Emergency medicine journal : EMJ
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The importance of end of life care (EoLC) for patients and their families is well documented, however, the skills and knowledge of emergency clinicians in delivering EoLC is not widely understood but it is clear from the existing literature that we fall short in delivering consistently good EoLC although there is recognition of the need to improve. This paper will acknowledge the challenges of delivering good EoLC in the emergency department (ED) but more importantly consider practical ways of improving EoLC in the ED in line with best practice guidelines on EoLC.
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Inter-rater reliability (IRR) is rarely determined for scoring systems used to recognise deterioration in children. Thus, the primary objective of this study was to determine the IRR of the Paediatric Observation Priority Score (POPS), a bespoke paediatric scoring system for ED use. The IRR of both the overall POPS and its individual parameters are to be investigated. ⋯ This study suggests there is statistically moderate to excellent IRR of the POPS when assessing a variety of clinical presentations between different healthcare professionals with a range of experience.
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The National Early Warning Scores (NEWS) is used in various healthcare settings to augment clinical decision making, and there is growing interest in its application in primary care. This research aimed to determine the distribution of NEWS among patients in UK out-of-hours (OOH) general practice and explore the relationship between NEWS and referral of patients to hospital. ⋯ Patients seen in out-of-hours general practice have low physiological acuity. Those referred to hospital have a slightly higher NEWS overall. NEWS is poorly associated with hospital referral, although the association is stronger for patients seen in at home compared with patients seen in treatment centres. Implementing NEWS-based referral from OOH general practice is likely to increase hospital admissions.