Australasian Emergency Care最新文献

{"title":"Meeting the wellness needs of emergency department clinicians: A scoping review of interventions","authors":"Karen M. Gerrard ,&nbsp;Julie Shepherd ,&nbsp;Rajesh Sehdev ,&nbsp;Vinay Gangathimmaiah ,&nbsp;Cate Nagle","doi":"10.1016/j.auec.2022.10.004","DOIUrl":"10.1016/j.auec.2022.10.004","url":null,"abstract":"<div><h3>Background</h3><p><span>Emergency Departments are stressful </span>work environments that can adversely affect clinicians’ wellbeing. The purpose of this scoping review was to report wellness interventions evaluated in Emergency Departments and clinicians’ experience of these interventions.</p></div><div><h3>Methods</h3><p>Five data bases were searched using a modification of Arksey and O’Malley’s framework. PRISMA guidelines for scoping reviews were employed to report the findings. The review included only peer-reviewed articles and had no date or language restrictions applied.</p></div><div><h3>Results</h3><p>Nine studies met inclusion criteria. Interventions included tactile massage, hypnosis, mindfulness, happiness practice, resiliency, meditation, and video-based debriefing. Three key themes emerged following data extraction and analysis: The value of mindfulness; One size doesn’t fit all; and Enablers and Barriers.</p></div><div><h3>Conclusions</h3><p>Successful wellness programs<span> must be relevant to Emergency Departments and staff need to be involved in the development and application of these programs to achieve maximum benefit. For long term benefits and sustainability, the strategies must be supported by senior hospital management.</span></p></div>","PeriodicalId":55979,"journal":{"name":"Australasian Emergency Care","volume":"26 2","pages":"Pages 169-178"},"PeriodicalIF":1.8,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9936605","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":"The psychometric properties of the Chinese version of the stressor scale for emergency nurses","authors":"Yuxin Wang ,&nbsp;Qi Zhang ,&nbsp;Saiwen Li ,&nbsp;Yi Jin","doi":"10.1016/j.auec.2022.10.005","DOIUrl":"10.1016/j.auec.2022.10.005","url":null,"abstract":"<div><h3>Background</h3><p>Emergency nurses are experienced specific stress factors. To evaluate stressors of emergency nurses effectively is useful to improve quality of nursing care.</p><p>This study aimed to translate the stressor scale for emergency nurses into Chinese (C-SSEN) and carry out the reliability and validity test among Chinese emergency nurses.</p></div><div><h3>Methods</h3><p>A total of 358 emergency nurses from four hospitals in Tianjin, Henan, and Shandong province of China are recruited through a convenience sampling. The C-SSEN was translated into Chinese applying a classic ‘forward-backward’ translation method. Reliability (internal consistency, test-retest reliability) and validity (content validity, construct validity) were assessed.</p></div><div><h3>Results</h3><p>The final version of C-SSEN was rated by the expert panel, indicating good content validity (I-CVI ≥ 0.83, S-CVI = 0.96). The scale had satisfactory content validity, internal consistency (Cronbach’s α coefficient = 0.958), and test-retest reliability (intra-class correlation coefficient = 0.824).</p></div><div><h3>Conclusion</h3><p>The C-SSEN is a useful and reliable scale to evaluate stressors among emergency nurses.</p></div>","PeriodicalId":55979,"journal":{"name":"Australasian Emergency Care","volume":"26 2","pages":"Pages 179-183"},"PeriodicalIF":1.8,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9578584","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":"Use of point of care ultrasound (POCUS) by intensive care paramedics to achieve peripheral intravenous access in patients predicted to be difficult: An out-of-hospital pilot study","authors":"Samuel O. Burton ,&nbsp;Jake K. Donovan ,&nbsp;Samuel L. Jones ,&nbsp;Luke M. Phillips ,&nbsp;David J. Anderson ,&nbsp;Benjamin N. Meadley","doi":"10.1016/j.auec.2022.10.003","DOIUrl":"10.1016/j.auec.2022.10.003","url":null,"abstract":"<div><h3>Introduction</h3><p>Intravenous cannulation<span> is a common procedure for paramedics. Difficulty is often encountered and may result in escalation of care to an intensive care paramedic (ICP). Ultrasound-guided peripheral intravenous access (USGPIVA) is used in-hospital as an alternative approach. Historically limited to physicians, it is increasingly embraced by non-physicians, with point of care ultrasound (POCUS) devices more affordable, portable, and suited to the out of hospital environment.</span></p></div><div><h3>Objective</h3><p>To explore the utility of ICP-performed USGPIVA for patients who are predicted to be difficult according to a difficult intravenous access scoring tool.</p></div><div><h3>Methods</h3><p>This was a prospective observational pilot study of ICPs who used the adult difficult intravenous access (A-DIVA) scale to predict difficulty and perform USGPIVA using a contemporary POCUS device.</p></div><div><h3>Results</h3><p>For the 32 patients enroled, the overall success rate was 50% of which 87% were successful on the first attempt. Mean A-DIVA score was 4.1/5, and paradoxically, success improved with A-DIVA-predicted difficulty.</p></div><div><h3>Conclusion</h3><p>ICPs can perform USGPIVA with moderate success. The A-DIVA score could be useful for paramedics to predict difficult cannulation. Future research should focus on increasing exposure, training time and enhancing feedback to paramedics performing USGPIVA.</p></div>","PeriodicalId":55979,"journal":{"name":"Australasian Emergency Care","volume":"26 2","pages":"Pages 164-168"},"PeriodicalIF":1.8,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9628446","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":"Public health messaging during disasters: Practice and attitudes of Australian emergency nurses","authors":"Nicole M. Coombs,&nbsp;Joanne E. Porter,&nbsp;Michael Barbagallo,&nbsp;Virginia Plummer","doi":"10.1016/j.auec.2022.11.001","DOIUrl":"10.1016/j.auec.2022.11.001","url":null,"abstract":"<div><h3>Background</h3><p><span>The growing frequency of disasters increases health system<span> demands, increasing the need for emergency departments to provide </span></span>public health messaging to prevent illness and reduce risk. This study aims to explore emergency nurse practice and attitudes in providing public health messages from the emergency department during disasters in Australia.</p></div><div><h3>Methods</h3><p>Quantitative phase of a mixed methods study, using an explanatory sequential design. Australian emergency nurses were surveyed using a validated online questionnaire. Data was analysed using descriptive and inferential statistics, an enumerative content analysis, participant profiling and a factor analysis.</p></div><div><h3>Results</h3><p>Disaster experience varied in 143 nurse participants. The perception of the emergency nurse’s role in providing public health messages is influencing practice. Embracing teachable moments and health promotion responsibilities, attributes to positive attitudes and practice. In contrast, negative attitudes, lack of confidence, time, policy, and training, are barriers to public health messages being provided in the emergency setting.</p></div><div><h3>Conclusions</h3><p>These barriers suggest that Australian emergency nurses may not have the capability, the opportunity, nor the motivation, to provide preventative messages to their patients during disasters. Intrinsic and extrinsic factors need to be addressed, ensuring nurses are confident and supported in their public health messaging practice during disasters.</p></div>","PeriodicalId":55979,"journal":{"name":"Australasian Emergency Care","volume":"26 2","pages":"Pages 193-197"},"PeriodicalIF":1.8,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9573382","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":"Pre-hospital predictors of long-term survival from out-of-hospital cardiac arrest","authors":"Katherine Pemberton ,&nbsp;Richard C. Franklin ,&nbsp;Emma Bosley ,&nbsp;Kerrianne Watt","doi":"10.1016/j.auec.2022.10.006","DOIUrl":"10.1016/j.auec.2022.10.006","url":null,"abstract":"<div><h3>Objective</h3><p>To identify predictors of longer-term outcomes from adult out-of-hospital cardiac arrest of presumed cardiac aetiology.</p></div><div><h3>Methods</h3><p>In this retrospective cohort study, three large routinely collected databases were linked: 1)QAS Out-of-Hospital Cardiac (OHCA) Registry; 2)Queensland Hospital Admitted Patient Data Collection; and 3)Queensland Registrar General Death Registry. Participants were adult (18years+) residents of Queensland, who suffered an OHCA of presumed cardiac aetiology and had resuscitation attempted by QAS paramedics between 2002 and 2014. Four mutually exclusive outcomes were analysed: 1) No pre-hospital return of spontaneous circulation (ROSC) sustained to the Emergency Department (ED) or ROSC in ED; 2) Survival&lt; 30 days (Pre-hospital ROSC sustained to ED or ROSC in ED but death within 30 days; 3) survival between 30 and 364 days; and 4) survival to 365 + days. Multinomial logistic regression was used to calculate odds ratios and 95 % confidence intervals.</p></div><div><h3>Results</h3><p>Variables significantly predictive of survival to 365 + days after adjusting for all measured confounders are: an initial shockable rhythm; bystander witnessed events with bystander CPR; paramedic witnessed events; intubation placement; time of day (midday-2.59 pm); and attendance by Critical Care Paramedic (CCP).</p></div><div><h3>Conclusion</h3><p>From a service provision perspective, attendance of a CCP at an OHCA may be an important factor to achieve preferred long-term outcomes. Enhanced experience, exposure and expertise, together with extended clinical practice, may explain this finding.</p></div>","PeriodicalId":55979,"journal":{"name":"Australasian Emergency Care","volume":"26 2","pages":"Pages 184-192"},"PeriodicalIF":1.8,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9566494","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":"Paramedic interactions with significant others during and after resuscitation and death of a patient","authors":"Harrison Risson,&nbsp;Bronwyn Beovich,&nbsp;Kelly-Ann Bowles","doi":"10.1016/j.auec.2022.08.007","DOIUrl":"10.1016/j.auec.2022.08.007","url":null,"abstract":"<div><h3>Background</h3><p>Out-of-hospital cardiac arrest often occurs at home, requiring paramedics to interact with family members and bystanders during resuscitation and inform them should the patient die. This study explores how paramedics navigate interactions and the changing needs of the patient and the bereaved.</p></div><div><h3>Methods</h3><p>Phenomenological methodology inspired individual, semi-structured interviews. Data was then coded using reflexive thematic analysis.</p></div><div><h3>Results</h3><p>Ten individual interviews with working paramedics with an average of 7.2 years of experience were analysed and resulted in four overarching themes. These themes encompassed communication goals and factors affecting their implementation. Four themes emerged: maximising patient outcome, minimising psychological trauma for significant others, paramedic engagement and communicating across cultures. Communication goals shift from maximising patient outcome to minimising psychological trauma for significant others during the resuscitation. Implementation of those goals is affected by paramedic engagement and communicating across cultures.</p></div><div><h3>Conclusions</h3><p>Paramedics used communication techniques based on personal and professional experiences, attempting to navigate limited resources, factors affecting paramedic engagement and a perceived lack of education and support in matters of grief and death.</p></div>","PeriodicalId":55979,"journal":{"name":"Australasian Emergency Care","volume":"26 2","pages":"Pages 113-118"},"PeriodicalIF":1.8,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9573358","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":"Effect of a specific training intervention with task interruptions on the quality of simulated advance life support: A randomized multi centered controlled simulation study","authors":"Jennifer Truchot ,&nbsp;Daphné Michelet ,&nbsp;Anne Laure Philippon ,&nbsp;David Drummond ,&nbsp;Yonathan Freund ,&nbsp;Patrick Plaisance","doi":"10.1016/j.auec.2022.10.001","DOIUrl":"10.1016/j.auec.2022.10.001","url":null,"abstract":"<div><h3>Purpose</h3><p>Task interruptions (TI) are frequent disturbances for emergency professionals performing advanced life support (ALS). The aim of our study was to evaluate a specific training intervention with TI on the quality of simulated ALS.</p></div><div><h3>Methods</h3><p>During this multi centered randomized controlled trial, each team included one resident, one nurse and one emergency physician. The teams were randomized for the nature of their training session: control (without interruption) or intervention (with TI). The primary outcome was non-technical skills assessed with the TEAM score. We also measured the no flow time, the Cardiff score and chest compression depth and rate.</p></div><div><h3>Results</h3><p>On a total of 21 included teams, 11 were randomized to a control training session and 10 to the specific TI training. During training, teams’ characteristics and skills were similar between the two groups. During the evaluation session, the TEAM score was not different between groups: median score for control group 33,5 vs 31,5 for intervention group. We also report similar no flow time and Cardiff score.</p></div><div><h3>Conclusion</h3><p>In this simulated ALS study, a specific training intervention with TI did not improve technical and non-technical skills. Further research is required to limit the impact of TI in emergency settings.</p></div>","PeriodicalId":55979,"journal":{"name":"Australasian Emergency Care","volume":"26 2","pages":"Pages 153-157"},"PeriodicalIF":1.8,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9578580","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":"Medical retrieval of pregnant women in labour: A scoping review","authors":"Jessica McInnes ,&nbsp;Bridget Honan ,&nbsp;Richard Johnson ,&nbsp;Cheryl Durup ,&nbsp;Ajay Venkatesh ,&nbsp;Fergus William Gardiner ,&nbsp;Rebecca Schultz ,&nbsp;Breeanna Spring","doi":"10.1016/j.auec.2022.10.002","DOIUrl":"10.1016/j.auec.2022.10.002","url":null,"abstract":"<div><h3>Background</h3><p><span><span>Remote Australian women in labour often rely on retrieval services to allow birthing in specialist </span>obstetric centres. However, there is currently debate over when </span><em>not</em> to transfer a woman in labour, for risk of an in-transit birth, associated with worse neonatal outcomes.</p></div><div><h3>Methods</h3><p>A scoping review methodology was undertaken, to define the scope of published literature on the topic and identify gaps in the current knowledge.</p></div><div><h3>Results</h3><p><span>A total of seven full texts were deemed suitable for synthesis, which were all retrospective observational studies. Four themes from the studies’ findings were identified: population features, predicting time-to-birth, use of tocolysis and birth during </span>medical evacuation.</p></div><div><h3>Conclusion</h3><p>The evidence identified in this review was of low methodological quality and heterogenous. The key findings were that births in-flight are rare, despite geographical distances and long transport times, with a knowledge gap on predictors of time-to-birth.</p></div>","PeriodicalId":55979,"journal":{"name":"Australasian Emergency Care","volume":"26 2","pages":"Pages 158-163"},"PeriodicalIF":1.8,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9578588","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":"A comparison of prospective observations and chart audits for measuring quality of care of musculoskeletal injuries in the emergency department","authors":"Fiona C.A. Coombes ,&nbsp;Kirsten Strudwick ,&nbsp;Melinda G. Martin-Khan ,&nbsp;Trevor G. Russell","doi":"10.1016/j.auec.2022.09.002","DOIUrl":"10.1016/j.auec.2022.09.002","url":null,"abstract":"<div><h3>Background</h3><p><span><span>Accurate and efficient data collection is crucial for effective evaluation of quality of care. The objective of this study is to compare two methods of data collection used to score quality indicators for musculoskeletal injury management in </span>Emergency departments: prospective observation, and chart </span>audit.</p></div><div><h3>Methods</h3><p>An analysis was undertaken of data collected from 633 patients who presented with a musculoskeletal injury to eight emergency departments in Queensland, Australia in 2016–17. Twenty-two quality indicators were scored using both prospective observation and chart audit data for each occasion of service. Quality indicators were included if they were originally published with both collection methods. Analyses were performed to compare firstly, the quality indicator denominators, and secondly, the quality indicator trigger rates, scored using each collection method. Chi Square statistics were used to identify significant differences.</p></div><div><h3>Results</h3><p>Prospectively collected data scored quality indicator denominators significantly (p value&lt;0.05) more often than chart audit data for five (22.7 %) of the 22 quality indicators. The remaining 17 quality indicators (77.3 %) showed no statistical differences. When comparing quality indicator trigger rates, 16 (72.7 %) had significantly different results between methods with 12 (54.5 %) scoring higher using prospective data and four (18.2 %) with chart audit data. The remaining six quality indicators (27.3 %) in this comparison showed no significant difference between chart and prospective data.</p></div><div><h3>Conclusion</h3><p>Quality indicators including aspects of care associated with patient safety, and those relying on clinician written orders or forms were adequately scored using either prospective observation or chart audit data. Whereas quality indicators relying on time-sensitive information, elements of a social history, general physical exams and patient education and advice scored higher using prospective observation data collection.</p></div>","PeriodicalId":55979,"journal":{"name":"Australasian Emergency Care","volume":"26 2","pages":"Pages 132-141"},"PeriodicalIF":1.8,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9574816","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 an emergency department rapid response system on inpatient clinical deterioration: A controlled pre-post study","authors":"Belinda Munroe ,&nbsp;Kate Curtis ,&nbsp;Margaret Fry ,&nbsp;Sharyn Balzer ,&nbsp;Panchalee Perara ,&nbsp;Tracey Couttie ,&nbsp;Karlie Royston ,&nbsp;Ping Yu ,&nbsp;Natasha Tidswell ,&nbsp;Julie Considine","doi":"10.1016/j.auec.2023.05.001","DOIUrl":"10.1016/j.auec.2023.05.001","url":null,"abstract":"<div><h3>Aim</h3><p>To determine the impact implementation of Emergency Department Clinical Emergency Response System (EDCERS) on inpatient deterioration events and identify contributing causal factors.</p></div><div><h3>Methods</h3><p>EDCERS was implemented in an Australian regional hospital, integrating a single parameter track and trigger criteria for escalation of care, and emergency, specialty and critical care clinician response to patient deterioration. In this controlled pre-post study, electronic medical records of patients who experienced a deterioration event (rapid response call, cardiac arrest or unplanned intensive care admission) on the ward within 72 h of admission from the emergency department (ED) were reviewed. Causal factors contributing to the deteriorating event were assessed using a validated human factors framework.</p></div><div><h3>Results</h3><p>Implementation of EDCERS reduced the number of inpatient deterioration events within 72 h of emergency admission with failure or delayed response to ED patient deterioration as a causal factor. There was no change in the overall rate of inpatient deterioration events.</p></div><div><h3>Conclusion</h3><p>This study supports wider implementation of rapid response systems in the ED to improve management of deteriorating patients. Tailored implementation strategies should be used to achieve successful and sustainable uptake of ED rapid response systems and improve outcomes in deteriorating patients.</p></div>","PeriodicalId":55979,"journal":{"name":"Australasian Emergency Care","volume":"26 4","pages":"Pages 333-340"},"PeriodicalIF":1.8,"publicationDate":"2023-05-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9491541","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}