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, higher rates of complications, and increased mortality. METHODS:In an attempt to improve patient flow and reduce time spent in the emergency department for patients requiring admission to the surgical intensive care unit (SICU), the emergency department, trauma service, and SICU collaborated on a guideline. The protocol developed focused on level I trauma-activated patients who were admitted directly from the emergency department to the SICU. We compared the transfer times before the protocol was initiated (January 1, 2016 to December 31, 2016) with the transfer times after initiation (January 1, 2017 to December 31, 2017) using a paired Students' t-test. Other outcome variables analyzed were hospital and intensive care unit (ICU) length of stay, mortality, complication rate, ventilator days, ventilator-free days, ICU-free days, and injury severity score (ISS). RESULTS:The average time to transfer for 2016 was 408.05 minutes (standard deviation 362.76) versus 142.73 minutes (standard deviation 101.90) for 2017. Emergency nurses saved 265.32 minutes per patient, totaling 8,755.56 minutes saved overall. Total amount of nursing hours saved was 146 hours. This was significant at P = 0.0015. No other variables analyzed were significant. CONCLUSION:We reduced the time to transfer from the emergency department to the SICU significantly by implementing a new protocol to expedite this transfer among level I trauma activations. Our protocol shows that a collaborative effort between the main emergency department and SICU can result in expedited care for injured and critically ill patients that not only increases care for the ill but also creates valuable space in a busy emergency department for better patient flow.
journal_name
J Emerg Nursjournal_title
Journal of emergency nursingauthors
Stankiewicz S,Larsen C,Sullivan F,Zullo C,Pugh SC,Kopp Mdoi
10.1016/j.jen.2018.10.006subject
Has Abstractpub_date
2019-03-01 00:00:00pages
144-148issue
2eissn
0099-1767issn
1527-2966pii
S0099-1767(18)30335-0journal_volume
45pub_type
杂志文章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: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
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
doi:10.1016/j.jen.2006.12.003
更新日期:2007-02-01 00:00:00
abstract:INTRODUCTION:Family violence is common with significant long-term negative health effects. Health professionals are recognised as key providers of family violence intervention. In 2002, the Hawke's Bay District Health Board launched a Family Violence Intervention Programme in its emergency department. The intervention ...
journal_title:Journal of emergency nursing
pub_type: 杂志文章
doi:10.1016/j.jen.2008.05.004
更新日期:2009-04-01 00:00:00
abstract:INTRODUCTION:The primary purpose of this study was to assess relationships between opioid prescribing practices, patient and ED attributes, and patient satisfaction ratings of nursing and physician care among patients with high utilization of the emergency department for pain relief. METHODS:A retrospective cohort stu...
journal_title:Journal of emergency nursing
pub_type: 杂志文章
doi:10.1016/j.jen.2017.03.022
更新日期:2017-11-01 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:New Zealand has an ethnically diverse population and continues to host immigrants from different countries. The present study aimed to examine the factors associated with ED use among new Asian immigrants in New Zealand. METHODS:A secondary analysis of 2016-2017 New Zealand Health Survey database. Univari...
journal_title:Journal of emergency nursing
pub_type: 杂志文章
doi:10.1016/j.jen.2020.07.011
更新日期:2021-01-01 00:00:00
abstract:INTRODUCTION:There are significant and negative psychological effects that can occur in nursing staff caring for pediatric patients experiencing critical incidents. Debriefings can provide relief from the stressors caused by critical incidents. Adapting a pre-existing critical incident stress debriefing (CISD) process ...
journal_title:Journal of emergency nursing
pub_type: 杂志文章
doi:10.1016/j.jen.2018.11.009
更新日期:2019-07-01 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:INTRODUCTION:This research was designed to examine if there is a difference in nurse attitudes and experience for those who assign Emergency Severity Index (ESI) scores accurately and those who do not assign ESI scores accurately. Studies that have used ESI scoring discussed the role of experience, but have not specifi...
journal_title:Journal of emergency nursing
pub_type: 杂志文章,多中心研究
doi:10.1016/j.jen.2013.09.009
更新日期:2014-09-01 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: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: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::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::The human body cannot change its preprogramming to meet the demands of working the night shift for a period of years. The effects are devastating to women and have been proven to shorten their life expectancy. Although the human body cannot change to meet society's demands of nighttime employment, society can change i...
journal_title:Journal of emergency nursing
pub_type: 杂志文章
doi:10.1016/s0099-1767(97)90277-4
更新日期:1997-12-01 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:The breath-actuated nebulizer (BAN) and the handheld nebulizer (HHN) are 2 nebulizers used in the ED of Cooper University Hospital. The purpose of this study was to compare the nebulizers to identify which device resulted in a resolution of symptoms with fewer treatments. The primary hypothesis was that ad...
journal_title:Journal of emergency nursing
pub_type: 杂志文章,随机对照试验
doi:10.1016/j.jen.2012.10.006
更新日期:2014-03-01 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::People who are emotionally distraught or mentally ill are rarely predictable. A calm, reassuring, but firm and decisive manner is most effective in dealing with out-of-control patients. Staff members should be careful to never position themselves with a potentially violent or distraught patient between them and the do...
journal_title:Journal of emergency nursing
pub_type: 杂志文章
doi:
更新日期:1991-10-01 00:00:00
abstract::The diagnosis of cancer or its recurrence is often emotionally devastating for patients and those close to them. People may have a great deal of difficulty accepting the diagnosis and may seek others' opinions about the best course of treatment. When a physician projects that there is no hope, or if a cure is no longe...
journal_title:Journal of emergency nursing
pub_type: 杂志文章
doi:
更新日期:1991-02-01 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::Our DMAT pulled together with the energy, flexibility, and adaptability necessary to make things work. Sally Coan expressed it best, saying, "I was with a group of people who would do anything [that was] needed." Dedication and trust within the DMAT helped create lasting friendships. The islanders were appreciative an...
journal_title:Journal of emergency nursing
pub_type: 杂志文章
doi:
更新日期:1991-06-01 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: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::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:Nurses, by the nature of their practice, are in a unique position to help patients complete advance directives (ADs). This article focuses on an open-ended question that was part of a larger quantitative survey, "What do emergency nurses need to increase their ability to assist patients with ADs?" METHODS...
journal_title:Journal of emergency nursing
pub_type: 杂志文章
doi:10.1016/j.jen.2005.02.001
更新日期:2005-04-01 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::Agitated patients may come to the emergency department because of flares of a psychiatric illness, drug withdrawal, or reaction to a medical condition or trauma. Pharmacologic agents such as lorazepam may offer benefits to these patients, regardless of the cause of their symptoms. It is important to be familiar with t...
journal_title:Journal of emergency nursing
pub_type: 杂志文章
doi:
更新日期:1993-10-01 00:00:00
abstract:UNLABELLED:Indwelling urinary catheters (IUCs) are placed frequently in older adults in the emergency department (ED). Though often a critical intervention, IUCs carry significant risks. Our objective was to examine current knowledge, attitudes, and practice of emergency nurses and other providers regarding IUC placeme...
journal_title:Journal of emergency nursing
pub_type: 杂志文章
doi:10.1016/j.jen.2015.02.013
更新日期:2015-09-01 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