Abstract：
INTRODUCTION:Evidence suggests that a significant number of patients discharged from the hospital with a diagnosis of ischemic stroke are not identified as having a stroke on admission. Those presenting with "nontraditional" stroke symptoms may be less likely to be diagnosed correctly. We aimed to establish whether there was an association between symptom presentation and diagnostic accuracy and to identify the type and frequency of nontraditional symptoms that resulted in a missed diagnosis in the emergency department. METHODS:We reviewed the medical records of 189 patients discharged with a diagnosis of ischemic stroke from Yale-New Haven Hospital. We performed χ(2) analysis to determine whether an association existed between symptom presentation and diagnostic accuracy. Descriptive statistics allowed us to identify symptom type and frequency in patients with a missed diagnosis. RESULTS:A diagnosis of suspected stroke was missed in 15.3% of patients who presented to the emergency department. We found a strong association (P < 0.0001) between symptom presentation and diagnostic accuracy. Of the patients presenting with any "traditional" symptom, 4% were missed. Of those presenting with only nontraditional symptoms, 64% were missed (odds ratio, 43.4; 95% confidence interval, 15.0-125.4). Nontraditional symptoms included generalized weakness, altered mental status, altered gait, and dizziness. DISCUSSION:In order to facilitate appropriate management of patients with ischemic stroke, emergency nurses must be aware that symptom presentation is highly variable. Patients presenting with nontraditional symptoms may benefit from an immediate and comprehensive neurological evaluation.
journal_name
J Emerg Nursjournal_title
Journal of emergency nursingauthors
Lever NM,Nyström KV,Schindler JL,Halliday J,Wira C 3rd,Funk Mdoi
10.1016/j.jen.2012.02.011subject
Has Abstractpub_date
2013-09-01 00:00:00pages
434-9issue
5eissn
0099-1767issn
1527-2966pii
S0099-1767(12)00074-8journal_volume
39pub_type
杂志文章abstract：OBJECTIVE:The purpose of this study was to assess the need for home health care referral screening for elderly patients after ED discharge. The specific research question addressed was: Is there a need for home care referral screenings for elderly patients discharged from the emergency department? DESIGN:A nonexperime...
journal_title：Journal of emergency nursing
pub_type： 杂志文章
doi：10.1016/s0099-1767(98)90014-9
更新日期：1998-04-01 00:00:00
abstract：:The rise in ED utilization among older adults is a nursing concern, because emergency nurses are uniquely positioned to have a positive impact on the care of older adults. Symptoms have been associated with ED utilization; however, it remains unclear whether symptoms are the primary reason for ED utilization. The purp...
journal_title：Journal of emergency nursing
pub_type： 杂志文章
doi：10.1016/j.jen.2016.10.001
更新日期：2017-01-01 00:00:00
abstract：INTRODUCTION:The objective of this study was to evaluate whether screening, brief intervention, and referral to treatment (SBIRT) could be incorporated into the emergency nursing workflow using a computerized physician order entry/clinical decision support system. We report demographic and operational factors associate...
journal_title：Journal of emergency nursing
pub_type： 杂志文章
doi：10.1016/j.jen.2013.10.007
更新日期：2014-11-01 00:00:00
abstract：:We have saved a minimum of $17,064 in personnel salaries of a patient representative (based on minimum wage and no paid benefits) during the past year. Although our liaison program was initially started as a cost-saving measure, the benefits of the program cannot be measured in monetary terms. Although this venture wa...
journal_title：Journal of emergency nursing
pub_type： 杂志文章
doi：10.1016/s0099-1767(95)80006-9
更新日期：1995-02-01 00:00:00
abstract：BACKGROUND:ED boarding is a major issue in many hospitals. ED boarding occurs when there is insufficient hospital capacity to supply inpatient beds for admitted patients. ED boarding is not only a problem because of increased wait times for patients but also because it results in delays in administration of medication,...
journal_title：Journal of emergency nursing
pub_type： 杂志文章
doi：10.1016/j.jen.2018.10.006
更新日期：2019-03-01 00:00:00
abstract：INTRODUCTION:Contracting the human immunodeficiency virus (HIV) is a genuine concern for sexually assaulted patients. Emergency departments are a place where sexually assaulted patients seek care, including treatment to prevent HIV. Prompt administration of nonoccupational postexposure prophylaxis is essential because ...
journal_title：Journal of emergency nursing
pub_type： 杂志文章
doi：10.1016/j.jen.2017.10.014
更新日期：2018-03-01 00:00:00
abstract：INTRODUCTION:Trauma is a leading cause of death in South Korea. This study aimed to identify the factors associated with secondary traumatic stress of nurses working at regional trauma centers. METHODS:A survey-based cross-sectional design was utilized. Data were collected through a structured questionnaire consisting...
journal_title：Journal of emergency nursing
pub_type： 杂志文章
doi：10.1016/j.jen.2020.08.006
更新日期：2020-11-20 00:00:00
abstract：INTRODUCTION:The purpose of this study was to describe characteristics, insights, and decision making of expert emergency nurses practicing in a triage environment. METHODS:A qualitative, descriptive study design was used. A purposive sample of 10 expert nurses from 2 midwestern emergency departments was recruited for...
journal_title：Journal of emergency nursing
pub_type： 杂志文章
doi：10.1067/men.2002.127513
更新日期：2002-10-01 00:00:00
abstract：INTRODUCTION:Patient experience ratings are important to health care organizations from both a clinical and financial perspective. Studies examining the relationship between patient experience and nurse staffing are prevalent in the inpatient setting, but not as much is known about how staffing affects these ratings in...
journal_title：Journal of emergency nursing
pub_type： 杂志文章
doi：10.1016/j.jen.2018.01.001
更新日期：2018-07-01 00:00:00
abstract：INTRODUCTION:Workplace violence is a significant occupational hazard in health care. As the largest group of employees in health care, nurses are particularly vulnerable to workplace violence, with those who work in emergency departments being especially at risk. The purpose of this research was to study the phenomenon...
journal_title：Journal of emergency nursing
pub_type： 杂志文章,多中心研究
doi：10.1016/j.jen.2005.07.008
更新日期：2005-12-01 00:00:00
abstract：INTRODUCTION:Handoff in the emergency department is considered a high-risk period for medical errors to occur. In response to concerns about the effectiveness of the nursing handoff in the emergency department of a Midwestern trauma center, a practice improvement project was implemented. The process change required nur...
journal_title：Journal of emergency nursing
pub_type： 杂志文章
doi：10.1016/j.jen.2018.09.007
更新日期：2019-03-01 00:00:00
abstract：INTRODUCTION:The objective of this study was to examine the effect of a novel mindfulness-based time-out intervention on state of mindfulness among emergency nurses and, accordingly, on patient satisfaction. METHODS:A pre-post intervention design among nurses in the emergency department was used with a between-subject...
journal_title：Journal of emergency nursing
pub_type： 杂志文章
doi：10.1016/j.jen.2020.09.009
更新日期：2020-11-30 00:00:00
abstract：INTRODUCTION:Prediabetes is an important public health issue. In 2011, 79 million Americans had prediabetes, and 7 million were undiagnosed. By 2025, the number of persons with prediabetes is projected to increase to 472 million globally. For many, the emergency department may be the only source of medical care or inte...
journal_title：Journal of emergency nursing
pub_type： 杂志文章
doi：10.1016/j.jen.2013.02.002
更新日期：2014-07-01 00:00:00
abstract：:HBO is the definitive treatment for carbon monoxide poisoning, air or gas embolism, and decompression sickness. It is an important adjunct to other treatment modalities in the management of patients with cyanide poisoning, exceptional blood loss (anemia), crush injury, and gas gangrene. In addition, HBO has many inves...
journal_title：Journal of emergency nursing
pub_type： 杂志文章
doi：
更新日期：1989-05-01 00:00:00
abstract：:ED volume and acuity were anticipated to increase at an inner-city hospital. A strategy to mitigate the impact was needed. METHODS:A multidisciplinary team facilitated a workflow modification project implementing a Super Track to treat low-acuity patients. A literature review led to the creation of an evidence-based ...
journal_title：Journal of emergency nursing
pub_type： 杂志文章,评审
doi：10.1016/j.jen.2016.03.029
更新日期：2017-03-01 00:00:00
abstract：INTRODUCTION:This study aimed to develop a new model on the basis of the National Early Warning Score to predict intensive care unit admission and the mortality of patients with acute pancreatitis. METHODS:Patients diagnosed with acute pancreatitis in the emergency department were enrolled. The values of the National ...
journal_title：Journal of emergency nursing
pub_type： 杂志文章
doi：10.1016/j.jen.2019.11.003
更新日期：2020-03-01 00:00:00
abstract：INTRODUCTION:As a result of Hurricane Katrina on August 29, 2005, ED nurses were faced with chaos during and after the storm. The purpose of this pilot study was to determine if emergency nurses have experienced signs and symptoms of post-traumatic stress disorder (PTSD) as a result of working in an emergency departmen...
journal_title：Journal of emergency nursing
pub_type： 杂志文章
doi：10.1016/j.jen.2007.01.008
更新日期：2007-08-01 00:00:00
abstract：OBJECTIVE:The primary purpose of this study was to compare the rate of hemolysis in blood samples obtained by an i.v. catheter versus the rate in samples obtained by venipuncture (Vacutainer tubes and needles; Becton Dickinson Vacutainer Systems, Franklin Lakes, N.J.). Subsequently, variance in i.v. catheter diameter w...
journal_title：Journal of emergency nursing
pub_type： 临床试验,杂志文章,随机对照试验
doi：10.1016/s0099-1767(96)80213-3
更新日期：1996-12-01 00:00:00
abstract：INTRODUCTION:ED crowding is a public health crisis, limiting quality and access to lifesaving care. The purpose of this study was to (1) evaluate the feasibility of radio-frequency identification tags to measure clinician-patient contact and (2) to test the relationship between ED occupancy and clinician-patient contac...
journal_title：Journal of emergency nursing
pub_type： 杂志文章
doi：10.1016/j.jen.2018.03.005
更新日期：2018-11-01 00:00:00
abstract：INTRODUCTION:Infection is a frequent complication experienced by many children with cancer, with potentially life-threatening consequences that may result in hospitalization, prolonged length of stay, and increased mortality. The need for prompt assessment and early intervention for infection is widely recognized by ED...
journal_title：Journal of emergency nursing
pub_type： 杂志文章
doi：10.1016/j.jen.2013.01.014
更新日期：2013-05-01 00:00:00
abstract：PROBLEM:A 7.2% increase in patient volume from 130,700 to 140,800 in 2012 prompted St Joseph's Regional Medical Center Emergency Department to review existing triage processes to decrease turnaround time. "Pivot triage" is a new, efficient intake process that entails use of 4 rather than 8 determinants to identify acui...
journal_title：Journal of emergency nursing
pub_type： 杂志文章
doi：10.1016/j.jen.2015.07.014
更新日期：2016-09-01 00:00:00
abstract：UNLABELLED:Caring is a universal phenomenon. However, as a result of higher patient acuity and staff shortages within the chaotic ED environment, caring behaviors may be in peril. The purpose of this study was to gain insight into the meaning of caring from the perspective of emergency nurses. Exploring nurses' perspec...
journal_title：Journal of emergency nursing
pub_type： 杂志文章
doi：10.1016/j.jen.2015.12.003
更新日期：2016-05-01 00:00:00
abstract：INTRODUCTION:This comparative correlational study investigated families who use the emergency department for childhood asthma to identify determinants of follow-up care. The primary hypothesis was: families who obtain follow-up care differ in predisposing, enabling, and need characteristics from families who do not obt...
journal_title：Journal of emergency nursing
pub_type： 杂志文章
doi：10.1016/j.jen.2008.09.008
更新日期：2009-09-01 00:00:00
abstract：INTRODUCTION:Up to 20% of pregnancies end in miscarriage, which can be a significant life event for women with psychological implications. Because the only preventative measure for a miscarriage is risk factor modification, the treatment focuses on confirming the miscarriage has occurred and medical management of sympt...
journal_title：Journal of emergency nursing
pub_type： 杂志文章,多中心研究
doi：10.1016/j.jen.2016.05.011
更新日期：2016-11-01 00:00:00
abstract：:Trauma nurse experts often are included on the professional teams who survey hospitals for trauma center designation. Evaluation of trauma nursing care includes interviews with staff and review of policies, procedures, and other documents. Medical records are reviewed to validate the verbal reports and examine complia...
journal_title：Journal of emergency nursing
pub_type： 杂志文章
doi：
更新日期：1989-09-01 00:00:00
abstract：:Testicular torsion is a surgical emergency and requires prompt recognition and treatment. Health care personnel often forget this differential diagnosis in males who present with abdominal pain as their only complaint. There is a 4- to 6-hour window from the onset of symptoms to the surgical intervention to salvage th...
journal_title：Journal of emergency nursing
pub_type： 杂志文章
doi：10.1016/j.jen.2020.09.006
更新日期：2021-01-01 00:00:00
abstract：UNLABELLED:More than 6 million people present to emergency departments across the United States annually with symptoms of acute myocardial infarction (AMI). Of the 1 million patients with AMI, 350,000 die during the acute phase. Accurate ED triage can reduce mortality and morbidity, yet accuracy rates are low. In this ...
journal_title：Journal of emergency nursing
pub_type： 杂志文章
doi：10.1016/j.jen.2015.12.011
更新日期：2016-07-01 00:00:00
abstract：:This clinical policy focuses on critical issues concerning the management of adult patients presenting to the emergency department (ED) with acute symptomatic carbon monoxide (CO) poisoning. The subcommittee reviewed the medical literature relevant to the questions posed. The critical questions are: Should hyperbaric ...
journal_title：Journal of emergency nursing
pub_type： 杂志文章
doi：10.1016/j.jen.2008.02.009
更新日期：2008-04-01 00:00:00
abstract：:Teddy bear/doll clinics continue to offer a feasible, effective opportunity to reach the community's children and their health information needs. Many thanks to Sunny B. Lee, RN, BS (Swedish Covenant Hospital, Chicago), and Kathy Powell, RN, PhD, and Barb Pierce, RN, MS (Children's Hospital, Birmingham). ...
journal_title：Journal of emergency nursing
pub_type： 杂志文章
doi：10.1016/s0099-1767(97)90060-x
更新日期：1997-02-01 00:00:00
abstract：OBJECTIVE:To determine what effect nurses' experience of interpersonal violence had on proposed nursing care of battered women ED patients. METHODS:One hundred ninety-five emergency nurses completed surveys on their personal experiences with violence involving patients or intimate partners and on their proposed nursin...
journal_title：Journal of emergency nursing
pub_type： 杂志文章
doi：10.1067/men.2002.124991
更新日期：2002-06-01 00:00:00
