International emergency nursing
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The need of emergency help often begins with a call to a dispatch center. The operator uses a medical index to prioritize dispatches. Since the resources of ambulances are limited, it is important that the priority grading decided by the operator at the dispatch center is as adequate as possible. ⋯ The results show a high sensitivity but low specificity in the dispatch system. The results also indicate that over prioritization exists since most of the patients with a high acute need of an ambulance are correctly identified, while many patients without that need are also given a high priority ambulance service. Therefore the conclusions were that both over- and under prioritizations were made.
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Standardised triage systems have been implemented in emergency departments (EDs) to improve the efficacy of assessment strategies as performed by registered nurses (RNs). However, the exact effect the standardised triage systems have on the decision-making process remains unclear. ⋯ Implementing a standardised triage system, including vital parameters and standardised algorithms for signs and symptoms, increased the use of vital parameters and signs and symptoms for decision making and acuity assignment.
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The purpose of this discussion is to present triage decision making research within the context of the Revised Cognitive Continuum Theory. Triage is an essential clinical skill in emergency nursing. Understanding the best way to facilitate this skill is vital when educating new nurses or providing continuing education to practicing nurses. Delineating research evidence within a theory allows clinical educators to understand practices that foster successful triage skills and permits the grounding of educational strategies within a theoretical framework.
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Multicenter Study
Emergency nurses: procedures performed and competence in practice.
Emergency nurses play an important role in identifying and managing critical illness. Thus, nurses' competence in performing a range of functions is important. This study aimed to identify the procedures performed and associated competencies of emergency nurses. ⋯ Emergency nurses in Ireland engage in a wide range of activities, many of which are described in other countries as advanced practice. Recognition needs to be given and education prioritised in deficit areas.
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Patients in prehospital care, irrespective of diseases or trauma might experience thermal discomfort because of a cold environment and are at risk for decreasing body temperature which can increase both morbidity and mortality. ⋯ Thermal discomfort became the largest problem independent of the severity of the injuries. We recommend the use of active heat supply to reduce the negative experiences of thermal discomfort when a person is injured in a cold environment.