Journal of emergency nursing : JEN : official publication of the Emergency Department Nurses Association
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Attempting to reduce ED crowding, the ED team at a rural academic medical center and specialty hospital implemented rapid medical evaluation (RME) with and without a provider in triage (PIT). The purpose of this performance improvement project was to explore how these interventions affected crowding metrics of door-to-disposition time, ED length of stay (LOS), and left without being seen (LWBS) rates for all patients. ⋯ The findings support other studies demonstrating that RME can have positive impact on ED crowding metrics for some patients. Although PIT took longer for some patients, anecdotal findings revealed benefits related to direct discharges and admission occurring during the RME process.
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Multicenter Study
Educating Emergency Department Staff on the Identification and Treatment of Human Trafficking Victims.
Hospitalization is one of the few circumstances in which the lives of trafficking victims intersect with the general population. Based on survivor testimonies, the majority of human trafficking victims may receive medical treatment in a hospital's emergency department while in captivity. With evidenced-based training, ED personnel have a better opportunity to screen persons who are being trafficked and intervene on their behalf. ⋯ Participants reported that they are more confident in identifying a possible trafficking victim and are more likely to screen patients for human trafficking after participation in the online training module. The proposed general guideline for care provided ED personnel with a useful tool in perpetuity. The results of this project, coupled with the growth of worldwide human trafficking, highlights the need for focused human trafficking education within the hospital setting.
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Violent behaviors in the emergency department are on the rise. Mitigation efforts are essential for staff and patient safety. The goal of this quality improvement project was to improve staff perception of knowledge, skills, abilities, confidence, and preparedness when managing violent patient behaviors using interprofessional simulation training and to evaluate staff learning style satisfaction and self-confidence using simulation. ⋯ Participants' self-reported changes in knowledge, skills, ability, confidence, and preparedness demonstrated significance for a short-term change, with preparedness having the greatest increase. Simulation debriefing allowed participants to provide feedback; satisfaction was higher for persons with less experience. The application of skills through simulation can prepare staff to handle difficult patient encounters.
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Injury from firearms is a significant problem in the United States, accounting for 73% of all homicides and 50% of all suicides that occurred among US residents. What is not known are the perceptions of emergency nurses regarding the impact of in-home access on the risk for firearm-related injury and death in their patient populations. The purpose of this study was to explore emergency nurses' perception of patient risk for firearm injury and in which ways that perception affected the process of ED patient screening, assessment, counseling, and discharge education. ⋯ Access to firearms poses risk to patients, and patient safety and the continuum of care depends upon the emergency nurse assessing patient firearms risk and taking appropriate action. The findings from this study suggest that emergency departments (1) normalize and standardize the assessment of firearms, (2) designate an ED staff member on each shift to further assess risk if a positive response is elicited, and (3) continue to improve workplace safety.