Journal of emergency nursing : JEN : official publication of the Emergency Department Nurses Association
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Review
Rethinking Traditional Emergency Department Care Models in a Post-Coronavirus Disease-2019 World.
As the nursing shortage in United States emergency departments has drastically worsened since the coronavirus disease-2019 (COVID-19) pandemic, emergency departments have experienced increased rates of inpatient onboarding, higher rates of patients leaving without being seen, and declining patient satisfaction scores. This paper reviews the impacts of the coronavirus disease-2019 pandemic on the current nursing shortage and considers how various medical personnel (emergency nurse-extenders) can ameliorate operational challenges by redesigning emergency department systems. ⋯ Health care workers who can be trained to augment the existing emergency department workforce include paramedics, Emergency Medical Technicians, emergency department technicians, ancillary staff, scribes, and motivated health sciences students. Utilizing non-nurse providers to fulfill tasks traditionally assigned to emergency nurses can improve emergency department flow and care delivery in a post-coronavirus disease-2019 world.
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This is a rapid review of the published evidence on the effectiveness of interventions for mitigating workplace violence against staff in hospital emergency departments. Focused on the specific needs of an urban emergency department in Canada, this project sought to address the question, "What interventions have evidence regarding effectiveness for addressing workplace patient/visitor violence toward staff in the emergency department?" ⋯ Despite a large body of literature on workplace violence, there is little guidance on effective strategies to mitigate workplace violence in emergency departments. Evidence suggests that multicomponent approaches targeting staff, patients/visitors, and the emergency department environment are essential to addressing and mitigating workplace violence. More research is needed that provides robust evidence on effective violence prevention interventions.
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Review
The Experience of Families Accompanying a Senior to the Emergency Department: A Scoping Review.
Seniors are often accompanied by a family member to the emergency department. Families advocate for their needs and contribute to the continuity of care. However, they often feel excluded from care. To improve the quality and safety of care for seniors, it is necessary to consider the experience of families in the emergency department. The aim was to identify and synthesize the available scientific literature dealing with the experience of families accompanying a senior to the emergency department. To identify and synthesize the available scientific literature dealing with the experience of families accompanying a senior to the emergency department. ⋯ The experience of families of seniors in the emergency department is multifactorial and part of a trajectory of care and health services.
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An updated stroke process was designed and implemented at an Acute Stroke Ready community hospital that relies on telestroke services. The objectives of the current quality improvement project were to describe the updates to the stroke process and compare pre- and postintervention data on nurse-driven elements of the process, namely telestroke notification and neurologist assessment. ⋯ This project led to significant improvements in nurse-driven elements of the stroke process. It demonstrates effective implementation of e-alert and collaboration with telestroke services at an Acute Stroke Ready Hospital serving rural communities.
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Case Reports
A Grade Ⅲ Severe Hypersensitivity Caused by Gadopentatic Acid Injection: A Case Report.
Gadopentetic acid is a common contrast agent for enhanced magnetic resonance imaging. Adverse reactions due to gadolinium-based contrast agents are rare and easily overlooked by medical staff. A patient developed a rash as the first symptom and quickly developed a severe allergic reaction after receiving gadopentetic acid. ⋯ This case stresses the importance of being equipped with the medicines, items, supplies, and equipment needed for emergency treatments in all departments where contrast agents are used. Patients with apparently mild adverse reactions to contrast agents should not be overlooked.