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 associated with failure to initiate the protocol and revenue collection from SBIRT. METHODS:We conducted a retrospective, observational cohort analysis of a protocol adding SBIRT to the emergency nursing workflow of a single, tertiary care urban emergency department for all adult patient visits in 2012. Emergency nurses prescreened for unhealthy alcohol or drug use during triage assessment and, when positive, administered SBIRT during treatment area care, all documented in the computerized physician order entry/clinical decision support system. Using multivariable logistic regression, we report demographic and operational factors associated with failure to initiate the protocol. From October 2012, we submitted charges for brief interventions and analyzed collection results. RESULTS:The inclusion criteria were met for 47,693 visits. Of these, 39,758 (83.4%) received triage protocol initiation. Variables associated with decreased odds of protocol initiation were younger age (odds ratio [OR] for rising age, 1.044; 95% confidence interval [CI], 1.042-1.045), arrival by ambulance (OR, 0.37; 95% CI, 0.35-0.40), and higher triage acuity (OR, 0.08; 95% CI, 0.07-0.09). Of visits with protocol initiation, 21.4% were documented as positive for at-risk alcohol and/or drug use. However, brief interventions were only administered during 971 visits. During the billing period, $3617.53 was collected on charges of $10,829.15 for 262 completed brief interventions. DISCUSSION:In this study electronic documentation of adults with at-risk alcohol and/or drug use was feasible by emergency nurses, but SBIRT execution and subsequent revenue collection were challenging.
journal_name
J Emerg Nursjournal_title
Journal of emergency nursingauthors
Slain T,Rickard-Aasen S,Pringle JL,Hegde GG,Shang J,Johnjulio W,Venkat Adoi
10.1016/j.jen.2013.10.007subject
Has Abstractpub_date
2014-11-01 00:00:00pages
568-74issue
6eissn
0099-1767issn
1527-2966pii
S0099-1767(13)00489-3journal_volume
40pub_type
杂志文章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:Emergency nurses routinely treat a wide variety of animal-related injuries, yet the trauma literature rarely addresses injuries associated with livestock. METHODS:The purpose of this retrospective, descriptive study was to examine the incidence, demographics, severity, and other factors associated with tr...
journal_title:Journal of emergency nursing
pub_type: 杂志文章
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更新日期:2001-04-01 00:00:00
abstract::TAC and half-strength TAC appear to be highly effective and convenient local anesthetic agents that offer an advantage over injected lidocaine in acceptance by children. The use of TAC is not without risk (cocaine toxicity, theft, and abuse). The decision of whether to use TAC is usually made by the physicians in the ...
journal_title:Journal of emergency nursing
pub_type: 杂志文章
doi:
更新日期:1994-06-01 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::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::The illicit manufacturing and use of methamphetamine continues to be a significant and growing problem in the United States. Children are often found in homes where this activity is occurring and are affected by it on many levels. This article will provide background information on the manufacturing of methamphetamine...
journal_title:Journal of emergency nursing
pub_type: 杂志文章,评审
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更新日期:2007-02-01 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
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更新日期:1996-12-01 00:00:00
abstract:INTRODUCTION:This quality-improvement project aimed to evaluate the effectiveness of implementing multidisciplinary education and deploying utilization tools aimed at reducing the inappropriate insertion of indwelling urinary catheters (IUCs) in the emergency department. Literature supports the use of decision support ...
journal_title:Journal of emergency nursing
pub_type: 杂志文章
doi:10.1016/j.jen.2012.07.022
更新日期:2014-05-01 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:INTRODUCTION:Abuse experiences can have negative health consequences for women. Many women present to the emergency department for episodic, nonemergent care and may have unique needs as survivors of abuse. The purpose of this study was to describe child sexual abuse experiences, intimate partner violence, substance us...
journal_title:Journal of emergency nursing
pub_type: 杂志文章
doi:10.1016/j.jen.2011.09.011
更新日期:2013-07-01 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::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:INTRODUCTION:The Centers for Disease Control and Prevention (CDC) reports 136.9 million ED visits in 2015, of which 21.4 million (15.6%) were by patients who were 65 or older. This US population demographic is expected to grow by 112% over the next 40 years, becoming just below 25% of the total US population. Emergency...
journal_title:Journal of emergency nursing
pub_type: 杂志文章
doi:10.1016/j.jen.2019.02.004
更新日期:2019-07-01 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: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::The care of the psychiatric patient in the emergency department offers yet another opportunity for emergency nurses to draw on specialty nursing resources or to create expanded roles for emergency practitioners themselves. As our emergency departments continue to encounter increasing numbers of patients, the need for ...
journal_title:Journal of emergency nursing
pub_type: 杂志文章
doi:
更新日期:1992-12-01 00:00:00
abstract::Herbal therapies are very safe, and side effects are uncommon. Side effects requiring ED treatment are rare and would most likely involve an allergic reaction or toxic effect from improper administration of the herb. However, a working knowledge of possible side effects of herbal therapies can be helpful in those rare...
journal_title:Journal of emergency nursing
pub_type: 杂志文章,评审
doi:10.1016/s0099-1767(98)70037-6
更新日期:1998-12-01 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: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: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::This descriptive study was conducted among 130 families in Milas, Turkey, who have children ages 0 to 14 years. Among the 130 families, a total of 53 children (40.8%) experienced a burn event. Twenty-seven subjects (51%) had treated the burn with inappropriate remedies including yogurt, toothpaste, tomato paste, ice, ...
journal_title:Journal of emergency nursing
pub_type: 杂志文章
doi:10.1016/j.jen.2009.12.018
更新日期:2010-03-01 00:00:00
abstract::The National Institutes of Health Stroke Scale (NIHSS) is commonly used in Comprehensive Stroke Centers, but it has not been easily implemented in smaller centers. The aim of this study was to assess whether nurse providers who were naive to stroke assessment scales could obtain accurate stroke severity scores using o...
journal_title:Journal of emergency nursing
pub_type: 杂志文章
doi:10.1016/j.jen.2016.09.002
更新日期:2017-05-01 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: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:INTRODUCTION:Today the proportion of acute patients entering the health care system through emergency departments continues to grow, the number of uninsured patients relying primarily on treatment in the emergency department is increasing, and patients' average acuities are rising. At the same time, support resources a...
journal_title:Journal of emergency nursing
pub_type: 杂志文章
doi:10.1016/j.jen.2009.11.027
更新日期:2010-09-01 00:00:00
abstract::Hydrofluoric acid is a caustic compound found in a wide variety of items for household and industrial uses. Dermal exposures can be visually unimpressive on presentation but still have fatal complications. This case review includes a description of a patient presenting with a dermal hydrofluoric acid burn that was eff...
journal_title:Journal of emergency nursing
pub_type: 杂志文章
doi:10.1016/j.jen.2020.08.005
更新日期:2021-01-01 00:00:00
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 the...
journal_title:Journal of emergency nursing
pub_type: 杂志文章
doi:10.1016/j.jen.2012.02.011
更新日期:2013-09-01 00:00:00
abstract:PROBLEM:Nursing burnout and high levels of nursing turnover contribute to negative work environments, diminished patient care, and increased health care costs. There is a gap in literature regarding cost-effective, easily implemented interventions to address burnout and turnover. The purpose of this project was to dete...
journal_title:Journal of emergency nursing
pub_type: 杂志文章
doi:10.1016/j.jen.2019.03.004
更新日期:2019-07-01 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:Geriatric trauma, mainly as a result of motor vehicle crashes (MVCs), has been a persistent and serious problem for those older than 65 years of age. Because of physiological changes and pre-existing disease, older adults present a unique clinical challenge to emergency nurses and staff. "Are older adults ...
journal_title:Journal of emergency nursing
pub_type: 杂志文章,评审
doi:10.1016/j.jen.2009.06.008
更新日期:2010-01-01 00:00:00