Journal of emergency nursing : JEN : official publication of the Emergency Department Nurses Association
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This project aimed to design and implement an emergency department-managed observation unit that improves inpatient bed and emergency department stretcher capacity, decreases observation patient length of stay, earns high patient satisfaction scores, and generates a positive fiscal impact on the organization. ⋯ This effective and efficient hybrid observation unit possessed specific aspects of inpatient and emergency department patient care models. Placing providers and nurses at the workstation for faster communication expedited care. Prioritizing all observation patient testing, transportation, phlebotomy, and intravenous (IV) services shortened disposition times. Emergency nurses transitioning to the observation unit were challenged to acquire inpatient care knowledge. Observation unit management struggled to maintain staffing while under an inpatient productivity model managed by the inpatient house supervisor. Reducing patient disposition time required clear communication between observation unit and inpatient staffing managers, between physician consultants and advanced practice nursing providers, and among nurses, patients, and providers. Observation units are 1 solution to decrease observation patient length of stay and improve emergency department capacity.
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Professional isolation, feelings of being isolated from one's professional peers and lacking mentoring and opportunities for professional interaction, collaboration, and development, is a challenge for workers across the labor market. The notion of professional isolation is particularly prevalent in low-resource health care settings and is common among emergency nurses. ⋯ This study suggests that lack of interprofessional collaboration and consultation, skills mismatch, and enforced loneliness have influenced feelings of professional isolation among emergency nurses working in low-resource environments. The findings of this research lend support to the idea that communities of practice may have a potential impact in addressing professional isolation.