Articles: emergency-services.
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Arch Pediat Adol Med · Dec 1996
Randomized Controlled Trial Multicenter Study Clinical TrialEffect of emergency department immunizations on immunization rates and subsequent primary care visits.
The Standards for Pediatric Immunization Practices recommend the routine use of emergency department (ED) encounters for screening the immunization status of children and, if indicated, immunizing them. ⋯ This study provides evidence that the immunization of children in this ED was ineffective at raising their immunization rates; primary care attendance was also unaltered. Major obstacles were as follows: (1) an inability to ascertain accurately the immunization status in the ED and (2) a high rate of parental refusal to accept immunizations in the ED. The standards should be modified to de-emphasize the ED as a routine immunization site for children with access to primary care. Efforts and resources should be directed toward strengthening the primary care system and tracking immunization status.
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Multicenter Study
Ambulatory visits to hospital emergency departments. Patterns and reasons for use. 24 Hours in the ED Study Group.
To characterize the reasons ambulatory patients use hospital emergency departments (EDs) for outpatient care and to determine the proportion of ED patients who initially are assessed as having nonurgent conditions, but subsequently are hospitalized. ⋯ Most ambulatory patients seek care in an ED because of worrisome symptoms or nonfinancial barriers to care. Although many ambulatory patients appear to have nonurgent conditions based on triage classification, a small but disturbing percentage of nonurgent patients are hospitalized.
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Multicenter Study
Community-wide emergency department visits by patients suspected of drug-seeking behavior.
To measure community-wide ED use by patients at high risk for drug-seeking behavior. ⋯ Patients identified as being at high risk for drug-seeking behavior have high community-wide ED visit rates. Improving communication between and within hospitals may help identify patients who could benefit from more consistent community-wide care and appropriate treatment for addiction.
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Randomized Controlled Trial Multicenter Study Clinical Trial
Should accident and emergency nurses request radiographs? Results of a multicentre evaluation.
To evaluate whether waiting time in accident and emergency (A&E) departments is shortened when experienced nurses request peripheral limb radiographs before a patient is assessed by a doctor. ⋯ 14 min can be saved by getting the patient to see the nurse first; however, because nurses in three out of four hospitals requested more radiological examinations than doctors, overall only 4 min waiting time was saved when peripheral limb radiographs were requested by nurses. The findings are somewhat against expectations but do identify that specific training and constant monitoring is essential if nurses are to request peripheral limb radiographs, as reflected in hospital C results.
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To determine the correlates of compliance with follow-up appointments and prescription filling after an emergency department visit. ⋯ Not having an appointment made before leaving the ED was an independent correlate of missing follow-up appointments. Lack of insurance and dissatisfaction with discharge instructions were independent correlates of not filling prescriptions.