RESUMO
BACKGROUND: Nursing work in the Eye, Ear, Nose, and Throat (EENT) emergency department is highly specialised and faces significant challenges. Therefore, a high level of nursing competence is necessary for nurses. To develop core competencies, a systematic and standardised training program is required. This study aims to construct a standardised, systematic, and professional training program for nurses working in the EENT emergency department in China. METHODS: Based on a literature review and semi-structured interviews, the training scheme draft was developed according to the theoretical framework of core competency for emergency nurses. From July 2023 to October 2023, a total of 21 experts including clinical experts, and nursing experts were selected to conduct 2 rounds of Delphi consultation to construct the training program for EENT emergency nurses. RESULTS: The effective response rate for 2 rounds of expert consultation was 100%. The expert authority coefficient was 0.905, and Kendall's W coefficients were found to be 0.359 and 0.340, respectively. The coefficients of variation for each item of the second round of expert consultation ranged from 0 to 0.19. The finalised training program for EENT emergency nurses consisted of 4 first-level indexes (training objectives, training management, training contents, and training assessment). The training objectives included 3 secondary indicators and 16 tertiary indicators. Training management included 5 secondary indicators and 8 tertiary indicators. Training contents included 4 secondary indicators and 16 tertiary indicators. Training assessment included 3 secondary indicators and 6 tertiary indicators. CONCLUSION: This study systematically and comprehensively explores the cultivation of nurses working in the EENT emergency department from the aspects of training objectives, training management, training contents, and training assessment. This training program is based on the theoretical framework of core competency standards for emergency nurses. It is in line with the actual needs of the clinic, and the training program is scientific and reliable, which can be promoted nationwide to provide a reference basis for the improvement of the training of emergency specialist nurses. TRIAL REGISTRATION: Not applicable.
Assuntos
Competência Clínica , Técnica Delphi , Enfermagem em Emergência , Humanos , China , Enfermagem em Emergência/educação , Feminino , Masculino , Serviço Hospitalar de Emergência/normas , Adulto , Desenvolvimento de ProgramasRESUMO
INTRODUCTION: Emergency department discharge education is intended to provide patients with information to self-manage their condition or injury, identify potential complications, and follow-up or referral. However, most patients cannot recall the discharge information provided, leading to adverse clinical outcomes, return visits, and higher costs. A scoping review was undertaken to explore discharge education interventions that have been studied in the emergency department setting and outcomes that have been used to evaluate the effectiveness of the interventions. METHODS: A literature review was conducted using the databases PubMed/Medline, Cumulative Index to Nursing and Allied Health Literature, and Education Resources Information Center, with search terms focused on emergency nursing and patient discharge education interventions. RESULTS: Of the publications identified, 18 studies met the inclusion criteria. There was variation among studies on the conditions/injuries and populations of focus for the intervention. The interventions were categorized by learning styles, including auditory (n=10), kinesthetic (n=1), visual (n=15), reading/writing (n=1), and multimodal (n=7). Outcomes evaluated included those that were patient-specific (education, self-management, clinical, and adherence) and metrics of the health system and public health. DISCUSSION: Multimodal discharge education that addresses various learning styles and levels of health literacy improved patient education, self-management, and clinical outcomes. Additional support and reminders improved patient adherence. Identified gaps included limited kinesthetic interventions and culturally tailored education. Translational science for advancing sustainable interventions in clinical practice is needed to enhance the emergency department discharge process and patient, system, and public health outcomes.
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Enfermagem em Emergência , Serviço Hospitalar de Emergência , Alta do Paciente , Educação de Pacientes como Assunto , Humanos , Educação de Pacientes como Assunto/métodos , Enfermagem em Emergência/educação , Letramento em SaúdeRESUMO
INTRODUCTION: The aim of this study was to assess the impact of the national government initiative Emergency Severity Index version 4.0 validated triage training on triage practitioners' knowledge and accuracy. METHODS: This pre/post intervention study evaluated the knowledge of triage practitioners, who constituted 30% of employees trained by the national program, in 74 emergency departments across Poland in 2020. Statistical analysis was used to evaluate the impact of the triage training. RESULTS: No significant differences in triage knowledge were found based on experience, length of ED service, or previous training. Training resulted in increased accuracy (61.3% vs 81.1%) and decreased overtriage and undertriage. Participants significantly reduced errors and improved Emergency Severity Index guideline-based case evaluations, especially for Emergency Severity Index 1-3 cases, with the most notable improvements observed among those without prior triage experience. The training significantly improved interrater reliability. DISCUSSION: The Emergency Severity Index pilot training demonstrated a significant improvement in the accuracy of triage practitioners. Emergency Severity Index level 4 has been identified as a challenging area to learn, as well as yielding promising results in the acquisition of knowledge across levels 1 and 2, among less experienced practitioners.
Assuntos
Competência Clínica , Enfermagem em Emergência , Serviço Hospitalar de Emergência , Triagem , Humanos , Triagem/métodos , Enfermagem em Emergência/educação , Enfermagem em Emergência/métodos , Competência Clínica/estatística & dados numéricos , Polônia , Feminino , Masculino , Índice de Gravidade de Doença , Adulto , Pessoa de Meia-IdadeRESUMO
INTRODUCTION: Charge nurses are shift leaders whose role includes managing nursing resources and facilitating appropriate patient care; in emergency departments, the charge nurse role requires both clinical and leadership skills to facilitate the flow of patients, while ensuring patient and staff safety. Literature on orientation and specific training is notably sparse. This study aimed to evaluate the content and process of core competency training and identify evaluation and implementation strategies necessary to improve charge nurse performance in United States emergency departments. METHODS: A modified Delphi technique was used in phase 1 and a qualitative content analysis method was used in phase 2 to address specific aims of the study. RESULTS: In total, 427 emergency nurse managers, directors, educators, and charge nurses responded to the initial survey to identify elements, teaching modalities, and evaluative processes; 22 participated in 1 of 2 focus groups to provide further information about the pedagogical approaches to teaching emergency charge nurse competencies. The top 5 competencies were identified as patient flow management, communication, situational awareness, clinical decision making, and nurse-patient assignment, with understanding that each competency overlapped significantly with the others. Low-fidelity simulation and gamification were identified as a preferred method of both training and evaluation. DISCUSSION: These findings have the potential to support a standardized approach to emergency charge nurse training and evaluation focusing on communication skills, clinical decision making, and situational awareness to facilitate safe and effective nurse-patient assignment and emergency department throughput.
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Competência Clínica , Técnica Delphi , Enfermagem em Emergência , Serviço Hospitalar de Emergência , Humanos , Enfermagem em Emergência/educação , Estados Unidos , Inquéritos e Questionários , Supervisão de Enfermagem , Grupos FocaisRESUMO
INTRODUCTION: Treatment for patients with cancer in the emergency department ranges from treating life-threatening emergencies to symptom management or issues unrelated to their cancer, but for which cancer and its treatment may be complicating factors. Nurses are expected to manage the care of this population and be aware of risk factors for complications that may be unique to cancer patients. To date, education for emergency nurses regarding oncologic emergencies and the care for patients with cancer has been limited. METHODS: We conducted a cross-sectional needs assessment to establish emergency nurses' educational needs (knowledge, skills, and attitudes) related to the care of patients with cancer and to evaluate if there are different educational needs for emergency nurses associated with the care of the cancer patient by practice setting type. RESULTS: Of 237 nurses surveyed, only 28% of nurse respondents indicated receiving any cancer-specific education or training. Overall, scores on a knowledge assessment were relatively low (mean 53%; range 9.5-85.7%; SD 13%). Nurses reported variable confidence and skills, with the weakest areas being in the triage of complications and oncologic emergencies, assessment of complications related to cancer treatment, and end-of-life conversations. Nearly all of the respondents (97%) indicated a need for oncologic education for emergency nurses with moderate-high priority in relation to other educational needs. DISCUSSION: Our findings suggest that emergency nurses need a stronger foundation of the knowledge and skills required to care for patients with cancer. Results from this study can inform future curriculum development efforts.
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Competência Clínica , Enfermagem em Emergência , Avaliação das Necessidades , Neoplasias , Enfermagem Oncológica , Humanos , Enfermagem em Emergência/educação , Estudos Transversais , Feminino , Enfermagem Oncológica/educação , Masculino , Neoplasias/enfermagem , Adulto , Pessoa de Meia-Idade , Conhecimentos, Atitudes e Prática em Saúde , Inquéritos e Questionários , Serviço Hospitalar de Emergência , Recursos Humanos de Enfermagem Hospitalar/educaçãoRESUMO
INTRODUCTION: Human trafficking is a heinous crime and violation of human rights affecting between 25 and 27 million adults and children globally each year. Current immigration and refugee policy could exacerbate the human trafficking public health crisis. Health care providers working in emergency department and urgent care settings interact with human trafficking victims and provide life-changing care. Research identifies a significant need for coordinated, consistent, and standardized education on human trafficking. The purpose of this study was to determine the effectiveness of online educational training in human trafficking on the knowledge and self-confidence of registered nurses and nurse practitioners working in the emergency department and urgent care settings in New York. METHODS: An asynchronous, online education module was designed for emergency department and urgent care registered nurses and nurse practitioners to address key components of human trafficking identification, assessment, and treatment. Using a 1-group pretest/posttest design, participants completed an existing published survey tool before and 6 weeks after education. RESULTS: Findings revealed statistically significant improvement (P < .05) in knowledge and confidence regarding components of identifying, assessing, and treating victims of human trafficking. Data demonstrated 63.8% of participants had never received human trafficking training, and 80% reported no history of contact with patients known or suspected of being trafficked. DISCUSSION: Results in this study demonstrate the need for increased standardized education regarding HT for frontline health care workers.
Assuntos
Enfermagem em Emergência , Tráfico de Pessoas , Humanos , Tráfico de Pessoas/prevenção & controle , Enfermagem em Emergência/educação , Adulto , Masculino , Feminino , Serviço Hospitalar de Emergência , New York , Profissionais de Enfermagem/educação , Pessoa de Meia-Idade , Educação a Distância/métodos , Inquéritos e QuestionáriosRESUMO
INTRODUCTION: Following the COVID-19 pandemic, a community emergency department was facing a staffing crisis with new emergency registered nurse turnover rates as high as 83.3%. There were limited experienced emergency nurses available to train the large number of novice nurses hired to fill vacancies. Based on this, the emergency department needed to restructure the orientation process to better align with evidence-based strategies and available resources. METHODS: The Seven Steps of Evidenced-based Practice were used to identify the best practices for an orientation program specific to the emergency department. Based on the evidence, a 16-week, competency-based, emergency nurse internship was implemented in the 33-bed community emergency department. RESULTS: The primary outcome of this initiative was new emergency nurse retention, which demonstrated a statistically significant reduction from 81.8% (pre-intervention) to 11.1% (post-intervention) (P < .001). Additionally, there was an improvement in the scores for each of the 6 healthy work environment standards. DISCUSSION: Based on the outcomes of this initiative, an emergency nurse internship is an effective method to improve emergency nurse competence and retention, contributing to a healthier work environment.
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COVID-19 , Enfermagem em Emergência , Recursos Humanos de Enfermagem Hospitalar , Reorganização de Recursos Humanos , Feminino , Humanos , Masculino , COVID-19/enfermagem , Enfermagem em Emergência/educação , Serviço Hospitalar de Emergência/estatística & dados numéricos , Internato não Médico , Recursos Humanos de Enfermagem Hospitalar/educação , Reorganização de Recursos Humanos/estatística & dados numéricos , Condições de Trabalho/estatística & dados numéricosRESUMO
AIM: This paper aims to highlight the vital importance of investing in advanced practice nursing (APN) for enhancing emergency care throughout Africa. BACKGROUND: APN's role is increasingly recognized as pivotal in optimizing healthcare, particularly in emergency settings in Africa. It offers improved patient care quality and strengthens the healthcare workforce. SOURCES OF EVIDENCE: Evidence is drawn from successful implementations of APN in various healthcare environments. This includes the development of APN-specific curricula and training, mentorship initiatives, clinical supervision, and defining advanced nursing roles within healthcare organizations. Investing in APNs in emergency care in Africa can lead to improved quality and access to care, cost-effectiveness, enhanced patient outcomes and satisfaction, and opportunities for professional development and career advancement in the healthcare workforce. DISCUSSION: Despite facing barriers in implementation, APN in emergency care presents innovative solutions. Investing in APN can help healthcare entities and policymakers surmount these challenges, providing specialized patient care and improving health outcomes. The discussion emphasizes the benefits such as enhanced access to care, reduced healthcare costs, and improved patient outcomes, alongside bolstering the healthcare workforce. CONCLUSION: The necessity and benefits of investing in APN for emergency care in Africa are clear. It is crucial for improving healthcare delivery and outcomes. IMPLICATIONS FOR NURSING PRACTICE: APN investment leads to a more competent and efficient nursing workforce, capable of addressing complex emergencies and improving patient care. IMPLICATIONS FOR NURSING POLICY AND HEALTH/SOCIAL POLICY: The paper advocates for policies that support APN development and integration into the healthcare system, emphasizing the need for research to assess APN's long-term impact and establish best practices for its implementation in emergency care across Africa.
Assuntos
Prática Avançada de Enfermagem , Papel do Profissional de Enfermagem , Humanos , Prática Avançada de Enfermagem/educação , África , Enfermagem em Emergência/educação , Serviços Médicos de Emergência/organização & administraçãoRESUMO
BACKGROUND: Basic trauma education for emergency department (ED) staff is available, but there are currently no advanced trauma nursing practice standards for ED nurses. OBJECTIVE: The purpose of this study was to identify consensus-based elements of an advanced trauma nursing program for ED nurses. METHODS: We used a modified Delphi process with three rounds of online survey data collection to ensure a large group of geographically diverse experts. Data were collected from February 2023 to May 2023. The sample for Round 1 was recruited from members of the Emergency Nurses Association reporting job titles, including trauma coordinator, trauma nursing core course instructor, and vice president of trauma services (n = 829). Participants in subsequent rounds were drawn from respondents to the initial invitation to participate (n = 131). Members of an emergency nursing research council with clinical and research expertise reviewed the results and provided expert input. RESULTS: An initial sample of 131 experts identified 17 elements that were assigned a median score equivalent to "agree/strongly agree" (i.e., median 4/5 or 5/5) in Round 2 (n = 69). These elements were presented in Round 3 (n = 43) to determine a rank order. Critical thinking/clinical judgment was the overall priority, followed by assessment/reassessment and early recognition of trauma. CONCLUSIONS: Emergency department trauma care experts identified priority content for advanced trauma education. Heterogeneity in the final ranking of components for this advanced trauma course, specifically differences by facility, regional, or demographic characteristics, suggests that training and education may not conform to a one-size-fits-all model.
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Técnica Delphi , Enfermagem em Emergência , Enfermagem em Ortopedia e Traumatologia , Humanos , Enfermagem em Emergência/educação , Feminino , Masculino , Enfermagem em Ortopedia e Traumatologia/educação , Inquéritos e Questionários , Adulto , Currículo , Competência Clínica , Pessoa de Meia-IdadeRESUMO
INTRODUCTION: Emergency department (ED) nurses and emergency medical technicians (EMTs) find themselves performing triage under time pressure and with limited information. Identifying an effective triage decision-making process can play a significant role in promoting patient safety. Experts are able to make faster and more effective decisions in emergencies than novices. OBJECTIVE: The current study aimed to identify the level of triage decision-making (TDM) and its' predictors in ED nurses and EMTs based on self-reported levels of nursing proficiency in Benner's theory from novice to expert. MATERIALS AND METHODS: Out of 821 ED nurses and EMTs who met the inclusion criteria, 320 ED nurses and 152 EMTs were included in this descriptive-analytical research. Data were collected by a demographic information form and triage decision-making inventory (TDMI) and analyzed by SPSSv.22 software using descriptive statistics, Pearson correlation test, t-test, ANOVA, and multiple linear regression. RESULTS: The total score of TDMI in the ED nurses and EMTs was higher in the expert nurses than in the proficient, competent, advanced beginner and novices. Multiple linear regression analysis showed that self-reported levels of nursing proficiency, age, work experience, marital status and triage training course were predictors of TDM in ED nurses (P < .05), and self-reported levels of nursing proficiency, service location, work experience, and triage training course were predictors of TDM in EMTs (P < .05). CONCLUSION: Understanding the predictors influencing TDM health professionals may facilitate the understanding of their training needs. The training needs of a novice and inexperienced person may be different from those of an expert person, it is recommended that the training methods be based on the experiences and professional levels of nurses so that the training provided is effective and quality. Moreover, to increase the TDM power and reduce TDM errors due to lack of experience, a system is suggested to be established to allow novice nurses in the first year to work with experienced nurses. Also it is suggested that the determining educational and training focus with regards to triage before entering the bedside be done based on predictors.
Assuntos
Auxiliares de Emergência , Enfermagem em Emergência , Humanos , Triagem/métodos , Enfermagem em Emergência/educação , Enfermagem em Emergência/métodos , Irã (Geográfico) , Tomada de Decisões , Serviço Hospitalar de EmergênciaRESUMO
The need for virtual education for nursing staff has dramatically increased because of social distancing measures after the coronavirus disease pandemic. Emergency departments in particular need to educate staff on caring for patients with coronavirus disease while concurrently continuing to ensure education related to core topic areas such as pediatric assessment and stabilization. Unfortunately, many nurse educators are currently unable to provide traditional in-person education and training to their nursing staff. Our inter-professional team aimed to address this through the rapid development and implementation of an emergency nursing telesimulation curriculum. This curriculum focused on the nursing assessment and initial stabilization of a child presenting to the emergency department in status epilepticus. This article describes the rapid development and implementation of a pediatric emergency nursing telesimulation. Our objectives in this article are (1) to describe the rapid creation of this curriculum using Kern's framework, (2) to describe the implementation of a fully online simulation-based pediatric emergency training intervention for nurse learners, and (3) to report learners' satisfaction with and feedback on this intervention.
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Enfermagem em Emergência/educação , Enfermeiras e Enfermeiros , Treinamento por Simulação , Telemedicina , Criança , Currículo , Serviço Hospitalar de Emergência , Humanos , Enfermagem PediátricaRESUMO
INTRODUCTION: Electrocardiogram interpretation is an essential skill for emergency and critical care nurses and physicians. There remains a gap in standardized curricula and evaluation strategies used to achieve and assess competence in electrocardiogram interpretation. The purpose of this study was to develop an importance ranking of the 120 American Heart Association electrocardiogram diagnostic labels with interdisciplinary perspectives to inform curriculum development. METHODS: Data for this mixed methods study were collected through focus groups and individual semi-structured interviews. A card sort was used to assign relative importance scores to all 120 American Heart Association electrocardiogram diagnostic labels. Thematic analysis was used for qualitative data on participants' rationale for the rankings. RESULTS: The 18 participants included 6 emergency and critical care registered nurses, 5 cardiologists, and 7 emergency medicine physicians. The 5 diagnoses chosen as the most important by all disciplines were ventricular tachycardia, ventricular fibrillation, atrial fibrillation, complete heart block, and normal electrocardiogram. The "top 20" diagnoses by each discipline were also reported. Qualitative thematic content analysis revealed that participants from all 3 disciplines identified skill in electrocardiogram interpretation as clinically imperative and acknowledged the importance of recognizing normal, life threatening, and time-sensitive electrocardiogram rhythms. Additional qualitative themes, identified by individual disciplines, were reported. DISCUSSION: This mixed-methods approach provided valuable interdisciplinary perspectives concerning electrocardiogram curriculum case selection and prioritization. Study findings can provide a foundation for emergency and critical care educators to create local ECG educational programs. Further work is recommended to validate the list amongst a larger population of emergency and critical care frontline nurses and physicians.
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Cardiologia/educação , Eletrocardiografia/classificação , Medicina de Emergência/educação , Enfermagem em Emergência/educação , Competência Clínica , Currículo , Grupos Focais , HumanosRESUMO
The emergency department is a care environment in which indwelling urinary catheters are placed frequently; however, the significance of the role of the emergency department in catheter-associated urinary tract infection prevention has been overlooked. The use of an external female urinary catheter is an alternative to placing an indwelling urinary catheter for female patients in the emergency department who are incontinent of urine or are immobile. The purpose was to describe the implementation of an initiative to decrease the number of indwelling urinary catheters and increase the use of external urinary female catheters in non-critically ill women who visited the emergency department at a 451-bed Magnet-designated community hospital in the Southeast. For this clinical implementation project, the Plan, Do, Check, Act framework was used to develop the initiative, and outcome data were collected retrospectively and included an indirect calculation of the number of indwelling urinary catheters placed in the emergency department. A total of 187 external catheters were used in place of indwelling catheters in female patients over a 3-month period. No skin irritation or breakdown was observed. This project demonstrated the initial staff acceptability and feasibility of external female urinary catheter use in the ED setting.
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Enfermagem em Emergência/educação , Serviço Hospitalar de Emergência , Cateterismo Urinário/enfermagem , Cateteres Urinários , Pessoal Técnico de Saúde/educação , Infecções Relacionadas a Cateter/prevenção & controle , Infecção Hospitalar/prevenção & controle , Desenho de Equipamento , Feminino , HumanosRESUMO
Nurse educators are confronted with ensuring skills competency and staff compliance to support the provision of safe and quality care. The ED setting presents additional challenges when conducting skills competency training. One military hospital's emergency department implemented a method of frequent, concise skills training sessions to overcome barriers unique to the ED setting; the same method was then implemented at a second military organization owing to the effectiveness of the training approach to increase staff compliance. This article outlines the methods for the implementation of frequent, concise skills training sessions, and it displays the cost savings and increased compliance experienced by the 2 health care organizations after the implementation of this frequent, concise skills training method.
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Competência Clínica , Redução de Custos , Enfermagem em Emergência/educação , Serviço Hospitalar de Emergência/economia , Hospitais Militares/economia , Capacitação em Serviço/economia , HumanosRESUMO
BACKGROUND: The management of acute gastrointestinal hemorrhage (GIH) is focused on early resuscitation through 2 large-bore intravenous (2LBIV) catheters, although adherence to this recommendation is low. LOCAL PROBLEM: Of 100 patients hospitalized with GIH in 2017, only 14 received 2LBIV access. The goal of this study was to improve this measure. METHODS: A multidisciplinary team used the DMAIC (define, measure, analyze, improve, and control) framework to perform a quality improvement initiative. INTERVENTIONS: The team used quality tools including a stakeholder survey, swimlane diagram, and fishbone diagram. The first intervention involved education of the hospitalists directing admissions, and the second intervention involved education of emergency department (ED) physicians and nurses regarding the importance of 2LBIV placement. RESULTS: Following the second intervention, there was a substantial increase in 2LBIV placement to 37 of 86 (43%). CONCLUSIONS: Carefully directed education of ED physicians and nurses with monthly feedback was effective in improving appropriate intravenous placement in patients with GIH.
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Administração Intravenosa , Catéteres , Enfermagem em Emergência/educação , Hemorragia Gastrointestinal/terapia , Medicina Interna/educação , Médicos , Melhoria de Qualidade/organização & administração , Centros Médicos Acadêmicos , Doença Aguda/terapia , Idoso , Serviço Hospitalar de Emergência/organização & administração , Feminino , Humanos , Masculino , Guias de Prática Clínica como Assunto/normas , Estudos RetrospectivosRESUMO
BACKGROUND: Early recognition of sepsis in the emergency room (ER) has been shown to improve treatment intervention times and decrease mortality. LOCAL PROBLEM: Failure to recognize early signs and symptoms of sepsis in the ER has led to poor sepsis bundle completion times. METHODS: A comparison of preintervention and postintervention data was performed to determine whether sepsis bundle implementation times, mortality, and length of stay (LOS) improved. INTERVENTIONS: An ER Nurse Sepsis Identification Tool, leadership buy-in from key stakeholders, and systemic inflammatory response syndrome (SIRS) education were implemented. RESULTS: Postintervention, average bundle compliance time decreased 458 minutes (P < .001), average antibiotic administration time decreased 101 minutes (P < .001), overall sepsis mortality decreased 5.9% (P = .074), and there was no change to LOS. CONCLUSIONS: The implementation of an ER early sepsis identification tool, leadership buy-in, and SIRS education can lead to improved bundle implementation times in the ER.
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Enfermagem em Emergência/educação , Equipe de Respostas Rápidas de Hospitais , Processo de Enfermagem/normas , Pacotes de Assistência ao Paciente/estatística & dados numéricos , Melhoria de Qualidade , Sepse/diagnóstico , Antibacterianos/uso terapêutico , Serviço Hospitalar de Emergência , Fidelidade a Diretrizes , Mortalidade Hospitalar/tendências , Humanos , Programas de Rastreamento , Sepse/mortalidade , Fatores de TempoRESUMO
PURPOSE: To assess the impact of a quality improvement (QI) project to increase nursing staff confidence in responding to neonatal emergencies. DESIGN: Mandatory neonatal emergency in situ scenarios done quarterly. SAMPLE: Bedside NICU nursing staff and the subset of NICU nurses that attend all high-risk deliveries and neonatal emergencies on the obstetrics unit. OUTCOME MEASURES: Confidence levels in responding to neonatal emergencies, demonstrating neonatal resuscitation skills, and communicating effectively during an emergency. RESULTS: Sixty-eight NICU nurses completed the pre- and postintervention surveys. Self-reported confidence levels increased in all areas measured. Overall, the percentage of nursing staff that reported confidence in being able to participate in a neonatal emergency increased from 48 percent to 77 percent.
Assuntos
Reanimação Cardiopulmonar/educação , Emergências/enfermagem , Enfermagem em Emergência/educação , Unidades de Terapia Intensiva Neonatal/organização & administração , Melhoria de Qualidade , Adulto , Competência Clínica , Feminino , Humanos , Recém-Nascido , Masculino , Medição de Risco , Inquéritos e QuestionáriosRESUMO
INTRODUCTION: Emergency nurses are on the frontlines of disaster response. Current research reveals low to moderate levels of disaster preparedness in this population and suggests education as an effective means of increasing preparedness. The purpose of this study was to measure, explore, and increase the preparedness levels among emergency nurses at an acute care community hospital in Southern California. METHODS: This was a single group pre/posttest of an educational intervention. The adapted Emergency Preparedness Information Questionnaire was administered to all emergency nurses at the practice site to assess disaster preparedness levels before and after a 6-month education intervention. The intervention was novel because the education was delivered through existing communication channels of daily shift huddles, regular e-mails, designated whiteboard, and staff meeting presentations. Descriptive statistics, Pearson correlation, and paired t tests were used to analyze the data. RESULTS: Moderate levels of disaster preparedness were reported. The number of years worked in the emergency department had the strongest correlation with perceived preparedness levels, followed by prior disaster education/training. A 16.9-point (23.5%) increase between the respondents' mean pre- and post-Emergency Preparedness Information Questionnaire scores (t(33) = -10.27, P ≤ 0.001) was observed. DISCUSSION: These results suggest that a tailored ED-specific disaster preparedness curriculum, delivered through established clinical communication channels, can effectively increase preparedness levels among nurses with little additional cost. The integration of concise, relevant disaster information can be implemented in any department interested in developing a more confident and prepared workforce.
Assuntos
Planejamento em Desastres , Enfermagem em Emergência/educação , Melhoria de Qualidade , Adulto , California , Currículo , Feminino , Hospitais Comunitários , Humanos , Masculino , Pessoa de Meia-Idade , Inquéritos e QuestionáriosRESUMO
PROBLEM: ED staff lack adequate exposure to critical pediatric patients to develop competence and confidence in resuscitation scenarios. Simulations of various designs have shown success at increasing health care staff performance and self-efficacy. METHODS: We developed a nurse-led, low-fidelity in situ simulation of a pediatric sepsis scenario. The primary goal was to improve staff adherence to resuscitation guidelines, as measured by the Clinical Performance Tool, a set of checklists designed to measure adherence to Pediatric Advanced Life Support algorithms by multidisciplinary teams during simulations. The secondary goal was to improve staff confidence, measured by the Confidence Scale, a 5-item Likert-type scale that can measure any psychomotor skill. RESULTS: A total of 43 RNs participated in 12 simulations over a period of 3 months. Mean Clinical Performance score improved by 74%, from 5.3 to 9.2 (P < 0.001). Mean confidence score for RNs improved by 56%, from 2.48 (standard deviation [SD] 0.83) to 3.88 (SD 0.66) (P < 0.001). Several systems issues were identified and addressed by multidisciplinary teams, such as increasing respiratory therapist response to the emergency department and updating of the Broselow cart. DISCUSSION: In situ low-fidelity simulations led by RNs contributed to significant improvement in adherence to resuscitation guidelines and in staff confidence. The simulation design had minimal impact on staffing and budget and enabled identification and correction of systems issues.
Assuntos
Competência Clínica , Enfermagem em Emergência/métodos , Ressuscitação/economia , Ressuscitação/métodos , Autoeficácia , Treinamento por Simulação/métodos , Enfermagem em Emergência/educação , HumanosRESUMO
Aeromedical prehospital care has seen an increase in the use of point-of-care-ultrasound (POCUS) in recent years. Prior research has focused on abdominal trauma exams by physician or advanced practice providers. In this study, we describe the implementation of an ultrasound curriculum designed for Flight Nurse assessment of pneumothorax and esophageal intubation. The study team conducted three one-hour training sessions over two months. The training curriculum included didactic and hands-on components. We enrolled twelve flight nurses with no prior ultrasound experience. A pre- and post-test was administered consisting of fifteen questions. The median pre-test score was seven correct for an average of 45.0%. After the training session, the median post-test score was fourteen correct for an average of 90.6%. The training intervention resulted in an average improvement in score of 45.6%. While not examining skill acquisition, we are encouraged by the implementation of this curriculum for future ultrasound education in esophageal intubation and pneumothorax.