Emergency medicine Australasia : EMA
-
Emerg Med Australas · Jun 2019
Observational StudyStructured Interdisciplinary Bedside Rounds in an Australian tertiary hospital emergency department: Patient satisfaction and staff perspectives.
To compare patient satisfaction levels, staff perspectives and the time required using Structured Interdisciplinary Bedside Rounds (SIBR; Emory University, Atlanta, GA, USA) versus traditional medical ward rounds (TR) in the ED. ⋯ Our study highlights the benefits that could be gained through SIBR technique over the TR method. Better workforce and resource planning is needed to support the sustainable implementation of SIBR in ED.
-
Emerg Med Australas · Jun 2019
Neurocognitive testing in the emergency department: A potential assessment tool for mild traumatic brain injury.
Despite mild traumatic brain injury (mTBI) accounting for 80% of head injury diagnoses, recognition of individuals at risk of cognitive dysfunction remains a challenge in the acute setting. The objective of this study was to evaluate the feasibility and potential role for computerised cognitive testing as part of a complete ED head injury assessment. ⋯ Computerised neurocognitive testing in the ED is feasible and can be utilised to detect deficits in cognitive performance in the mTBI population as part of a routine head injury assessment.
-
Emerg Med Australas · Jun 2019
Impact of the Four-Hour Rule/National Emergency Access Target policy implementation on emergency department staff: A qualitative perspective of emergency department management changes.
It has been 10 years since the ACEM Access Block Solutions Summit and 5 years since the introduction of the Four-Hour Rule/National Emergency Access Target (4HR/NEAT) policy. The impact of this policy on ED management and on ED staff has been poorly understood. The aim of the present study was to identify changes in ED management resulting from the policy based on ED staff experiences. ⋯ Policy implementation is a complex process that had both positive and negative consequences on how ED staff managed the implementation of the 4HR/NEAT policy and how it changed their work environment. Understanding the perceptions of staff involved in policy implementation has significance for the design of future implementation strategies. The biggest insight from the present study is that ED management is very complex and the policy generated multiple positive and negative changes demonstrating the wide range of processes involved in this area of health services research.
-
Emerg Med Australas · Jun 2019
Human factor-designed multimodal intervention reduces the rate of unused peripheral intravenous cannula insertion.
Our objective was to examine the impact of a human factor-designed multimodal intervention on the proportion of unused peripheral i.v. cannula (PIVC) insertion in our ED. ⋯ Our multimodal intervention successfully reduced the number of unused PIVCs inserted in the ED, with a reduction in overall and unused PIVC insertions without any change in appropriate insertions.
-
Emerg Med Australas · Jun 2019
Modified Sequential Organ Failure Assessment sepsis score in an emergency department setting: Retrospective assessment of prognostic value.
Use of the Sequential Organ Failure Assessment (SOFA) score has been proposed by the Third International Consensus Definitions for Sepsis and Septic Shock. The utility in the ED is not yet well established. We retrospectively studied the application of a modified SOFA (mSOFA) score, to assess its ability to predict mortality. ⋯ For ED patients thought likely to have sepsis, the mSOFA score distinguished those with a high or low mortality risk. The high negative predictive value could be practically useful. Prospective study of the mSOFA score used in ED will be needed to validate these observations.