian states of Victoria and New South Wales.Results: There were 59 survey responses. The domains Lawful Practice, Professional Ethics and Communication were rated as practiced with the greatest frequency, and Lawful Practice and Teamwork were rated very important by respondents. 79 % of CNSs planned to continue working in ED, with all CNSs reporting plans to continue working in healthcare. 77 % of CNSs were satisfied in their current role.Conclusion: The Practice Standards for the Specialist Emergency Nurse are used regularly and are relevant to CNS practice. CNSs are largely satisfied with their role, which is versatile and multifaceted. However, CNSs face challenges to perform all elements of their role, and reported protected non-clinical time and collaboration with management as enablers to their role.","PeriodicalId":55979,"journal":{"name":"Australasian Emergency Care","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143674971","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

Developing practice-level quality indicators to assist in evaluating the application of the Australasian Triage Scale: A modified e-Delphi process.

IF 2.1 4区医学

Australasian Emergency Care Pub Date : 2025-03-17 DOI: 10.1016/j.auec.2025.03.001

Wayne Varndell, Matthew Lutze, Carrie Janerka

{"title":"Developing practice-level quality indicators to assist in evaluating the application of the Australasian Triage Scale: A modified e-Delphi process.","authors":"Wayne Varndell, Matthew Lutze, Carrie Janerka","doi":"10.1016/j.auec.2025.03.001","DOIUrl":"https://doi.org/10.1016/j.auec.2025.03.001","url":null,"abstract":"Background: Triage quality is central to patient safety and the efficient distribution of emergency department resources. Currently, there are no identified quality indicators for application of the Australasian Triage Scale.Aim: To address a gap in quality indicators specific to triage.Design: A literature review and modified Delphi technique.Method: A review of the literature published between 2001 and 2024 was conducted to identify potential indicators and metrics of triage quality, and were categorised across six quality of care domains (patient-centeredness, timeliness, effectiveness, equity, efficiency and safety). Three consecutive online surveys where panellists rated these indicators for perceived appropriateness, validity and feasibility were completed between August and December 2023.Results: From the review, 17 initial quality indicators across six quality of care domains were developed. Following round 1, 3 indicators were modified and 8 indicators were added. After two further survey rounds, 18 (72 %) indicators met consensus.Conclusion: An expert panel validated a set of triage quality indicators for measuring Australian triage practice. A continuous quality improvement approach is required to optimise triage practice, develop processes for detecting and reducing patient harm and minimising variation. Further research is needed to test applicability of the indicators.","PeriodicalId":55979,"journal":{"name":"Australasian Emergency Care","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143659455","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

Screening and assessment of falls risk in the emergency department.

IF 2.1 4区医学

Australasian Emergency Care Pub Date : 2025-03-15 DOI: 10.1016/j.auec.2025.03.003

Paul Fulbrook, Sandra J Miles, Faye Jordan, Sarah Hazelwood, Hwee Yong Debbie Lee

{"title":"Screening and assessment of falls risk in the emergency department.","authors":"Paul Fulbrook, Sandra J Miles, Faye Jordan, Sarah Hazelwood, Hwee Yong Debbie Lee","doi":"10.1016/j.auec.2025.03.003","DOIUrl":"https://doi.org/10.1016/j.auec.2025.03.003","url":null,"abstract":"Background: Falls are a source of harm, repeat emergency department visits and hospital admission for older adults. Undertaking a comprehensive geriatric screening including falls-risk is recommended in guidelines for optimal older adult emergency department care.Methods: A pragmatic prospective cohort study was undertaken to evaluate use of further falls-risk screening in older adults in a large tertiary Australian hospital emergency department. Primary outcome measures of interest were length of stay; discharge destination; 30-day and 90-day re-presentations.Results: Of 651 eligible cases, 320 were randomly recruited for further screening following consent. The implementation cohort spent an average 45 m longer in the emergency department with a greater proportion admitted to the short stay unit, staying there longer than a comparison cohort. There were significantly fewer 30-day fall-related representations (2.9 %) in the implementation cohort.Conclusions: Despite a small reduction in emergency department re-presentation within 30 days in the implementation cohort, hospital admission was not reduced. Further research is needed to examine any cost-benefit ratio of additional falls-risk screening and intervention in emergency departments.","PeriodicalId":55979,"journal":{"name":"Australasian Emergency Care","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143639704","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

The impact of emergency nurse practitioners on short-term survival in out-of-hospital cardiac arrest.

IF 2.1 4区医学

Australasian Emergency Care Pub Date : 2025-02-17 DOI: 10.1016/j.auec.2025.02.002

Weerapont Kaewpaengchan, Wachira Wongtanasarasin, Worapot Khampeera, Borwon Wittayachamnankul

{"title":"The impact of emergency nurse practitioners on short-term survival in out-of-hospital cardiac arrest.","authors":"Weerapont Kaewpaengchan, Wachira Wongtanasarasin, Worapot Khampeera, Borwon Wittayachamnankul","doi":"10.1016/j.auec.2025.02.002","DOIUrl":"https://doi.org/10.1016/j.auec.2025.02.002","url":null,"abstract":"Background: Emergency Medical Services (EMS) are critical for improving survival in out-of-hospital cardiac arrest (OHCA). The expertise of EMS team leaders, such as emergency nurse practitioners (ENPs), may impact patient outcomes. This study aimed to evaluate the role of ENPs and their association with outcomes in OHCA.Methods: A retrospective analysis was conducted on OHCA cases treated by EMS from 2017 to 2020. Data included ENP presence, number of healthcare personnel, patient demographics, initial rhythm, bystander CPR, physician presence, patient access time, and scene time. Primary outcome was prehospital return of spontaneous circulation (ROSC), with secondary outcome being ROSC at the emergency department (ED).Results: Among 212 OHCA cases treated by EMS, ENPs were present in 14.6 % of cases. Prehospital ROSC was 11.3 %, while ROSC at the ED was 48.1 %. ENP presence was not associated with increased prehospital ROSC (p = 0.19) but was linked to higher overall ROSC rates at the ED (p = 0.03).Conclusions: Including ENPs in EMS teams may improve short-term survival outcomes for OHCA patients, particularly at the ED. Further research is needed to explore the broader impact of ENPs in prehospital care.","PeriodicalId":55979,"journal":{"name":"Australasian Emergency Care","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-02-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143450279","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

Mitigating conflict between emergency department and inpatient staff due to access block.

IF 2.1 4区医学

Australasian Emergency Care Pub Date : 2025-02-12 DOI: 10.1016/j.auec.2025.01.003

Benjamin Aston, Gideon de Jong, Sarah Tillott

引用次数: 0

Effects of cold needle and ShotBlocker applied in the emergency department on pain and satisfaction in intramuscular injection pain: A randomized controlled trial.

IF 2.1 4区医学

Australasian Emergency Care Pub Date : 2025-02-08 DOI: 10.1016/j.auec.2025.02.001

Yadigar Ordu, Hilal Türkben Polat, Kadir Küçükceran

{"title":"Effects of cold needle and ShotBlocker applied in the emergency department on pain and satisfaction in intramuscular injection pain: A randomized controlled trial.","authors":"Yadigar Ordu, Hilal Türkben Polat, Kadir Küçükceran","doi":"10.1016/j.auec.2025.02.001","DOIUrl":"https://doi.org/10.1016/j.auec.2025.02.001","url":null,"abstract":"Background: The most commonly reported side effect of intramuscular injection is pain. Cold needles and ShotBlocker can be used as non-pharmacological methods for pain relief. This study aims to determine the effect of cold needle and ShotBlocker on pain and satisfaction in intramuscular injection pain.Methods: This is a triple-blind, randomized controlled study. The study was conducted on 120 patients (40: control, 40: cold needle, 40: ShotBlocker) who presented to the emergency department of a university hospital in Turkey for cyanocobalamin injection in July-August 2024. Data were collected using a patient identification form, visual pain scale (VPS), and injection satisfaction scale. SPSS statistical package (version 22.0; SPSS, Inc., USA) was used to analyze the data.Results: In the study, the groups were found to be similar except for age and continuous drug use. The pain scores of the control group were significantly higher than those of the cold needle and ShotBlocker groups. Injection satisfaction was significantly higher in the cold needle and ShotBlocker groups than in the control group.Conclusion: Both the Cold Needle and the ShotBlocker can be used as effective methods to reduce pain associated with intramuscular injections and improve injection satisfaction. Both methods are non-pharmacological, inexpensive, and easy to use, and they can be used safely and effectively in all clinical settings.","PeriodicalId":55979,"journal":{"name":"Australasian Emergency Care","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-02-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143383693","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

Enhancing end-of-life care for advanced heart failure patients in Saudi Arabian emergency departments (EDs): Perspectives of ED staff on challenges.

IF 2.1 4区医学

Australasian Emergency Care Pub Date : 2025-02-05 DOI: 10.1016/j.auec.2025.01.004

Ali Jaber Alqahtani, Geoffrey Keith Mitchell, Lisa Crossland, Hanan Mesfer Alyami

{"title":"Enhancing end-of-life care for advanced heart failure patients in Saudi Arabian emergency departments (EDs): Perspectives of ED staff on challenges.","authors":"Ali Jaber Alqahtani, Geoffrey Keith Mitchell, Lisa Crossland, Hanan Mesfer Alyami","doi":"10.1016/j.auec.2025.01.004","DOIUrl":"https://doi.org/10.1016/j.auec.2025.01.004","url":null,"abstract":"Background: Providing care for patients nearing the end of life who have advanced heart failure presents significant challenges, especially in emergency settings where the primary focus is on life-saving interventions. Exploring the perceptions of emergency department staff is essential for identifying barriers and improving care delivery in this critical context.Methods: A qualitative study was conducted in two hospitals in Saudi Arabia. Semi-structured interviews were completed with thirty emergency staff. A thematic analysis was used to identify the challenges in delivering care for patients nearing the end of life.Results: Seven themes were identified: current practices for advanced heart failure patients, communication barriers, inadequate training in end-of-life care, limitations in emergency department design, heavy workloads, the influence of cultural and religious factors, and the importance of psychological and emotional support for patients and families. The findings highlight the need for structured training, cultural sensitivity, and improved environments to address these challenges.Conclusions: This study emphasizes the complexities of providing care for patients nearing the end of life in emergency settings. Addressing gaps in communication, training, and cultural competence is critical. Tailored strategies for Saudi Arabia's unique context are essential to enhance care for advanced heart failure patients.","PeriodicalId":55979,"journal":{"name":"Australasian Emergency Care","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-02-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143366895","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

How confident are Queensland paramedics with seizure recognition, differentiation, and management? A pilot study.

IF 2.1 4区医学

Australasian Emergency Care Pub Date : 2025-01-29 DOI: 10.1016/j.auec.2025.01.002

Jordan J Hill, Brooke L Hill, Brett Williams

{"title":"How confident are Queensland paramedics with seizure recognition, differentiation, and management? A pilot study.","authors":"Jordan J Hill, Brooke L Hill, Brett Williams","doi":"10.1016/j.auec.2025.01.002","DOIUrl":"https://doi.org/10.1016/j.auec.2025.01.002","url":null,"abstract":"Background: Paramedics in Australia present as the opportune medical personnel to initiate medical intervention of seizure presentations and perform a fundamental role in the prevention of seizure associated morbidity and mortality. Despite being well equipped to manage seizures, no literature exists regarding their confidence to recognise, differentiate, or manage seizures.Methods: An online cross-sectional survey was undertaken by 168 paramedics practicing clinically for the Queensland Ambulance Service in Australia. The survey assessed paramedic perceived self-confidence surrounding seizure presentations. Non-parametric Kruskal-Wallis H-Test and post hoc pairwise comparisons were conducted to assess between group differences in relation to practicing qualifications, and years of service.Results: Paramedics were confident in generalised convulsive seizure recognition and management, however, displayed less confidence surrounding non-convulsive, focal, and psychogenic seizure classifications. Critical care paramedics reported higher confidence than advanced care and graduate paramedics across various seizure presentation elements (p < 0.05). Paramedics with greater than 10 years of service reported higher confidence than those with fewer years of service, particularly less than two years.Conclusion: Future education and professional development opportunities for paramedics require a greater focus on the development of self-confidence, with mechanisms implemented to increase paramedics' exposure to the broad spectrum of seizure presentations.","PeriodicalId":55979,"journal":{"name":"Australasian Emergency Care","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-01-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143069840","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

Consumer experiences of emergency department pre-triage waiting period: A mixed-methods study.

IF 2.1 4区医学

Australasian Emergency Care Pub Date : 2025-01-22 DOI: 10.1016/j.auec.2025.01.001

Rebecca Sedgman, Noah Pallot, Annette Peart, Sebastian Wrobel, Joseph Miller, Liam Hackett, Katrina Maybury, Emogene Aldridge, Patrick J Owen, Paul Buntine

{"title":"Consumer experiences of emergency department pre-triage waiting period: A mixed-methods study.","authors":"Rebecca Sedgman, Noah Pallot, Annette Peart, Sebastian Wrobel, Joseph Miller, Liam Hackett, Katrina Maybury, Emogene Aldridge, Patrick J Owen, Paul Buntine","doi":"10.1016/j.auec.2025.01.001","DOIUrl":"https://doi.org/10.1016/j.auec.2025.01.001","url":null,"abstract":"Background: Emergency department pre-triage waiting periods have received limited attention. We aimed to explore the pre-triage experiences and perspectives of consumers attending emergency departments.Methods: This mixed-methods cross-sectional study included 92 participants (patients, carers, and guardians) who attended one of three public hospital emergency departments in metropolitan Melbourne (Victoria, Australia). Quantitative self-report outcomes were waiting time (minutes) and number of previous emergency department visits. Qualitative outcomes (explored through content analysis) were consumer experiences and perspectives of emergency departments in general and the pre-triage waiting period specifically.Results: Participants reported a median (IQR) waiting time since triage of 45 (100) minutes and 65 % (n = 60) experienced a pre-triage waiting time of 3-90 minutes. The most common perception of the pre-triage waiting period was an expectation to wait (n = 16, 17 %), yet 46 % (n = 42) reported difficulties during this period, such as other patients cutting in queue (n = 6, 6.5 %). Few positives were associated with the pre-triage waiting period and suggestions to improve this period tended to focus on facilitating a queuing system (n = 18, 20 %).Conclusion: Consumers expected and understood triage, yet reported various difficulties and few positives during the pre-triage waiting period and suggested improvements to the current system, warranting investigation of interventions to improve queuing.","PeriodicalId":55979,"journal":{"name":"Australasian Emergency Care","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-01-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143030364","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