Journal of emergency nursing : JEN : official publication of the Emergency Department Nurses Association
-
Cognitive impairment in older adults is underrecognized in emergency departments. Despite emergency nurses' central role in facilitating ED screening for clinical and social needs, little is known about their perspectives on implementing delirium and dementia screenings. Nurses can provide insights to promote the uptake of these screenings. ⋯ Emergency nurses conceptualize screenings in terms of patient safety, which may be the best way to frame initiatives to implement screenings for cognitive impairment. In light of ED crowding and boarding's impacts on patient safety, nurses highlighted screening for cognitive impairment as increasingly relevant. However, they found current working conditions of delivering patient care in waiting rooms and hallways not conducive to implementing screenings. Using the Consolidated Framework for Implementation Research framework helped identify workflow limitations that are barriers to ED screening.
-
This paper developed and used practice vignettes to understand sexual assault nurse examiners' perceptions of self-confidence to provide care for Black, Indigenous, and transgender sexual violence survivors. Sexual assault nurse examiners are uniquely positioned to provide patient-centered postsexual violence health care but not all sexual assault nurse examiners receive culturally specific and identity-affirming training. Black/African American, Indigenous, and/or transgender people disproportionately experience sexual violence but may receive poorer health care after sexual violence compared with white cisgender people. Understanding sexual assault nurse examiner confidence to provide this care is paramount to improving sexual assault nurse examiner training and patient outcomes. ⋯ Training and mentorship programs could improve sexual assault nurse examiner confidence to provide trauma- and violence-informed care for Black, Indigenous, and transgender survivors, and vignettes could be used to measure changes in confidence owing to training.
-
The number 1 reason children 15 years of age and younger present to the emergency department is fever. To successfully address this common chief complaint, a consistent message must be sent by all health care team members. ⋯ In addition, treatment of fever must be evidence based with a goal of comfort rather than normothermia. Nurses must address caregivers' concerns and consider the age, medical history, and clinical presentation of the child with fever when determining the appropriate triage level and management.
-
Comparative Study Observational Study
Comparative Analysis of Frailty Scales in Emergency Department: Highlighting the Strengths of the Triage Frailty and Comorbidity Tool.
Currently, there is uncertainty about which frailty scale is most appropriate and valid for use in the emergency department. The objective of this study was to compare the most commonly used frailty scales in triage and evaluate their performance. ⋯ The findings of this study suggest that the Triage Frailty and Comorbidity tool is a valid instrument for assessing frailty in the emergency department. Moreover, among the scales used, it is the only 1 that considers the entire adult population, not just those aged >65 years, making it more inclusive for a setting such as the emergency department.
-
Over the past 15 years, the emergency nurse practitioner has been recognized as a nursing specialty role with dedicated scope and standards of practice. However, a paucity of objective data exists to validate the actual practice of emergency nurse practitioners in the emergency care setting. The purpose of this pilot study was to describe the initial acuity of patients assigned to emergency nurse practitioners, actions, decisional complexity, and disposition decisions of advanced practice nurses as they function in emergency departments in a single system. ⋯ Although descriptive, this study is highly illustrative of the broad scope of complex skills and clinical decision making required to perform as an advanced practice nurse in the emergency department. Further examination of education and training is warranted.