International emergency nursing
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How does the organizational micro culture in emergency departments (EDs) impact the care of older adults presenting with a complaint or condition perceived as non-acute? This scoping study reviews the literature and maps three levels of ED culture (artifacts, values and beliefs, and assumptions). Findings on the artifact level indicate that EDs are poorly designed for the needs of older adults. ⋯ Finally, finding on the assumptions level underpinning ED behaviors suggest that older adults do not belong in the ED, most older adults in the ED are not critically ill and therefore can wait, and staff need to be available for acute cases at all times. A systematic review on the effect of ED micro culture on the quality of geriatric care is warranted.
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The objectives of this study were to: identify the incidence and types of brain injuries; classify brain injury severity; identify additional injuries; and identify predictors of length of stay, mortality and trauma center admission. ⋯ Brain injuries are common sequelae from falls among older adults. Additional research is needed to understand sociodemographic factors that are associated with trauma center admission.
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To evaluate quality of care delivered to patients presenting to the emergency department (ED) with pain and managed by emergency nurse practitioners by: 1 Evaluating time to analgesia from initial presentation 2 Evaluating time from being seen to next analgesia 3 Measuring pain score documentation ⋯ The majority of patients assessed by nurse practitioners received analgesia within 30 minutes after assessment. However, opportunities for substantial improvement in such times along with documentation of pain scores were identified and will be targeted in future research.
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To examine the injury patterns, characteristics, and outcomes of older adults presenting with minor injuries compared with younger adults. ⋯ Older adults with minor injuries have different injury patterns, higher acuity, longer length of stay, and lower discharge rates compared with younger adults. Clinicians may need to modify their approach and differential diagnoses when treating older adults with minor injuries. Further research is needed to explore the reasons for these differences and whether older adults have different service needs compared with younger adults with minor injuries.
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The Hague Protocol is used by professionals at the adult Emergency Departments (ED) in The Netherlands to detect child abuse based on three parental characteristics: (1) domestic violence, (2) substance abuse or (3) suicide attempt or self-harm. After detection, a referral is made to the Reporting Center for Child Abuse and Neglect (RCCAN). This study investigates whether implementing this Protocol will lead parents to avoid medical care. ⋯ ED nurses and doctors referring children based on parental characteristics do not have to fear losing these families as patients.