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Mastitis and breast abscess associated with nipple piercings: a case study. 乳腺炎和乳房脓肿与乳头穿孔：一个案例研究。
Emergency nurse : the journal of the RCN Accident and Emergency Nursing Association Pub Date : 2026-10-08 DOI: 10.7748/en.2026.e2278
Jennifer Worrall
{"title":"Mastitis and breast abscess associated with nipple piercings: a case study.","authors":"Jennifer Worrall","doi":"10.7748/en.2026.e2278","DOIUrl":"https://doi.org/10.7748/en.2026.e2278","url":null,"abstract":"<p><p>This article presents a composite case study of a 27-year-old woman who attended a first contact service with right breast pain and systemic symptoms six months after undergoing a nipple piercing. She was subsequently diagnosed with non-lactational mastitis and treated successfully with antibiotics. The article reviews the anatomy of the female breast, the presentation and management of mastitis and breast abscess, and the pathogens associated with nipple piercing, including Staphylococcus aureus and non-tuberculous mycobacteria. It highlights the diagnostic challenges posed by the similarity of breast changes associated with mastitis, breast abscess and other potentially more serious conditions, including breast cancer. The article also identifies limitations in the evidence base regarding complications associated with nipple piercing and notes the lack of robust evidence informing the management of non-lactational mastitis. Further research is required to support evidence-based recommendations for diagnosis and treatment.</p>","PeriodicalId":94315,"journal":{"name":"Emergency nurse : the journal of the RCN Accident and Emergency Nursing Association","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149129708","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Patients' and healthcare professionals' perceptions of advanced practitioners in emergency medicine: a service evaluation. 患者和医疗保健专业人员对急诊医学高级从业人员的看法：一项服务评估。
Emergency nurse : the journal of the RCN Accident and Emergency Nursing Association Pub Date : 2026-09-22 DOI: 10.7748/en.2026.e2273
Mercy Vincent, Sudha Arun, Bismi Sukumaran, Jeena Jose
{"title":"Patients' and healthcare professionals' perceptions of advanced practitioners in emergency medicine: a service evaluation.","authors":"Mercy Vincent, Sudha Arun, Bismi Sukumaran, Jeena Jose","doi":"10.7748/en.2026.e2273","DOIUrl":"https://doi.org/10.7748/en.2026.e2273","url":null,"abstract":"<p><p>Advanced practitioner (AP) roles have been promoted as a way of expanding NHS workforce capacity and supporting sustainable service delivery. Evidence shows that APs can enhance clinical practice, improve team performance and increase service efficiency while maintaining high patient satisfaction, although there remains confusion about the role among the public and healthcare professionals. This article describes a service evaluation that sought to assess the impact of APs working in the 'acute medical take' (the process for receiving, assessing and treating patients who require emergency, non-surgical hospital admission) in one hospital in England from the perspectives of patients ( n =50) and healthcare professional colleagues ( n =50). Patients and colleagues were asked to complete two different questionnaires. The results indicate that both patients and colleagues have positive perceptions of the medical take APs, with high levels of confidence in and acceptability of care reported by patients. Colleagues consistently rated the APs' performance as 'above expectation' or 'meets expectation' with regards to clinical care and interprofessional relationships. Overall, the results support the important role of APs in enhancing patient experience, multidisciplinary team functioning and service delivery in emergency medicine.</p>","PeriodicalId":94315,"journal":{"name":"Emergency nurse : the journal of the RCN Accident and Emergency Nursing Association","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149019315","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Effectiveness of using the NEWS2 in the management of sepsis in emergency departments: an integrative literature review. NEWS2在急诊科脓毒症管理中的有效性：综合文献综述
Emergency nurse : the journal of the RCN Accident and Emergency Nursing Association Pub Date : 2026-09-08 DOI: 10.7748/en.2026.e2276
Noora Alrowaiei, Sarah Turner
{"title":"Effectiveness of using the NEWS2 in the management of sepsis in emergency departments: an integrative literature review.","authors":"Noora Alrowaiei, Sarah Turner","doi":"10.7748/en.2026.e2276","DOIUrl":"https://doi.org/10.7748/en.2026.e2276","url":null,"abstract":"<p><p>Sepsis is a time-critical emergency in which early recognition and rapid intervention are essential to improve patient outcomes. The National Early Warning Score 2 (NEWS2) is a widely used tool for standardising physiological assessment and escalation in acute care; however, its effectiveness within emergency department (ED) sepsis pathways is unclear. The integrative literature review detailed in this article aimed to evaluate the effectiveness of NEWS2 in the early detection and management of sepsis in ED and acute care settings, and to identify implications for clinical practice, policy, education and future research. A structured literature search identified four studies that met the inclusion criteria, reflecting the limited evidence available specifically examining the effectiveness of NEWS2 in the management of sepsis in ED settings. Several key findings emerged, including that: repeated NEWS2 assessments are more informative than single scores; NEWS2 is sensitive to detecting patient deterioration but limited in predicting mortality; combining NEWS2 with other tools improves risk stratification; and performance depends on setting and implementation factors.</p>","PeriodicalId":94315,"journal":{"name":"Emergency nurse : the journal of the RCN Accident and Emergency Nursing Association","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148908576","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Improving door-to-needle time for antibiotic treatment of neutropenic sepsis: a quality improvement project. 提高中性粒细胞减少性脓毒症抗生素治疗从门到针的时间：一个质量改进项目。
Emergency nurse : the journal of the RCN Accident and Emergency Nursing Association Pub Date : 2026-09-01 Epub Date: 2026-03-24 DOI: 10.7748/en.2026.e2261
Catherine Louise Kimmins, Daniella Leloch
{"title":"Improving door-to-needle time for antibiotic treatment of neutropenic sepsis: a quality improvement project.","authors":"Catherine Louise Kimmins, Daniella Leloch","doi":"10.7748/en.2026.e2261","DOIUrl":"10.7748/en.2026.e2261","url":null,"abstract":"<p><p>Neutropenic sepsis is a serious, potentially fatal complication of systemic anticancer therapy. Patients with suspected neutropenic sepsis require treatment with intravenous antibiotics within one hour of presentation to hospital. However, national and local audits suggest that this door-to-needle time target is not always met. This article details a quality improvement project (QIP) undertaken in a medical assessment unit (MAU) that aimed to increase the percentage of patients with suspected neutropenic sepsis receiving antibiotics within the one hour door-to-needle time target by 25%. The QIP comprised several components, including audit of door-to-needle times, staff training and a series of improvement initiatives. The results of the audit showed that 60% ( n =30/50) of patients received antibiotics within one hour of presentation to the MAU, an increase of 30% compared with baseline audit data. Although the QIP did not achieve universal adherence to the target door-to-needle time, there was significant improvement which demonstrates that small changes can enhance patient care.</p>","PeriodicalId":94315,"journal":{"name":"Emergency nurse : the journal of the RCN Accident and Emergency Nursing Association","volume":" ","pages":"22-28"},"PeriodicalIF":0.0,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147505825","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
How to start non-invasive ventilation for COPD-associated type 2 respiratory failure. copd相关的2型呼吸衰竭如何开始无创通气。
Emergency nurse : the journal of the RCN Accident and Emergency Nursing Association Pub Date : 2026-09-01 Epub Date: 2026-04-01 DOI: 10.7748/en.2026.e2260
Stacey Norton
{"title":"How to start non-invasive ventilation for COPD-associated type 2 respiratory failure.","authors":"Stacey Norton","doi":"10.7748/en.2026.e2260","DOIUrl":"10.7748/en.2026.e2260","url":null,"abstract":"<p><strong>Rationale and key points: </strong>Exacerbations of chronic obstructive pulmonary disease (COPD) can result in type 2 respiratory failure, which can be effectively and safely treated with non-invasive ventilation (NIV). NIV involves delivering oxygen to the patient via a mask and ventilator, so it does not require the use of an endotracheal tube. NIV is commonly used in the emergency department for patients presenting with type 2 respiratory failure caused by a COPD exacerbation. It is important that emergency department nurses are confident in the steps required to start patients on NIV. • NIV can feel overwhelming for patients, who are often critically unwell, so nurses must explain NIV to patients and provide reassurance. • NIV constitutes level 2 care, so frequent and careful monitoring is vital for ensuring patient safety and optimal outcomes. • It is important to treat patients holistically, including when monitoring the effectiveness of NIV. REFLECTIVE ACTIVITY: 'How to' articles can help to update your practice and ensure it remains evidence based. Apply this article to your practice. Reflect on and write a short account of: • How the article can improve your practice when starting patients with COPD-associated type 2 respiratory failure on NIV. • How you could use this information to educate nursing students or colleagues on the appropriate technique and evidence base for starting patients presenting with COPD-associated type 2 respiratory failure on NIV.</p>","PeriodicalId":94315,"journal":{"name":"Emergency nurse : the journal of the RCN Accident and Emergency Nursing Association","volume":" ","pages":"29-33"},"PeriodicalIF":0.0,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147597399","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Redesigning emergency department processes: a nurse-led, portal-based flow model to optimise resource use and patient care. 重新设计急诊科流程：以护士为主导，基于门户的流程模型，以优化资源使用和患者护理。
Emergency nurse : the journal of the RCN Accident and Emergency Nursing Association Pub Date : 2026-09-01 Epub Date: 2026-02-24 DOI: 10.7748/en.2026.e2249
Marilyn McCullum
{"title":"Redesigning emergency department processes: a nurse-led, portal-based flow model to optimise resource use and patient care.","authors":"Marilyn McCullum","doi":"10.7748/en.2026.e2249","DOIUrl":"10.7748/en.2026.e2249","url":null,"abstract":"<p><p>Emergency departments (EDs) face ongoing challenges such as overcrowding, long waiting times and patient dissatisfaction. Traditional triage-to-bed models of ED care tend to delay diagnostic tests and treatment for moderate-acuity and low-acuity patients. This article describes the redesign of patient flow in one ED in California, in the US, through the creation of portal rooms for early diagnostic tests and QuickPass rooms for low-acuity encounters, with the goal of reducing delays and improving throughput. Early feedback from patients and staff was positive, including improved patient perceptions of receiving timely care. The use of portal rooms and QuickPass rooms represents a practical, low-cost strategy for addressing overcrowding. While formal outcome data are needed, this initiative highlights how lean, resource-conscious ED redesign can meaningfully address long-standing challenges in emergency care. By redefining the use of their physical space and initiating diagnostic tests earlier, EDs can improve patient experience and staff efficiency.</p>","PeriodicalId":94315,"journal":{"name":"Emergency nurse : the journal of the RCN Accident and Emergency Nursing Association","volume":" ","pages":"35-41"},"PeriodicalIF":0.0,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147278159","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Navigating complexity: the management of anorexia nervosa in the emergency department. 导航复杂性：急诊科神经性厌食症的处理。
Emergency nurse : the journal of the RCN Accident and Emergency Nursing Association Pub Date : 2026-08-25 DOI: 10.7748/en.2026.e2269
Declan Moran, Barry McBrien
{"title":"Navigating complexity: the management of anorexia nervosa in the emergency department.","authors":"Declan Moran, Barry McBrien","doi":"10.7748/en.2026.e2269","DOIUrl":"https://doi.org/10.7748/en.2026.e2269","url":null,"abstract":"<p><p>The integration of physical and mental healthcare in emergency departments (EDs) is essential when addressing the complex needs of patients with anorexia nervosa. Although the condition is predominantly classified as a mental health disorder, it presents considerable physical health risks. This article features a hypothetical case study that examines the significant role of advanced nurse practitioners in promoting physical and mental health for individuals with anorexia nervosa. The article also considers key factors such as cognitive impairments and emotional dysregulation, which are commonly present in individuals with anorexia nervosa, as well as the associated physiological complications. The authors advocate for a comprehensive care model in EDs that recognises the intricate interplay between physical and mental health in patients with anorexia nervosa.</p>","PeriodicalId":94315,"journal":{"name":"Emergency nurse : the journal of the RCN Accident and Emergency Nursing Association","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148815319","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Bilateral spontaneous pneumothorax as an initial manifestation of pulmonary metastases in a patient with osteosarcoma. 双侧自发性气胸是骨肉瘤患者肺转移的初始表现。
Emergency nurse : the journal of the RCN Accident and Emergency Nursing Association Pub Date : 2026-08-18 DOI: 10.7748/en.2026.e2265
Rohit Bhoil, Medha Kaith, Nikhil Sharma, Vikrant Negi, Nitin Kumar, Sabina Bhoil
{"title":"Bilateral spontaneous pneumothorax as an initial manifestation of pulmonary metastases in a patient with osteosarcoma.","authors":"Rohit Bhoil, Medha Kaith, Nikhil Sharma, Vikrant Negi, Nitin Kumar, Sabina Bhoil","doi":"10.7748/en.2026.e2265","DOIUrl":"https://doi.org/10.7748/en.2026.e2265","url":null,"abstract":"<p><p>Spontaneous bilateral pneumothorax is an uncommon but serious complication seen in patients with osteosarcoma that has metastasised to the lungs. This article describes the case of a 20-year-old man with a history of osteosarcoma who presented to hospital with increasing dyspnoea (shortness of breath) and was found to have mild bilateral spontaneous pneumothorax secondary to pulmonary metastases. This case report highlights the features of this rare but serious condition and the importance of close patient monitoring following treatment for osteosarcoma.</p>","PeriodicalId":94315,"journal":{"name":"Emergency nurse : the journal of the RCN Accident and Emergency Nursing Association","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148804197","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Use of household super glue to close wounds in remote environments. 在偏远环境中使用家用强力胶缝合伤口。
Emergency nurse : the journal of the RCN Accident and Emergency Nursing Association Pub Date : 2026-08-04 DOI: 10.7748/en.2026.e2272
Vincent Paris Tremayne
{"title":"Use of household super glue to close wounds in remote environments.","authors":"Vincent Paris Tremayne","doi":"10.7748/en.2026.e2272","DOIUrl":"https://doi.org/10.7748/en.2026.e2272","url":null,"abstract":"<p><p>Ethyl-cyanoacrylate (household super glue) is similar to medical-grade adhesive and is easily found in supermarkets and hardware shops. It can be used to close wounds when medical care is not easy to access and no other form of wound closure is available, for example when travelling or living in remote environments. While it is inexpensive and can be effective, using super glue to close wounds is not without risk and it could cause tissue damage, infection and significant burns if used incorrectly. This article explains when it would be appropriate to use super glue to close a wound, its similarities to medical-grade adhesive and its antimicrobial properties. It includes a step-by-step guide to using super glue to close a wound. The article aims to prepare nurses to reduce harm when super glue is the only option to close wounds in remote areas.</p>","PeriodicalId":94315,"journal":{"name":"Emergency nurse : the journal of the RCN Accident and Emergency Nursing Association","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-08-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148671858","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Mitigating emergency department crowding: the role of advanced clinical practitioners. 缓解急诊科拥挤：高级临床医生的作用。
Emergency nurse : the journal of the RCN Accident and Emergency Nursing Association Pub Date : 2026-07-07 DOI: 10.7748/en.2026.e2258
Karl Cook
{"title":"Mitigating emergency department crowding: the role of advanced clinical practitioners.","authors":"Karl Cook","doi":"10.7748/en.2026.e2258","DOIUrl":"https://doi.org/10.7748/en.2026.e2258","url":null,"abstract":"<p><p>Emergency department (ED) crowding is a critical and persistent challenge in healthcare systems globally, with particularly acute effects in the UK. It is associated with increased patient morbidity and mortality, delays in care delivery, and significant staff burnout. The multifactorial nature of crowding - spanning input, throughput and output factors - necessitates a comprehensive and system-wide response. This article explores evidence-based strategies to mitigate ED crowding, focusing on the pivotal role of advanced clinical practitioners (ACPs) in senior-first clinical assessment, diagnostic streamlining and admission avoidance pathways. The author synthesises the latest evidence, policy guidance and clinical practice to argue for the expanded deployment of ACPs as a strategic solution to ED crowding. The article also provides system-level recommendations to support sustainable implementation and optimise emergency care outcomes.</p>","PeriodicalId":94315,"journal":{"name":"Emergency nurse : the journal of the RCN Accident and Emergency Nursing Association","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-07-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148400358","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
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