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Emergency nurse : the journal of the RCN Accident and Emergency Nursing Association最新文献

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A strategic solution to preventing the harm associated with ambulance handover delays. 防止救护车交接延误造成伤害的战略解决方案。
Emergency nurse : the journal of the RCN Accident and Emergency Nursing Association Pub Date : 2024-11-05 Epub Date: 2024-04-30 DOI: 10.7748/en.2024.e2199
Cliff Evans, Adebayo Da'Costa
{"title":"A strategic solution to preventing the harm associated with ambulance handover delays.","authors":"Cliff Evans, Adebayo Da'Costa","doi":"10.7748/en.2024.e2199","DOIUrl":"10.7748/en.2024.e2199","url":null,"abstract":"<p><p>Ambulance handover delays arise when emergency departments become overcrowded as patients waiting prolonged periods for admission occupy clinical cubicles designed to facilitate the assessment and treatment of emergency arrivals. In response, many organisations become reliant on temporarily lodging acutely unwell patients awaiting admission in undesignated areas for care such as corridors, to provide additional space. This results in a significant risk of avoidable harm, indignity and psychological trauma for patients and has a negative effect on the well-being of healthcare professionals, since unacceptable standards of care become normalised. A two-phase strategic quality improvement project was implemented at the authors' acute trust. Ambulance handover data from between 2 November 2020 and 26 July 2021 provided a benchmark for the project. The first phase was implemented between 2 November 2021 and 26 July 2022 and aimed to reduce 60-minute ambulance handover delays. The second phase was implemented between 2 November 2022 and 26 July 2023 and aimed to eradicate 60-minute ambulance handover delays and improve overall performance. Phase one resulted in a 32% reduction in 60-minute ambulance handover delays. Phase two resulted in a 97% reduction in 60-minute ambulance handover delays. Over the course of the project there was a 24% increase in handovers completed within 15 minutes. This project demonstrates how strategic planning and collaboration between healthcare teams can reduce the potential for avoidable patient harm, while simultaneously promoting workforce well-being and retention.</p>","PeriodicalId":94315,"journal":{"name":"Emergency nurse : the journal of the RCN Accident and Emergency Nursing Association","volume":" ","pages":"15-20"},"PeriodicalIF":0.0,"publicationDate":"2024-11-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140856453","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
Developing and evaluating a major trauma course and coaching programme for ward nurses. 为病房护士开发和评估重大创伤课程和辅导计划。
Emergency nurse : the journal of the RCN Accident and Emergency Nursing Association Pub Date : 2024-09-03 Epub Date: 2024-02-20 DOI: 10.7748/en.2024.e2184
Chris Knight, Stella Ruth Smith
{"title":"Developing and evaluating a major trauma course and coaching programme for ward nurses.","authors":"Chris Knight, Stella Ruth Smith","doi":"10.7748/en.2024.e2184","DOIUrl":"10.7748/en.2024.e2184","url":null,"abstract":"<p><p>Nurses working with major trauma patients in ward environments in the UK are expected to evidence their knowledge and skills in a set of national competencies. This article describes a bespoke major trauma course and a coaching and portfolio development programme designed to enhance ward nurses' knowledge and skills, help them evidence their competence and support their professional development. Evaluation of the course showed an overall improvement in nurses' self-rated competence and confidence in a range of relevant major trauma topics and clinical skills. Evaluation of the coaching and portfolio development programme showed that nurses believed their knowledge and skills had improved after taking part and that they valued the opportunity for professional development.</p>","PeriodicalId":94315,"journal":{"name":"Emergency nurse : the journal of the RCN Accident and Emergency Nursing Association","volume":" ","pages":"26-33"},"PeriodicalIF":0.0,"publicationDate":"2024-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139907267","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
Reducing the burden on Welsh ambulance services and emergency departments: a mental health 999 clinical support desk initiative. 减轻威尔士救护车服务和急诊部门的负担：精神健康 999 临床支持台倡议。
Emergency nurse : the journal of the RCN Accident and Emergency Nursing Association Pub Date : 2024-09-03 Epub Date: 2024-02-13 DOI: 10.7748/en.2024.e2212
Mark Jones, Simon Amphlett
{"title":"Reducing the burden on Welsh ambulance services and emergency departments: a mental health 999 clinical support desk initiative.","authors":"Mark Jones, Simon Amphlett","doi":"10.7748/en.2024.e2212","DOIUrl":"10.7748/en.2024.e2212","url":null,"abstract":"<p><p>Demand for ambulances has increased significantly in recent years due, for example, to ongoing public health issues and lack of availability of alternative healthcare services. However, as demand increases, so too do ambulance waiting times, partly due to significant pressures on emergency departments (EDs) resulting in handover delays. People experiencing mental health distress who cannot access the care they need often contact ambulance services or present to the ED. Ambulance trusts across the UK are attempting to address this by employing mental health professionals (MHPs) in various capacities. In this article, the authors explore some of the issues related to mental health-related calls to 999 services. The authors then describe a service improvement initiative in Wales which involves MHPs working in 999 call centre clinical support desk services to improve the quality of care delivered to people with mental health issues and reduce demand on ambulance and ED services.</p>","PeriodicalId":94315,"journal":{"name":"Emergency nurse : the journal of the RCN Accident and Emergency Nursing Association","volume":" ","pages":"23-27"},"PeriodicalIF":0.0,"publicationDate":"2024-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139725611","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
Using body-worn cameras in emergency departments: a pilot project. 在急诊科使用随身摄像机：试点项目。
Emergency nurse : the journal of the RCN Accident and Emergency Nursing Association Pub Date : 2024-09-03 Epub Date: 2024-01-11 DOI: 10.7748/en.2024.e2188
Emily Spencer
{"title":"Using body-worn cameras in emergency departments: a pilot project.","authors":"Emily Spencer","doi":"10.7748/en.2024.e2188","DOIUrl":"10.7748/en.2024.e2188","url":null,"abstract":"<p><p>Nurses and other emergency department (ED) staff often experience verbal and physical abuse as part of their everyday work. Body-worn cameras are one tool that ED staff can use to try to reduce workplace violence and abuse and have been shown to be effective in other healthcare environments, such as mental health units. This article describes a pilot service evaluation which used a survey to assess the effectiveness of using body-worn cameras for staff in the author's ED. Findings suggest that nurses believed the cameras provided support when they were confronted by abusive or aggressive patients or relatives and in some instances diffused potentially violent situations.</p>","PeriodicalId":94315,"journal":{"name":"Emergency nurse : the journal of the RCN Accident and Emergency Nursing Association","volume":" ","pages":"20-24"},"PeriodicalIF":0.0,"publicationDate":"2024-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139418911","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
Ensuring effectiveness and safety in emergency department triage. 确保急诊科分诊的有效性和安全性。
Emergency nurse : the journal of the RCN Accident and Emergency Nursing Association Pub Date : 2024-07-23 DOI: 10.7748/en.2024.e2205
Hugh Gorick
{"title":"Ensuring effectiveness and safety in emergency department triage.","authors":"Hugh Gorick","doi":"10.7748/en.2024.e2205","DOIUrl":"https://doi.org/10.7748/en.2024.e2205","url":null,"abstract":"<p><p>Triage is the first stage of a patient's journey through the emergency department and is used to determine patient acuity. There is no single quantifiable metric for determining acuity, which amalgamates different factors that are more or less relevant depending on the patient's presentation. This article explains the aim and process of triage and how nurses can ensure the process is effective and safe. The author discusses strategies nurses can use to mitigate uncertainty and to make their acuity assessments rapid, targeted and comprehensive. The author also highlights triage safety considerations, including infection prevention and control and the physical and emotional safety of patients and staff.</p>","PeriodicalId":94315,"journal":{"name":"Emergency nurse : the journal of the RCN Accident and Emergency Nursing Association","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141750156","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
Understanding body fluid balance, dehydration and intravenous fluid therapy. 了解体液平衡、脱水和静脉输液疗法。
Emergency nurse : the journal of the RCN Accident and Emergency Nursing Association Pub Date : 2024-07-09 DOI: 10.7748/en.2024.e2201
Tiago Horta Reis da Silva
{"title":"Understanding body fluid balance, dehydration and intravenous fluid therapy.","authors":"Tiago Horta Reis da Silva","doi":"10.7748/en.2024.e2201","DOIUrl":"https://doi.org/10.7748/en.2024.e2201","url":null,"abstract":"<p><p>This article examines the role of water in the body, the balance of fluids in the body and the provision of intravenous (IV) fluids to patients who are dehydrated, providing a comprehensive overview of these topics for nurses. The author details various aspects of practice in IV fluid therapy, including the types of fluids used, their indications, administration and potential side effects. The article also discusses dehydration and how nurses can identify and treat this complication, which can occur as a result of many different conditions. Drawing on the relevant research, this article aims to advance nurses' knowledge of the care of patients who are dehydrated and require IV fluid therapy.</p>","PeriodicalId":94315,"journal":{"name":"Emergency nurse : the journal of the RCN Accident and Emergency Nursing Association","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141560712","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
Nitrous oxide tank cold burn to the forearm: a case study and discussion of the literature. 氧化亚氮罐前臂冷灼伤：病例研究与文献讨论。
Emergency nurse : the journal of the RCN Accident and Emergency Nursing Association Pub Date : 2024-07-02 Epub Date: 2024-01-25 DOI: 10.7748/en.2024.e2191
Oliver Allen, Muireann Keating
{"title":"Nitrous oxide tank cold burn to the forearm: a case study and discussion of the literature.","authors":"Oliver Allen, Muireann Keating","doi":"10.7748/en.2024.e2191","DOIUrl":"10.7748/en.2024.e2191","url":null,"abstract":"<p><p>Nitrous oxide (N 2 O) has become one of the most popular recreational drugs in Europe. While N 2 O is often used in medical settings as an analgesic and anaesthetic agent, its recreational use was documented many years before its introduction into clinical practice. The desired effects from inhaling N 2 O for recreational purposes include rapid feelings of relaxation, calmness and euphoria, which can be accompanied by giddiness and laughter. There are various adverse effects associated with N 2 O use, including headache, nausea, vomiting, drowsiness and the development of permanent neurological damage. Furthermore, its use is associated with cold burns and road accidents. This article details the case of a patient who sustained an N 2 O tank burn to his forearm from recreational use. It also discusses the prevalence, legal status and adverse effects of N 2 O use as well as the pathophysiology and management of cold burn injuries.</p>","PeriodicalId":94315,"journal":{"name":"Emergency nurse : the journal of the RCN Accident and Emergency Nursing Association","volume":" ","pages":"22-27"},"PeriodicalIF":0.0,"publicationDate":"2024-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139548047","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 care for patients who experience miscarriage in emergency departments: a practice innovation. 改进急诊部门对流产患者的护理:一项实践创新。
Emergency nurse : the journal of the RCN Accident and Emergency Nursing Association Pub Date : 2024-07-02 Epub Date: 2023-11-28 DOI: 10.7748/en.2023.e2183
Aliza Lynn Fleitz, Linda Nancy Roney
{"title":"Improving care for patients who experience miscarriage in emergency departments: a practice innovation.","authors":"Aliza Lynn Fleitz, Linda Nancy Roney","doi":"10.7748/en.2023.e2183","DOIUrl":"10.7748/en.2023.e2183","url":null,"abstract":"<p><p>Vaginal bleeding during pregnancy is a common patient presentation in emergency departments (EDs), and in some cases this will occur due to miscarriage. However, there are several barriers to effective and sensitive communication with patients experiencing a miscarriage. Women presenting to EDs who are experiencing a miscarriage are more likely to be psychosocially vulnerable and less satisfied with their care compared with those seeking care in the outpatient setting. There is a gap in nursing and advanced practice provider preparation regarding techniques for breaking bad news to patients in the ED setting. At one high-volume, urban ED in the US, an education programme for staff regarding best practice in breaking bad news to patients experiencing a miscarriage was developed based on an established protocol. The intention was to increase the confidence levels of nurses and other healthcare professionals in breaking bad news to these patients. After the education programme, many participants self-reported increased confidence in breaking bad news and comfort in managing patients' emotions. The results can be used to inform education for healthcare professionals who deliver bad news in the ED and other departments.</p>","PeriodicalId":94315,"journal":{"name":"Emergency nurse : the journal of the RCN Accident and Emergency Nursing Association","volume":" ","pages":"28-33"},"PeriodicalIF":0.0,"publicationDate":"2024-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138447710","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
Enhancing the nutritional care of older people by recording actual body weight: a quality improvement project. 通过记录实际体重来加强老年人的营养护理：一个质量改进项目。
Emergency nurse : the journal of the RCN Accident and Emergency Nursing Association Pub Date : 2024-07-02 Epub Date: 2023-10-24 DOI: 10.7748/en.2023.e2180
Cathy Shannon
{"title":"Enhancing the nutritional care of older people by recording actual body weight: a quality improvement project.","authors":"Cathy Shannon","doi":"10.7748/en.2023.e2180","DOIUrl":"10.7748/en.2023.e2180","url":null,"abstract":"<p><p>Malnutrition can have significant negative effects on older people's health, as well as a cost burden for health and social care services. Accurate, reliable and regular measurement of a patient's weight is important for prompt identification and management of malnutrition. This article discusses a quality improvement project that was undertaken in an emergency assessment unit for patients aged over 74 years in Northern Ireland. The aim of the project was to improve completion of Malnutrition Universal Screening Tool (MUST) scores for patients attending the unit by nursing staff recording actual weight rather than recalled weight. A simple intervention of relocating weighing scales in the unit's triage bay resulted in an increase in completed MUST scores from 60% ( n =18) to 97% ( n =29) in the six months following the intervention. Feedback from members of the multidisciplinary team indicated that the intervention had a positive effect on the care they provided to patients and on their working relationships with colleagues.</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":"2024-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49695741","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
Understanding the demographics, training experiences and decision-making practices of UK triage nurses. 了解英国分诊护士的人口统计、培训经历和决策实践。
Emergency nurse : the journal of the RCN Accident and Emergency Nursing Association Pub Date : 2024-05-23 DOI: 10.7748/en.2024.e2202
Hugh Gorick, Marie McGee, Toby Smith
{"title":"Understanding the demographics, training experiences and decision-making practices of UK triage nurses.","authors":"Hugh Gorick, Marie McGee, Toby Smith","doi":"10.7748/en.2024.e2202","DOIUrl":"https://doi.org/10.7748/en.2024.e2202","url":null,"abstract":"<p><strong>Background: </strong>International research suggests that triage nurses' decision-making practices and training experiences vary significantly across emergency departments (EDs). However, there does not appear to be similar research published in the UK. Understanding factors, such as demographics, training and decision-making could provide a picture of triage nurses working in UK EDs, identify the interventions required to improve practice and inform further research.</p><p><strong>Aim: </strong>To explore the demographics, training experiences and decision-making practices of registered nurses who assess patient acuity at triage in UK EDs.</p><p><strong>Method: </strong>The study used an online, descriptive, cross-sectional survey design.</p><p><strong>Results: </strong>A total of 51 triage nurses from across the UK responded to the survey. Most (61) had achieved a bachelor's degree as their highest qualification, while 3 had postgraduate qualifications. Respondents had a median of seven years since qualifying, six years working in their current ED and five years working in triage and used a range of titles to describe their role. Low staffing and busy ED environments increased respondents' stress levels, which affected confidence in triage decision-making abilities among less experienced nurses. More experienced respondents coped with their stress by relying on their knowledge and skills. Not all respondents had received triage training, and for those that had, the training varied in type and frequency across EDs. Overall, respondents had low satisfaction with the amount, quality and content of the training they had received.</p><p><strong>Conclusion: </strong>There is a need for safer staffing levels in EDs and greater support for staff welfare. The development of national standards, incorporating defined knowledge and skills and set time periods for refresher training, is required to enhance triage practice in EDs.</p>","PeriodicalId":94315,"journal":{"name":"Emergency nurse : the journal of the RCN Accident and Emergency Nursing Association","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141082004","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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