Journal of emergency nursing : JEN : official publication of the Emergency Department Nurses Association
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Pressure ulcers (PUs) are a serious health complication that develop as a result of pressure alone or pressure in combination with shearing forces. Although PUs are typically associated with older adults and chronic illness, acutely injured trauma patients may have a particular risk for the development of PUs. To prevent PU development or detect PUs in an early stage, skin assessment and PU classification should start during the ED stay, before hospital admission. The aim of this study was to assess the PU identification and classification skills of emergency nurses and emergency physicians and to evaluate the short-term effect of an educational intervention. ⋯ This study investigated the effect of an educational intervention on the interrater reliability, PU identification, and PU classification skills of emergency nurses and physicians when tested immediately after the intervention. Study results show that interrater reliability, PU identification, and PU classification of photographs all improved, but identifying the presence of a PU in a photograph was less challenging than categorizing the same wound.
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Comparative Study
A Comparison of Paper Documentation to Electronic Documentation for Trauma Resuscitations at a Level I Pediatric Trauma Center.
Although the electronic medical record reduces errors and improves patient safety, most emergency departments continue to use paper documentation for trauma resuscitations. The purpose of this study was to compare the completeness of paper documentation with that of electronic documentation for trauma resuscitations. ⋯ Electronic documentation produced superior records of pediatric trauma resuscitations compared with paper documentation. Because the electronic medical record improves patient safety, it should be adopted as the standard documentation method for all trauma resuscitations.
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Boarding, especially among psychiatric patients, has been characterized as a significant cause of ED crowding, but no quantitative analysis has described boarding nationally. This study determines the incidence, duration, and factors associated with ED boarding in the United States. ⋯ US EDs experienced high proportions and durations of boarding with psychiatric patients disproportionately affected. Additional research concerning mental health care services and legislation may be required to address ED psychiatric patient boarding.
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Hospital capacity constraints lead to large numbers of inpatients being held for extended periods in the emergency department. This creates concerns with safety, quality of care, and dissatisfaction of patients and staff. The aim of this quality-improvement project was to improve satisfaction and processes in which nurses provided care to inpatient boarders held in the emergency department. ⋯ Post-questionnaire results indicated improved satisfaction for both staff and patients. It was recognized early that the ED inpatient area would benefit from the supervision of an inpatient director, managers, and staff. Outcomes showed that creating an inpatient unit within the emergency department had a positive effect on staff and patient satisfaction.