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

{"title":"'Corridor care' in the emergency department: managing patient care in non-clinical areas safely and efficiently.","authors":"Christopher Williams","doi":"10.7748/en.2023.e2187","DOIUrl":"10.7748/en.2023.e2187","url":null,"abstract":"<p><p>Overcrowding in the emergency department (ED) is a significant issue and often leads to nursing care being delivered in areas not intended for clinical use, a practice commonly referred to as 'corridor care'. Delivering care in non-clinical areas negatively affects patient safety and poses unique professional challenges for emergency nurses while also reducing their well-being. To end - or at least reduce - corridor care, system-level interventions are needed. In the meantime, there are practical solutions that can be implemented at an individual and departmental level to mitigate some of the risks associated with it. This article discusses a pragmatic approach to patient care, and explores opportunities for nurses to mitigate risks and enhance safety and efficiency, in overcrowded EDs.</p>","PeriodicalId":94315,"journal":{"name":"Emergency nurse : the journal of the RCN Accident and Emergency Nursing Association","volume":" ","pages":"34-41"},"PeriodicalIF":0.0,"publicationDate":"2023-10-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41224711","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}

{"title":"Trauma pain management in the emergency department: use of methoxyflurane as a patient-administered analgesic.","authors":"C. Wood","doi":"10.7748/en.2022.e2124","DOIUrl":"https://doi.org/10.7748/en.2022.e2124","url":null,"abstract":"Evidence suggests that pain is highly prevalent among patients with traumatic injuries who attend emergency departments (EDs), yet accurate assessment and management of patients with acute pain can be challenging in this setting. Effective and rapid pain management is beneficial for patients and can support timely discharge from the ED, which is particularly important in the context of the coronavirus disease 2019 (COVID-19) pandemic. This article describes a service development project that introduced the use of a patient-administered analgesic, methoxyflurane, for patients with traumatic injuries with moderate to severe pain in one ED. The author outlines the benefits and rationale for using methoxyflurane as a first-line analgesic in this patient group and describes the main elements of training sessions for emergency nurses and other ED clinicians in the administration and supervision of patient-administered methoxyflurane.","PeriodicalId":94315,"journal":{"name":"Emergency nurse : the journal of the RCN Accident and Emergency Nursing Association","volume":"23 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-06-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74916554","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}

{"title":"Acute behavioural disturbance: recognition, assessment and management.","authors":"Matthew Peel","doi":"10.7748/en.2022.e2126","DOIUrl":"https://doi.org/10.7748/en.2022.e2126","url":null,"abstract":"<p><p>Acute behavioural disturbance (ABD) is a clinical emergency which typically affects overweight men in their mid-thirties who chronically misuse illicit stimulants. People with ABD are most likely to be seen in police custody or emergency departments, therefore nurses working in these areas must be able to recognise the signs and symptoms and know how to respond appropriately. Presentation varies, but the signs and symptoms commonly include extreme agitation, hyperthermia, hostility and exceptional strength without fatigue. Further, it is important to recognise that people with ABD are at risk of developing metabolic acidosis, hyperkalaemia, rhabdomyolysis or disseminated intravascular coagulation. This article gives an overview of ABD and describes the main elements of management 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":"2022-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139907268","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}

{"title":"Ensuring effective intercultural communication in the emergency department.","authors":"D. Tuohy, Evans Wallace","doi":"10.7748/en.2022.e2122","DOIUrl":"https://doi.org/10.7748/en.2022.e2122","url":null,"abstract":"Globalisation and migration trends are reflected in emergency departments (EDs), which increasingly care for patients and employ staff from diverse cultural and/or ethnic backgrounds. EDs are busy, pressured and unpredictable environments where effective communication with patients and families is challenging at the best of times. This is compounded by language and cultural barriers experienced by patients and families whose background differs from the prevailing culture. Cultural differences and language comprehension may also be a challenge for overseas nurses recruited to the ED, who may need support from colleagues and organisations. ED nurses therefore need to be competent in intercultural communication. This involves combining optimal interpersonal skills with cultural awareness, knowledge and sensitivity.","PeriodicalId":94315,"journal":{"name":"Emergency nurse : the journal of the RCN Accident and Emergency Nursing Association","volume":"15 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74279858","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}

{"title":"Factors that affect nurses' triage decisions in the emergency department: a literature review.","authors":"Hugh Gorick","doi":"10.7748/en.2022.e2123","DOIUrl":"https://doi.org/10.7748/en.2022.e2123","url":null,"abstract":"Accurate triaging of patients in emergency departments (EDs) is crucial, since triage determines how quickly patients are assessed and treated. Understanding the factors that influence ED nurses' triage decisions is important to ensure that patients are prioritised appropriately and cared for in a timely manner. This article reports and discusses the findings of a literature review on the factors that affect nurses' triage decisions in the ED. Triage decisions by nurses in EDs are influenced by several factors relating to the patient, the nurse, the triage algorithm and the environment where triage takes place. Nurses' ability to triage patients accurately is negatively affected by high patient numbers, inadequate staffing levels, lack of privacy and lack of training.","PeriodicalId":94315,"journal":{"name":"Emergency nurse : the journal of the RCN Accident and Emergency Nursing Association","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88949816","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}

{"title":"Assessing and managing people exposed to conducted energy device (Taser) discharge.","authors":"Matthew Peel, David Tremlett","doi":"10.7748/en.2022.e2125","DOIUrl":"https://doi.org/10.7748/en.2022.e2125","url":null,"abstract":"The use of conducted energy devices - better known under the brand name Taser - by police officers is subject to scrutiny. Consequently, the clinical assessment and management of people who have been exposed to Taser discharge is also subject to scrutiny. In 2021 the Conducted Energy Device Joint Working Group published a new guideline on assessment in police custody after Taser discharge. The guideline enables any appropriately trained and competent healthcare professional, including nurses, to undertake post-Taser assessments and determine the person's fitness to be detained in police custody. This would be done in the first instance by nurses working in police custody suites, but emergency department (ED) nurses may also be involved, as people who have been 'tasered' may need referral to the ED. This article explains how Tasers work, their physiological effects and potential complications, and the required approaches to clinical assessment and management as outlined in the new guideline.","PeriodicalId":94315,"journal":{"name":"Emergency nurse : the journal of the RCN Accident and Emergency Nursing Association","volume":"13 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-02-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"91014248","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}

{"title":"Skin problems.","authors":"Sarah Gear","doi":"10.7748/en.13.10.6.s10","DOIUrl":"https://doi.org/10.7748/en.13.10.6.s10","url":null,"abstract":"If you ever need to find out more about skin rashes then try clicking on dermatlas.med.jhmiedu/derm/.","PeriodicalId":94315,"journal":{"name":"Emergency nurse : the journal of the RCN Accident and Emergency Nursing Association","volume":"4 1","pages":"6"},"PeriodicalIF":0.0,"publicationDate":"2022-01-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90397713","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}

{"title":"Taking ownership.","authors":"C. Beck","doi":"10.7748/en.10.6.2.s4","DOIUrl":"https://doi.org/10.7748/en.10.6.2.s4","url":null,"abstract":"Nurse prescribing would allow ENPs to 'take ownership' of work they are undertaking already, an NHS Scotland official urged delegates.","PeriodicalId":94315,"journal":{"name":"Emergency nurse : the journal of the RCN Accident and Emergency Nursing Association","volume":"38 1","pages":"2"},"PeriodicalIF":0.0,"publicationDate":"2021-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80336793","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}

{"title":"Testicular torsion.","authors":"A. Summers","doi":"10.1891/9780826185235.0009l","DOIUrl":"https://doi.org/10.1891/9780826185235.0009l","url":null,"abstract":"","PeriodicalId":94315,"journal":{"name":"Emergency nurse : the journal of the RCN Accident and Emergency Nursing Association","volume":"28 1","pages":"22-3"},"PeriodicalIF":0.0,"publicationDate":"2020-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89862412","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}

{"title":"Patient satisfaction.","authors":"Gillian A. Corbett, T. McGuigan","doi":"10.1002/9781119057840.ch90","DOIUrl":"https://doi.org/10.1002/9781119057840.ch90","url":null,"abstract":"To the Editor: In their survey of patient satisfaction with intravenous PCA or epidural morphine, Egan and Ready conclude that satisfaction is very high with both modalities, but the perceived advantages and disadvantages differ, t While I share the authors' enthusiasm for both techniques, I feel there are some methodological concerns which may limit the validity of the conclusions. The authors reported differences between the two patient groups with respect to advantages, disadvantages and patient satisfaction. I question if such comparisons are valid when the demographics of the two groups studied are so clearly different; the PCA group was, on average, nine years younger than the epidural group, and presumably represented a different case mix. Although not reported, it is reasonable to assume that the patients undergoing more serious surgery were also more likely to receive epidural narcotics postoperatively. Within each group the authors have identified relative advantages and disadvantages perceived by the patients. However, on the basis of the very considerable demographic differences, I would argue that no valid between-group comparisons of PCA versus epidural narcotics are possible. The authors also state that\" ... patients converted from one form of therapy to the other for any reason were excluded.\" This would seem to bias the reported satisfaction scores, since the only obvious reason for a change in therapy is patient or physician dissatisfaction. It would be useful to know how often this occurred. Quite tightly, Egan and Ready point out that, \"Although patients willingly offer (satisfaction) ratings, it is by no means clear what such ratings represent.\" This is further illustrated in a randomized prospective study of PCA versus im morphine in patients following hip arthroplasty. 2 In both groups, the patients reported satisfaction scores of approximately nine out of ten, yet pain control assessed using visual analogue scores for both intensity and distress was often inadequate. In fact, the highest satisfaction score was coincident with the worst reported pain. Barring the most egregious errors, one suspects that if your patient likes you, reported satisfaction will be high.","PeriodicalId":94315,"journal":{"name":"Emergency nurse : the journal of the RCN Accident and Emergency Nursing Association","volume":"6 1","pages":"26-35"},"PeriodicalIF":0.0,"publicationDate":"2020-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81839108","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}