Advanced emergency nursing journal
-
Randomized Controlled Trial
Effects of Video Discharge Instructions on Patient Understanding: A Prospective, Randomized Trial.
Previous studies demonstrated that patients have difficulty understanding and retaining discharge instructions due to the lack of time spent counseling patients and low health literacy rates. The purpose of this study was to evaluate the effects of video instructions on patient understanding of their discharge instructions. This was a prospective, randomized, controlled trial of a convenience sample conducted in a military hospital emergency department. ⋯ Baseline characteristics between groups were not significantly different (30 video discharge instructions and 30 standard discharge instructions). We found a significant difference between groups with respect to discharge instructions knowledge in favor of the video discharge instructions group (4.53 vs. 4; p = 0.009). Video discharge instructions, used as an adjunct to standard verbal and written discharge methods, improved patient understanding and retention of their discharge instructions.
-
Randomized Controlled Trial
Exploring Emergency Department Provider Experiences With and Perceptions of Weight-Based Versus Individualized Vaso-Occlusive Treatment Protocols in Sickle Cell Disease.
Treatment of vaso-occlusive episodes (VOEs) is the most common reason for emergency department (ED) treatment of sickle cell disease (SCD). We (1) compared perceptions of the usability and ability to manage VOE pain between ED nurses and other ED provider types, ED sites, and VOE protocols (individualized vs. weight-based), and (2) identified ED nurse and other provider protocol suggestions. A secondary analysis of provider survey data collected immediately after caring for a patient enrolled in a randomized controlled trial comparing weight-based versus individualized opioid dosing for VOE. ⋯ The individualized protocol was perceived as better in managing VOE than the weight-based ED strategy. While physicians were satisfied with the clarity of the protocols, nurses were not. Improved protocol usability is required for widespread ED implementation.
-
Randomized Controlled Trial
A Randomized, Double-Blind Trial to Determine if Vapocoolant in the Adult Population Improves Patient Perception of Pain With Peripheral Intravascular Access.
The purpose of this study was to investigate whether the use of a topical anesthetic spray (vapocoolant) at the site of intravenous access reduces pain and anxiety associated with peripheral intravenous (PIV) catheter insertion in an adult emergency department population. A randomized, double-blind, placebo-controlled, single-center trial, conducted from July to August, in an adult emergency department where 72 patients with orders for PIV insertion receiving either topical vapocoolant spray (n = 38) or placebo spray (n = 34). Vapocoolant or placebo was applied to the intravenous site and allowed to evaporate before cleansing and insertion. ⋯ Eighty-nine percent of nurses and patients would use vapocoolant in future procedures, whereas 74% would use placebo; the difference was not significant (p > 0.05). No skin blanching or lesions were noted. Among adult patients in the Parkland Emergency Department receiving PIV access, no significant differences in pain relief or alleviation of anxiety were found between treatment using a topical anesthetic spray or placebo.
-
Case Reports Randomized Controlled Trial
Rehydration of children with gastroenteritis.
Review of recent evidence with translation to practice for the advanced practice nurse role is presented using a case study module for "Intravenous Dextrose for Children With Gastroenteritis and Dehydration: A Double-Blind Randomized Controlled Trial." The study results showed that 35% of the children who received dextrose in normal saline (D5NS) were hospitalized as compared with 44% who received normal saline. The implications and clinical relevance of these findings for advanced practice nurses are discussed highlighting best evidence.
-
Randomized Controlled Trial
EMLA application exceeding two hours improves pediatric emergency department venipuncture success.
The purpose of this study was to determine whether placing Eutectic Mixture of Local Anesthetics (EMLA) at emergency department (ED) triage improves venipuncture success. Emergency department triage nurses prospectively identified patients aged 0-18 years assessed to have 50% or greater chance of needing venipuncture while in the emergency department. Identified patients received EMLA or no intervention according to randomized 24-h blocks. ⋯ Barriers to triage EMLA placement should be evaluated. Application longer than 2 h should be studied further as a means to improve success. EMLA was supplied as a part of the Investigator-sponsored study program of AstraZeneca.