Articles: emergency-services.
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Health services research · Dec 2002
Multicenter StudyError reduction and performance improvement in the emergency department through formal teamwork training: evaluation results of the MedTeams project.
To evaluate the effectiveness of training and institutionalizing teamwork behaviors, drawn from aviation crew resource management (CRM) programs, on emergency department (ED) staff organized into caregiver teams. ⋯ Our findings point to the effectiveness of formal teamwork training for improving team behaviors, reducing errors, and improving staff attitudes among the ETCC-trained hospitals.
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Multicenter Study
Prevalence of atrial fibrillation and antithrombotic prophylaxis in emergency department patients.
The emergency department (ED), as the point of first medical contact for many complaints referable to atrial fibrillation (AF) and a common source of primary care, occupies a unique position to identify AF patients at risk of stroke. This study evaluates that potential by determining the prevalence of AF in an ED population and assessing antithrombotic use in those patients with recurrent AF. ⋯ AF is a common finding in an ED population. Many are warfarin eligible and untreated or undertreated. Methods to increase anticoagulant use in this at-risk population warrant further investigation.
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Multicenter Study
Validity of a decision rule to reduce cervical spine radiography in elderly patients with blunt trauma.
A decision instrument based on 5 clinical criteria has been shown to be highly sensitive in selecting patients who require cervical spine imaging after blunt trauma, while simultaneously reducing overall imaging. We examine the performance of this instrument in the elderly and explore some of the common features of geriatric cervical spine injury (CSI). ⋯ The prevalence of CSI, and especially odontoid fracture, is relatively increased among geriatric patients with blunt trauma. The NEXUS decision instrument can be applied safely to these patients, with an expected reduction in cervical imaging comparable with that achieved in nongeriatric patients.
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Multicenter Study Comparative Study
High technology and nursing: ethical dilemmas nurses and physicians face on high-technology units in Norway.
Results from two studies of ethical dilemmas nurses and doctors experience on two high-technology units are compared and discussed. The qualitative comparative methodology of grounded theory was used to generate theoretical frameworks grounded in the empirical realities of the units. ⋯ Differences between the two study units were patient diagnosis, hierarchical structure on one unit while one had a vertical structure and decision-making processes, and finally how nursing knowledge and autonomy were used. The two studies demonstrated that clinical, ethical and administrative interactions and decisions are highly compounded, stressful and intertwined.
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Multicenter Study
[Activity and epidemiology in an ophthalmological emergency center].
To investigate the numbers and characteristics of patients with ophthalmological emergencies presenting at a general hospital. ⋯ There is a real need for ophthalmic emergency services in general hospitals. Benign pathologies not needing diagnosis and adapted treatment were not noted in our study. The cheapest and most efficient way to diagnose these ophthalmic emergencies appeared to be the ophthalmological emergency center with a senior ophthalmologist, according to the regional health organization.