Journal of emergency nursing : JEN : official publication of the Emergency Department Nurses Association
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Nursing care is widely recognized to be a vital element in stroke care delivery. However, no publications examining clinical education and optimal workflow practices as predictors of acute ischemic stroke care metrics exist. This study aimed to explore the impact of a nurse-led workflow to improve patient care that included telestroke encounters in the emergency department. ⋯ In this sample, implementation of the nurse-driven acute stroke care protocol is associated with improved nurse-sensitive stroke time metrics but did not translate to faster delivery of thrombolytic agents for acute ischemic stroke, emphasizing the importance of well-outlined workflows and standardized stroke code protocols at every point in acute ischemic stroke care.
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Many low- and middle-income countries lack resources for well-functioning emergency care systems. Emergency nurses interact with injured and critically ill patients as the first contact in many health care settings. However, insufficient training limits nurses from providing ideal emergency care. The purpose of this research was to highlight educational needs specific to nurses working in 2 emergency departments in Nairobi, Kenya. ⋯ The results of this study suggest there is a knowledge gap and educational needs among emergency nurses in Nairobi, Kenya. It identified injuries/trauma; cardiovascular, respiratory, and neurological disease; and other emergencies as topics of focus areas with a high need. To address these knowledge and skills needs, a future specialty training in emergency nursing is recommended and this could be achieved through continuing professional development and short courses or postgraduate-level training.
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Coronavirus disease 2019 was declared a national emergency in the United States on March 13, 2020, at which time the Children's National Hospital Emergency Department in Washington, DC, mobilized to develop and implement a unit-based Incident Command System. Anticipating that the unique and challenging nature of this pandemic might require a large interprofessional team, emergency nurses, emergency physicians, and emergency physician assistants were placed in traditional Incident Command System roles to provide an organizational framework for the ED response. This framework served multiple purposes but most importantly it helped to efficiently streamline and coordinate communications within the emergency department, with hospital leadership and with other hospital departments. ⋯ This paper highlights a unique concept of applying the Incident Command System model to a single hospital department in a disaster scenario, using existing ED staff to function in various roles not typically held during regular operations. Given that policies and procedures can be ever-changing during a pandemic, emergency departments can implement an interprofessional incident command structure to provide a framework for communications and operational planning that allows for agility based on evolving priorities. The Children's National Hospital ED Incident Command System model established during the coronavirus disease 2019 pandemic can serve as a guide for other emergency departments during a disaster response.
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The use of personal protective equipment increased rapidly during the COVID-19 pandemic that began in 2019. The purpose of this study was to examine the effects of uninterrupted 4-hour use of internationally certified nonvalved filtering facepiece respirators on venous blood gas in health care workers during the COVID-19 pandemic. ⋯ Continuous nonvalved filtering facepiece respirator use for 4 hours was not associated with clinician impairment in blood gas and peripheral SpO2 levels during nonexertional clinical ED work.
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Calcium chloride is commonly used in emergency departments in the treatment of a variety of emergencies. Historically, administration via central venous catheters has been preferred owing to its high osmolarity and vesicant properties. Although preferred, central access may not always be available in time-sensitive, emergent situations leading to many instances of peripheral administration. The objective of this analysis was to evaluate the charted safety of peripheral venous administration of 10% calcium chloride. ⋯ This study demonstrated that administration of 10% calcium chloride via peripheral venous catheters may be feasible and seemed to carry a low incidence of documented complications. Further prospective studies are needed to confirm study observations.