International emergency nursing
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Within health care, there has been a change in practice from an illness-orientated service to one that is more health-focused and person-centred. The concept of person-centredness is frequently espoused by practitioners as being not only a desirable, but a necessary element of health care provision. Indeed, nationally and internationally, person-centred care has underpinned many healthcare documents and policies. ⋯ There is evidence to suggest that emergency nurses view their role as one, which is predominantly concerned with providing urgent physical care, rather than one, which espouses the theories of holistic healthcare. To this extent, being person-centred in the context of emergency care, requires the nurse to move beyond the traditional notions of his/her role and to embrace the more holistic aspects of patient care. The aim of this article is to critically analyse how a change in nurse-led triage training in one Irish Emergency Department facilitated an improved person-centred approach in practice.
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Comparative Study
An investigation comparing the Oxford Chair Technique with the traditional methods of glenohumeral dislocation reduction currently implemented.
This paper reports on the findings of a quantitative, retrospective service evaluation. It compared a new, conscious, sedation-free technique to reduce anterior glenohumeral dislocations with the traditional methods of reduction (TMR) currently implemented. ⋯ Overall, the success rate for reduction using the OCT was good in view of this being a new treatment to the ED. While the OCT had a lower success rate of reduction compared to TMR, when reduction was successful using the OCT, there were overwhelming time-saving benefits to the patient with subsequent logistical benefits to the ED. The use of conscious sedation and morphine was also significantly less for the OCT group compared to TMR.
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This study examined emergency department (ED) staff attitudes and beliefs about alcohol-related ED presentations in order to recommend improved detection and brief intervention strategies. ⋯ This study reported that many staff lack the confidence or sense of clinical responsibility to fully and appropriately manage ED patients with alcohol-related problems. ED staff appear to require additional training, resources and support to enhance their management of patients with alcohol-related problems.
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Severe sepsis and septic shock are syndromes resulting in a systemic inflammatory response and the dysfunction of one or more organs following infection. The Surviving Sepsis Campaign is an international effort to reduce mortality in severe sepsis and septic shock by 25% by 2009 using a care bundle approach. It comprises evidenced-based interventions to be carried out within 6h of onset of sepsis. ⋯ Administration of an antibiotic was also very slow. Local recommendations include improvements to the track and trigger scoring system in A&E to improve recognition of sick patients, ensuring the doctor responsible for prescribing the antibiotic will administer it, and increasing awareness of the surviving sepsis campaign via education and training of all A&E staff. Given current evidence greater compliance to the care bundle may well improve patient outcomes for this client group.