Articles: emergency-services.
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Emerg Med (Fremantle) · Mar 2001
Multicenter Study Comparative StudyNTS versus waiting time: an indicator without definition.
The National Triage Scale versus waiting time is a key performance indicator for Australasian emergency departments. However, the point at which the clock starts to measure waiting time has not been defined. The aim of this study was to determine how this indicator is measured in Australia, as well as a number of other issues relating to the application of the National Triage Scale. ⋯ The measurement of this key performance indicator is not consistent across Australia. Therefore, caution is advised when comparing such data between departments. The Australasian College for Emergency Medicine should produce operational definitions relating to the use of the National Triage Scale in order to provide meaningful comparative data.
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Randomized Controlled Trial Multicenter Study Clinical Trial
Prehospital and emergency department delays after acute stroke: the Genentech Stroke Presentation Survey.
Patient delays in seeking treatment for stroke and delays within the Emergency Department (ED) are major factors in the lack of use of thrombolytic therapy for stroke. The Genentech Stroke Presentation Survey was a multicentered prospective registry of patients with acute stroke. The study was designed to characterize prehospital delays and delays within the ED. ⋯ Despite its limitations, this large geographically diverse study strongly suggests that the use of emergency medical services is an important modifiable determinant of delay time for the treatment of acute stroke.
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Social science & medicine · Oct 2000
Multicenter StudyFactors associated with non-urgent utilization of Accident and Emergency services: a case-control study in Hong Kong.
Accident and Emergency Departments (A&E) have been a popular source of primary care, and studies have shown that up to two thirds of patients attending A&E have problems that could be managed by general practitioners (GPs). Although many studies have found that patients of lower socio-economic class with less social support have a higher utilization rate of A&E, some recent studies have revealed contrary evidence. In this study 2410 patients were randomly selected from four A&E at different times. ⋯ The reasons for high level of utilization of A&E services are complex and reflect problems of delivery of GP services. There is an urgent need for GPs to set up a network system to provide out of hours services, and also for a better interfacing between primary and secondary care, and between public and private sectors, so that patients can be referred back to GPs. Interim clinical services provided to those non-urgent cases by nursing practitioners or by GPs working in A&E could also facilitate discharge of patients to primary care facilities.
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Multicenter Study
Seen but not heard: battered women's perceptions of the ED experience.
A plethora of studies describe helping professionals' responses to and actions directed toward battered women in the emergency department. However, research that yields data regarding the clients' perceptions about their actual experiences in the ED setting is sorely needed. The aim of this study was to describe battered women's perceptions of their ED experience. ⋯ The women's narratives explicate their feelings during the ED visit and sensitize nurses to their experience. The reports of dissatisfaction with the care they received in the emergency department add to the validity of findings from previous studies that have documented similar results and point to the need to examine and reshape the delivery of care to abused women in the emergency department.
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Multicenter Study
Emergency department discharge of patients with a negative cranial computed tomography scan after minimal head injury.
To determine the negative predictive value of cranial computed tomography (CT) scanning in a prospective series of patients and whether hospital admission for observation is mandatory after a negative diagnostic evaluation after minimal head injury (MHI). ⋯ Patients with a cranial CT scan, obtained on a helical CT scanner, that shows no intracerebral injury and who do not have other body system injuries or a persistence of any neurologic finding can be safely discharged from the emergency department without a period of either inpatient or outpatient observation. Implementation of this practice could result in a potential decrease of more than 500,000 hospital admissions annually.