Emergency medicine Australasia : EMA
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Emerg Med Australas · Jun 2019
Patient attitudes towards analgesia and their openness to non-pharmacological methods such as acupuncture in the emergency department.
To investigate patient attitudes to analgesia, opioids and non-pharmacological analgesia, including acupuncture, in the ED. ⋯ Most patients were generally satisfied with ED analgesia and were open to non-pharmacologic analgesia including acupuncture.
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Emerg Med Australas · Jun 2019
ReviewReview article: A primer for clinical researchers in the emergency department: Part VIII. Implementation science: An introduction.
New research findings may not lead to change in practice, or a change at the front line may be delayed by years. A number of terms have been used to describe efforts and strategies to speed a change in evidence-based practice, such as: implementation science, knowledge translation, research translation and others. ⋯ There are now theoretical frameworks and evolving evidence providing guidance how to change clinician behaviour and, specifically, emerging evidence on how to achieve this in the emergency setting. This review will provide an introduction to implementation science and illustrate how to target evidence practice gaps using ED examples.
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Emerg Med Australas · Jun 2019
Qualitative analysis of perceptions and experiences of emergency department staff in relation to implementation and outcomes of the Four-Hour Rule/National Emergency Access Target in Australia.
The implementation of the time target policy (Four-Hour Rule/National Emergency Access Target [4HR/NEAT]) constituted a major change for ED, and potentially on quality of care. The present study aimed to understand perceptions and experiences of ED staff during 4HR/NEAT implementation. ⋯ ED staff perceived important effects on quality and safety of care; access block and overcrowding; and medical education and training. In relation to an optimised ED role, quality of care and access block were overall felt to be improved, while education and training deteriorated. Our study increases understanding of the complexity of policy implementation processes and its impact on staff. Staff perceptions are a valuable measure of system performance and should be incorporated into system change evaluations.
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Emerg Med Australas · Jun 2019
ReviewReview article: Postoperative bariatric patients in the emergency department: Review of surgical complications for the emergency physician.
With the rise of obesity in adult populations in the western world there has been a concurrent rise in bariatric procedures to address this problem. Although the safety of bariatric procedures has improved significantly over the past 20 years, there are still a number of serious surgical complications that can occur in the postoperative period that emergency physicians need to be familiar with. ⋯ This review will cover the more common bariatric procedures that are being performed today. It will discuss the complications, clinical presentations and management of these patients that emergency physicians should be familiar with.
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Emerg Med Australas · Jun 2019
Observational StudyAn early warning system for emerging drugs of concern in the emergency department: Protocol for the Western Australian Illicit Substance Evaluation (WISE) study.
An ever-increasing number of novel psychoactive substances are being detected worldwide. These emerging drugs have been demonstrated to cause toxicity in clusters, and deaths have been reported. We urgently need to learn more about their effects. We report the protocol for the Western Australian Illicit Substance Evaluation (WISE) study, a research project investigating illicit drug use in the ED. ⋯ We consider the novel approach outlined forms a template for an early warning system for emerging drugs of concern, while also providing vital and comprehensive information on current drugs of abuse, their clinical effects and their impact on the health system.