The triage of psychiatric patients in the hospital emergency department: a comparison between emergency department nurses and psychiatric nurse consultants.

The triage of patients in the hospital emergency department (ED) has developed as an efficient method to determine the level of urgency and provide appropriate care and treatment. The triage process has been found to be less effective for patients presenting with mental health related problems. Triage guidelines specifically tailored for mental health needs have been introduced in the attempt to overcome existing problems, however, the effectiveness of these guidelines has not been extensively tested. This paper presents the findings of a study conducted in a large metropolitan hospital in Melbourne, Australia. All presentations to the ED for psychiatric problems (n = 137) were triaged using the mental health guidelines over a 3-month period. The same presentations were triaged by psychiatric nurse consultants employed in the ED and the results compared. The results indicate a high level of difference in the triage ranking by the two groups of nurses, with emergency nurses tending to classify presentations as more urgent than their psychiatric nurse colleagues. These findings suggest that mental health education for emergency nurses is necessary if the guidelines are to be used effectively and improve outcomes for patients presenting with psychiatric problems.

Socio-cultural factors associated with malaria transmission: a review.

PIP: Poverty creates preconditions for malaria and ways for its spread, thereby making it difficult to control malaria. Individual perceptions of illness, in this case malaria, determine people's response to seeking medical care. For example, in Orissa state, India, tribal peoples do not take treatment for malaria or take part in parasite control because they do not consider mosquito bites to be harmful and consider malaria as a mild disease. Untreated people are potential sources of malaria infection. Research from rural areas in other developing countries show the widespread belief that mosquitoes do not transmit malaria. The bad smell emitted by insecticides keep people from various areas in developing countries from spraying their households. The practice forbidding nonkin males from entering houses where only women assemble (purdah) prevents teams from spraying Muslim households in Sri Lanka. Thus, refusal to allow spraying increases the density of mosquitoes, resulting in an increased frequency of mosquito bites, and spread of malaria. Sleeping habits which contribute to the spread of malaria include not using mosquito nets or any protective device, outdoor sleeping, and children sharing a bed. People should protect themselves from mosquito bites by using bed nets, protective repellents, and screening and site selection for dwellings. A study in the Gambia revealed that, among 3 ethnic groups, Mandinkas children had the lowest prevalence rate because almost everyone used bed nets while 1-6% of people in Fula and Wolof villages did. Further, Mandinka children slept on mattresses and the other children slept on the floor. Research needs to examine whether cultural beliefs and values or poverty prevent some people from not using bed nets or any other protective device.^ieng

Manual handling activities and injuries among nurses: an Australian hospital study.

The aims of this study were to identify patterns of manual handling activities and their associated injuries and consequences among nurses working at a large teaching and referral medical centre in Melbourne, Australia. A self-report 140-item questionnaire was distributed to 523 registered nurses working full time at the medical centre. Of the 269 (51.4%) nurses who completed the questionnaire, 108 (40.1%) retrospectively reported an injury associated with manual handling activity, of which 75.9% (82) comprised back injuries. When all full-time nurses working at the medical centre are considered, the prevalence of all manual handling injuries was 20.6% (n=108) and 15.7% (n=87) for back injuries. About two-thirds (67.6%) of all manual handling injuries were associated with direct patient care activities and another third (32.4%) with non-direct patient care activities. Approximately one-third (34.3%) of all injuries were associated with lifting patients and this activity comprised one half of all causes associated with injuries arising from direct patient care activities. The consequences of injuries were significant. Recommendations for reducing manual handling activities and injuries are made and future research directions are discussed.

Manual handling practices and injuries among ICU nurses.

This paper describes manual handling practices and injuries among Intensive Care Units (ICU) nurses working in a large tertiary referral medical centre in Australia. The objectives of this study were to identify patterns of manual handling activities; the incidence, types of injury and body site injured; and establish the consequences of injuries. The rate of manual handling injuries among ICU nurses was unacceptably high (52.2%), as was back injury (71.4% of all injuries). In order to reduce manual handling injuries, employers should provide lifting assistance devices; design workplaces so as to minimise the need for ICU nurses to twist, bend and/or lift items from the floor; introduce regular equipment maintenance procedures; provide adequate staffing to assist with lifting patients; and implement processes that facilitate more detailed statistics on manual handling activities and outcomes.

Describing what chaplains do in hospitals.

Reports on a research project that describes the unique activities in which chaplains engage as they provide pastoral care and counseling and spiritual direction to patients in a large, acute tertiary referral medical center in Melbourne, Australia. Analyzes 57,704 entries which described what hospital chaplains do when interacting with patients over a period of five and one-half years. Identifies as the core activities "promoting spiritual transcending" (57.6% of all entries), "promoting spiritual intactness" (36.1% of all entries) and "enacting ministry" (6.2% of all entries).

Trends in malaria morbidity and mortality in Sri Lanka.

Trends since 1930 in malaria morbidity and mortality in Sri Lanka were analysed. The Malaria Control Programme, which began in 1945 with DDT spraying, was associated with a 100-fold reduction in morbidity and mortality over the following ten years, and gave way to the Malaria Eradication Programme in 1958. DDT spraying ceased in 1964 and a vivax malaria epidemic in 1968 returned to the island to 1952 morbidity levels, though with little mortality. After the discovery of DDT resistance in 1969, malathion spraying took over in 1973, and USAID-assisted control programme, involving case-detection and treatment, started in 1977. However, morbidity levels comparable to 1952 levels were observed in 1975 and 1986 when falciparum malaria morbidity levels were especially high. Mortality rates since 1960 have however remained lower than at any other previous time.