Australasian emergency nursing journal : AENJ
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Australas Emerg Nurs J · Nov 2014
Observational StudyThe emergency department prediction of disposition (EPOD) study.
Emergency departments (ED) continue to evolve models of care and streaming as interventions to tackle the effects of access block and overcrowding. Tertiary ED may be able to design patient-flow based on predicted dispositions in the department. Segregating discharge-stream patients may help develop patient-flows within the department, which is less affected by availability of beds in a hospital. We aim to determine if triage nurses and ED doctors can predict disposition outcomes early in the patient journey and thus lead to successful streaming of patients in the ED. ⋯ Triage nurses, ED consultants and ED registrars are able to predict a patient's discharge disposition at triage with high levels of confidence. Triage nurses, ED consultants, and ED registrars can predict patients who are likely to be admitted with equal ability. This data may be used to develop specific admission and discharge streams based on early decision-making in EDs by triage nurses, ED registrars or ED consultants.
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Australas Emerg Nurs J · Nov 2014
Multicenter Study Comparative StudyA comparison of emergency triage scales in triaging poisoned patients.
Triage of toxicology patients presents a challenge due to their complexity, underlying psychosocial issues, and additional pharmacological considerations. Two emergency department triage systems used in Australia, the Australasian Triage Scale (ATS) and the Manchester Triage System (MTS), were compared in triaging patients presenting with poisoning and envenoming. ⋯ When compared to the ATS, MTS gave a lower acuity triage score for all common and rarely encountered poisoning scenario groups, which included highly toxic ingestions that appear well at triage but may progress to severe poisoning. Triage nurses should refer to information on highly toxic exposures and envenomation guidelines during their triage risk assessment.
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Disaster nursing was one of the first forms of nursing practice in Iran, and nurses have long served voluntarily in disasters. Despite their key role throughout a disaster management cycle, few studies have examined nurses' unique role in the management of disasters in this region of the world. ⋯ The integration of dedicate organisational units to educate human workforces, formalising a relationship between nursing staff and the disaster organisations, creative educational content, and effective economical systems to educate nurses may further enable disaster preparedness and response.
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Australas Emerg Nurs J · Nov 2014
Multicenter StudyManagement of patients on chemotherapeutic treatment for advanced cancer with acute conditions in the emergency department.
Chemotherapy is increasingly used in people with advanced cancer to palliate symptoms and improve survival. New Zealand provides medical oncology services in a Hub and Spoke model, with an increasing emphasis on delivering treatment at out-patient spoke services, where after hours and urgent care is provided by the Emergency Department (ED). This study sought to describe the factors that influenced the care and clinical decision-making of this group of patients in the ED. ⋯ A more collaborative relationship between Oncology and ED nurses may support the provision of emergency care within the context of active cancer treatment.
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Australas Emerg Nurs J · Nov 2014
Initial emergency nursing management of patients with severe traumatic brain injury: development of an evidence-based care bundle for the Thai emergency department context.
Thai emergency nurses play a vital role in caring for patients with severe TBI, and are an important part of the healthcare team throughout the resuscitation phase. They are also responsible for continuous physiological monitoring, and detecting deterioration associated with increased intracranial pressure and preventing secondary brain injury. However, there is known variation in Thai nurses' knowledge and care practices for patients with severe TBI. In addition, there are no specific evidence-based practice guidelines available for emergency nursing management of patients with severe TBI. ⋯ A care bundle is one method of promoting consistent, evidence-based emergency nursing care of patients with severe TBI, decreasing unnecessary variations in nursing care and reducing the risk of secondary brain injury from suboptimal care. Implementation of this evidence-based care bundle developed specifically for the Thai emergency nursing context has the potential to improve the care of the patients with severe TBI.