Artificial Intelligence Technology-Based Medical Information Processing and Emergency First Aid Nursing Management.

This study was aimed at exploring the new management mode of medical information processing and emergency first aid nursing management under the new artificial intelligence technology. This study will use the artificial intelligence algorithm to optimize medical information processing and emergency first aid nursing management process, in order to improve the efficiency of emergency department and first aid efficiency. The successful rescue rates of hemorrhagic shock, coma, dyspnea, and more than three organs injury were 96.7%, 92.5%, 93.7%, and 87.2%, respectively, after the emergency first aid nursing mode was used in the hospital emergency center. The success rates of first aid within three years were compared, which were 91.8%, 93.4%, and 94.2%, respectively, showing an increasing trend year by year. 255 emergency patients in five batches in June and five batches in July were selected as the research objects by convenience sampling method. Among them, 116 cases in June were taken as the experimental group, and 139 cases in July were taken as the control group, which was used to verify the efficiency of the design model in this study. The results showed that the triage time of the two groups was 8.16 ± 2.07 min and 19.21 ± 6.36 min, respectively, and the difference was statistically significant (P < 0.01). The triage coincidence rates were 96.35% and 90.04%, respectively, and the difference was statistically significant (P < 0.05). The research proved that the design of intelligent medical information processing and emergency first aid nursing management research model can effectively improve the triage efficiency of the wounded, assist the efficiency of emergency nursing of medical staff, and improve the survival rate of emergency patients, which is worthy of clinical promotion.

Enfermeiros no atendimento de urgência em presídios: explorando razões do chamado e local da assistência / Enfermeras en atención de urgencia en cárceles: explorando razones de la llamada y local de la asistencia / Nurses in urgent care in prisons: exploring reasons for the call and place of assistance

RESUMO Objetivo: analisar as percepções dos enfermeiros do Serviço de Atendimento Móvel de Urgência (SAMU) em atendimentos realizados em penitenciárias perante as razões das demandas e o local da assistência. Método: trata-se de um estudo exploratório e descritivo de abordagem qualitativa. Realizaram-se entrevistas nos meses de agosto a dezembro de 2017, individuais e audiogravadas, seguindo roteiro semiestruturado com 91 enfermeiros que atuavam no SAMU de cidades do estado da Paraíba, Brasil. Aplicou-se o referencial metodológico da Análise de Conteúdo proposta por Bardin para categorização dos dados obtidos. Resultados: das análises das falas dos participantes emergiu a presença de dificuldades como demandas não pertinentes ao serviço, local inadequado para assistência, falta de privacidade durante os atendimentos e de escolta para transporte quando necessário. Considerações finais: os problemas relatados evidenciam a necessidade do estabelecimento de estratégias para melhorar as condições da assistência potencializando a capacidade de resolutividade do serviço e para problemas que não podem ser resolvidos em uma única visita de profissionais do SAMU no ambiente prisional, que seja garantido a continuidade da assistência em outros serviços articulados a ele e para isso são necessários fortes laços intersetoriais.

RESUMEN Objetivo: analizar las percepciones de los enfermeros del Servicio de Atención Móvil de Urgencia (SAMU) en atenciones realizadas en prisiones ante las razones de las demandas y el lugar de la asistencia. Método: se trata de un estudio exploratorio y descriptivo de enfoque cualitativo. Se realizaron entrevistas en los meses de agosto a diciembre de 2017, individuales y audiograbadas, siguiendo guion semiestructurado con 91 enfermeros que actuaban en el SAMU de ciudades del estado de Paraíba, Brasil. Se aplicó el referencial metodológico del Análisis de Contenido propuesto por Bardin para categorización de los datos obtenidos. Resultados: de los análisis de los relatos de los participantes surgió la presencia de dificultades como demandas no pertinentes al servicio, local inadecuado para asistencia, falta de privacidad durante las atenciones y de escolta para transporte cuando necesario. Consideraciones finales: los problemas relatados evidencian la necesidad de que se establezcan estrategias para mejorar las condiciones de la asistencia, perfeccionando la capacidad de resolución del servicio y para problemas que no pueden ser resueltos en una sola visita de profesionales del SAMU en el ambiente carcelario, que se garantice la continuidad de la asistencia en otros servicios articulados a él y para ello son necesarios fuertes lazos intersectoriales.

ABSTRACT Objective: to analyze the perceptions of nurses from the Mobile Emergency Care Service (SAMU) in care provided in penitentiaries regarding the reasons for the calls and the place where care is provided. Method: this is an exploratory and descriptive study with a qualitative approach. Individual and audio-recorded interviews were carried out from August to December 2017 following a semi-structured script with 91 nurses who worked in the SAMU in cities in the state of Paraíba, Brazil. The methodological framework of Content Analysis proposed by Bardin was applied to categorize the data obtained. Results: the presence of difficulties emerged from the analysis of the speeches of the participants. They included calls for reasons not relevant to the service, inadequate place for assistance, lack of privacy during consultations, and lack of escort for transport when necessary. Final considerations: the reported problems highlight the need to establish strategies to improve the conditions of care provision so as to enhance the service's ability to solve problems that cannot be solved in a single visit by SAMU professionals in the prison environment, which guarantees the continuity of assistance in other services articulated to it, making strong intersectoral links necessary.

Triage practice in emergency departments in tertiary hospitals across China: A multicenter national descriptive survey.

Triage procedure remains at a developing stage in mainland China, and few studies have reported the current status. This study aimed to explore the triage practices presently implemented in emergency departments in mainland China. A descriptive online national survey was administered to nurses with experience in emergency department triage who worked in 64 hospitals in 2019. A total of 361 participants completed the survey. Only 210 nurses (58.2%) used triage systems. Approximately 5% of the participants reported that no nurse was allocated to triage during the evening and night shifts in their emergency departments. Most participants had fewer than 5 years of nursing experience (47%) and emergency nursing experience (58.2%) before fulfilling the triage role. This study shows the variability in triage guidelines as well as the inconsistency between different hospitals in nurses' entry qualifications to triage, in hospital workforce arrangements, and in triage training. These problems underscore the need to unify triage guidelines and to establish reasonable entry qualifications and appropriate workforce arrangements for triage nurses that ensure high triage quality and high levels of patient safety.

Nurses and the Manchester: rearranging the work process and emergency care?

OBJECTIVE: to understand the changing roles of nurses in labor division organization in hospitals from the Manchester Triage System implementation in an emergency hospital. METHODS: this is an ethnographic study that used different production techniques and data analysis. RESULTS: the Manchester Triage System organized flows and places resulting in quality of care and changes in work processes. Conflict relationships related to disagreements in risk stratification were present. FINAL CONSIDERATIONS: the traditional roles of nurses have been transformed, but it cannot be said that there was a structural change in their position in labor division organization in hospitals. The frontiers of autonomy, therefore of increasing the professionalization of nurses, are neither fixed nor stable, expanding or contracting according to the micropolitical changes in the governance of care.

Registered nurses' understandings of emergency medical dispatch center work: A qualitative phenomenographic interview study.

Non-urgent and urgent telephone nursing services are increasing globally, and phenomenographic research has shown that how work is understood may influence work performance. This descriptive study makes a qualitative inductive investigation of understandings of emergency medical dispatch center work among registered nurses. Twenty-four registered nurses at three mid Swedish emergency medical dispatch centers were interviewed. Analysis based on phenomenographic principles identified five categories in the interviews: (i) Assess, prioritize, direct, or refer; (ii) Facilitate ambulance nursing work; (iii) Perform nursing care; (iv) Always be available for the public; and (v) Have the person behind the patient in mind. The first constitutes the basis of the work. The second emphasizes cooperation with and support for the ambulance staff. The third entails remotely providing nursing care, whilst the fourth stresses serving the entire population. The fifth and most comprehensive way of understanding work involves having a holistic view of the person in need, including person-centered care. Provision of high-quality emergency medical dispatch center work involves all categories. Combined, they constitute a "work map," valuable for reflection, competence development, and introduction of new staff.

Effect of emergency critical care nurses and emergency department boarding time on in-hospital mortality in critically ill patients.

STUDY HYPOTHESIS: We hypothesized that establishing a program of specialized emergency critical care (ECC) nurses in the ED would improve mortality of ICU patients boarding in the ED. METHODS: This was a retrospective before-after cohort study using electronic health record data at an academic medical center. We compared in-hospital mortality between the pre- and post-intervention periods and between non-prolonged (≤6 h) boarding time and prolonged (>6 h) boarding time. In-hospital mortality was stratified by illness severity (eccSOFA category) and adjusted using logistic regression. RESULTS: Severity-adjusted in-hospital mortality decreased from 12.8% pre-intervention to 12.3% post-intervention (-0.5% (95% CI, -3.1% to 2.1%), which was not statistically significant. This was despite a concurrent increase in ED and hospital crowding. The proportion of ECC patients downgraded to a lower level of care while still in the ED increased from 6.4% in the pre-intervention period to 17.0% in the post-intervention period. (+10.6%, 8.2% to 13.0%, p < 0.001). Severity-adjusted mortality was 12.8% in the non-prolonged group vs. 11.3% in the prolonged group (p = 0.331). CONCLUSIONS: During the post-intervention period, there was a significant increase in illness severity, hospital congestion, ED boarding time, and downgrades in the ED, but no significant change in mortality. These findings suggest that ECC nurses may improve the safety of boarding ICU patients in the ED. Longer ED boarding times were not associated with higher mortality in either the pre- or post-intervention periods.

Hospital Nurses' Willingness to Respond in a Disaster.

OBJECTIVE: This study examined the factors associated with nurses' willingness to respond in a disaster. BACKGROUND: Nurses are key personnel in case of disasters, and therefore, understanding factors associated with willingness to respond is important. METHODS: Questionnaires were distributed to 200 nurses recruited from 2 public hospitals in Seoul, Korea. Data were collected in January and February 2018 and 181 responses were analyzed. RESULTS: Factors predicting willingness to respond in a disaster among public hospital nurses were level of education, self-efficacy, and disaster management competency. CONCLUSIONS: Providing well-organized disaster preparedness and response training programs would enhance nurses' level of knowledge about disasters. In addition, training could improve nurses' self-efficacy and disaster management competency, which should enhance willingness to respond in a disaster.

Novice nurse's transitioning to emergency nurse during COVID-19 pandemic: A qualitative study.

AIM: To explore the experiences and perceptions of recent nursing graduates working in emergency departments during the COVID-19 outbreak. BACKGROUND: Overcrowding in emergency departments has been one of the most prominent issues arising in these units for more than 20 years. However, it has become even more problematic due to the novelty of the coronavirus pandemic, which has forced hospitals to recruit larger numbers of beginner nursing staff as the number of quarantined health professionals increases. METHODS: Sixteen semi-structured interviews were conducted in Spanish emergency departments, which were analysed and synthesized using content analysis. RESULTS: Three major themes emerged from the data analysis: (a) Fears and concerns, (b) Organisational issues and (c) Support for novice nurses. CONCLUSIONS: Our findings may help to understand how shadowing periods as a learning programme for nurses, continuing professional development, evidence-based apps and better planning are needed to ensure both novice nurses' confidence in emergency departments and expert emergency room nurses' ability to cope with complications in critical situations. IMPLICATIONS FOR NURSING MANAGEMENT: Training periods that include shadowing expert emergency room nurses, along with evidence-based technology, provide an opportunity to support novice nurses' transition into the workplace. These measures would provide a safety net and would increase novice nurses' confidence as well as high-quality care.

Nurses and the Manchester: rearranging the work process and emergency care? / Enfermeras y Manchester: ¿reconfigurando el proceso de trabajo y la atención de emergencia? / Os enfermeiros e o Manchester: reconfiguração do processo de trabalho e do cuidado em emergência?

ABSTRACT Objective: to understand the changing roles of nurses in labor division organization in hospitals from the Manchester Triage System implementation in an emergency hospital. Methods: this is an ethnographic study that used different production techniques and data analysis. Results: the Manchester Triage System organized flows and places resulting in quality of care and changes in work processes. Conflict relationships related to disagreements in risk stratification were present. Final considerations: the traditional roles of nurses have been transformed, but it cannot be said that there was a structural change in their position in labor division organization in hospitals. The frontiers of autonomy, therefore of increasing the professionalization of nurses, are neither fixed nor stable, expanding or contracting according to the micropolitical changes in the governance of care.

RESUMEN Objetivo: comprender los roles cambiantes de las enfermeras en la organización de la división del trabajo en el hospital desde la implementación del Sistema de Triaje Manchester en un hospital de urgencia y emergencia. Métodos: estudio etnográfico, utilizando diferentes técnicas de producción y análisis de datos. Resultados: el Sistema de Triaje Manchester organizó flujos y lugares, lo que resultó en calidad de atención y cambios en los procesos de trabajo. Estuvieron presentes relaciones conflictivas relacionadas con desacuerdos en la clasificación del riesgo. Consideraciones finales: los roles tradicionales de las enfermeras se han transformado, pero no se puede decir que hubo un cambio estructural en su posición en la organización de la división del trabajo en el hospital. Las fronteras de la autonomía, por tanto de incrementar la profesionalización del enfermero, no son fijas ni estables, ampliándose o contrayéndose según los cambios micropolíticos en la gobernanza del cuidado.

RESUMO Objetivos: compreender as mudanças de papéis dos enfermeiros na organização da divisão do trabalho no hospital a partir da implantação do Sistema Manchester de Classificação de Risco em hospital de urgência e emergência. Métodos: estudo etnográfico, com o emprego de diferentes técnicas de produção e de análise de dados. Resultados: o Sistema Manchester de Classificação de Risco organizou os fluxos e lugares, resultando em qualidade do cuidado e em mudanças nos processos de trabalho. Relações de conflito relacionadas às discordâncias na classificação do risco estiveram presentes. Considerações finais: os papé is tradicionais dos enfermeiros se transformaram, mas não se pode afirmar que houve mudança estrutural da posição deles na organização da divisão do trabalho no hospital. As fronteiras da autonomia, portanto de aumento de profissionalização dos enfermeiros, não são fixas nem estáveis, alargando ou contraindo de acordo com as mudanças micropolíticas da governabilidade do cuidado.

Disaster Nursing: Taking Your Faith to the Field.

National and global disasters require immense resources, including nurses. Personal, professional, and spiritual preparation is strongly recommended for healthcare workers who desire to serve in disaster settings. Most nurses are underprepared for this role; options for preparation are described along with the ministry of nursing and spiritual care that expresses God's heart of mercy and care for hurting and desperate people.

Práctica avanzada de la enfermera en urgencias extrahospitalarias y comparación con la casuística atendida por equipos con médicos / Advanced practice of the nurse in out-of-hospital emergencies and comparison with the casuistry attended by teams with doctors

OBJETIVO: Explorar la práctica enfermera en urgencias extrahospitalarias y comparar su casuística con la de equipos con médico presencial. METODOLOGÍA: Estudio transversal, con pacientes del Distrito Málaga atendidos por una enfermera (2012-2016) y por 6 equipos con médico presencial (2012). VARIABLES: prioridad, motivo de asistencia, diag-nósticos enfermeros, medicamentos y derivación. Estadística descriptiva e inferencial multivariante. RESULTADOS: La enfermera atendió 2253 pacientes. Los equipos con méicos atendieron 21226, presentando patologías similares el 34,8%. Motivos de asistencia: cérvico-dorso-lumbo-ciatalgia (12,6%), mareos/vértigo (9.6%), sin patología urgente (9,2%), etc. El 63,9% de pacientes precisó medicación: diazepam (19,3%), metoclopramida (13,6%), metamizol (12,5%), etc. El manejo del tratamiento y de dispositivos sanitarios, junto al afrontamiento de problemas se asociaron a los motivos de asistencia. El 92% de avisos fueron resueltos in situ. CONCLUSIÓN: La enfermera es una opción muy eficiente para la atención compartida de la demanda, aún con la legalización de la prescripción de medicamentos pendiente

OBJECTIVE: To explore prehospital emergency nursing and to compare the case-mix attended with prehospital medical teams. METHODS: Cross-sectional study, including patients from Málaga District attended by a prehospital nurse (2012 - 2016), and by prehospital medical teams (2012). MAIN VARIABLES: priority, cause of the demand, nursing diagnosis, medication and referral. Descriptive and multiple inferencial analyses. RESULTS: The nurse attended 2253 patients. Medical teams attended 21226 patients, and 34.8% presented similar pathologies. Case-mix: Cervical-back-sciatica pain (12.6%), dizziness/vertigo (9.6%), no urgent pathology (9.2%), etc. 63.9% of patients needed medication: Diazepam (19.3%), metoclopramida (13.6%), metamizol (12.5%), etc. Management of medication or healthcare devices, and problem coping were usually associated to assistance demands. 92% of demands were resolved in situ. CONCLUSIONS: The emergency nurse turns out to be an efficient choice for sharing prehospital demands, even with nursing prescription not yet legalized

Panorama Internacional de los Enfermeros en los servicios de bomberos / The International Overview of Nurses at firefighter services

OBJETIVOS: Describir lafigura del enfermero profesional de las secciones sanitarias de los Servicios de Extinción de Incendios y Salvamento (SEIS). METODOLOGÍA: Revisión panorámica mediante búsqueda sistemática de información a partir de artículos indexados en PubMed, Cuiden y CINAHL. Compilación de información de webs de las administraciones públicas, o tras la solicitud directa. Recopilación de datos sobre determinados items. Análisis de datos realizado mediante síntesis cualitativa. RESULTADO: Se han encontrado 7 artículos, 6 ponencias de congresos, 7 páginas web y contacto con otros SEIS, obteniendo información de 11 secciones sanitarias. Los requisitos de acceso son variables. Los problemas de salud centrados en el compromiso vital. Enfermeros acompañados de técnicos o médicos. Disponiendo de ambulancias o helicópteros sanitarios. CONCLUSIÓN: Los aspectos comunes permiten establecer un perfil profesional del enfermero y de recursos para su extensión a otros SEIS, ajustado a un modelo de práctica avanzada en un escenario complejo

OBJECTIVE: To describe the Professional Nurse in the Healthcare Units of Fire and Rescue Services. METHODOLOGY: Panoramic review through systematic research of information from articles indexed in PubMed, Cuiden and CINAHL. Compilation of information from websites of public administrations, or after direct requEst Collection of data on certain items. Data analysis performed using qualitative synthesis. RESULTS: 7 publications, 6 congress communications, 7 websites and contact with other Healthcare Units of Fire and Rescue Services, obtaining information from a total of 11 sanitary sections. Except for the nursing degree, there is a great variety of access requirements. The health problems addressed focus on life threatening situations. Nurses are accompanied by technicians and/ordoctors. Having ambulances and/or medical helicopters. CONCLUSION: The common aspects enable the establishment of the nurse and resource profile for its extension to other Fire and Rescue Servicesa, adjusted to an advanced practice model in a complex scenario

Sistema informatizado de Valoración Enfermera de la Urgencia Pediátrica en Atención Primaria VEUPAP y su enlace a la historia clínica informatizada de atención primaria / Computerized Nurse Assessment System for Pediatric Emergency in Primary Care VEUPAP and its link to the computerized medical record of primary care

OBJETIVO: Implementación informática del sistema de Valoración Enfermera de la Urgencia Pediátrica en Atención Primaria (VEUPAP). DISEÑO: El desarrollo de la aplicación informática de VEUPAP siguió las siguientes fases: 1. Diseño de salidas y entradas al sistema necesarias para asegurar esas salidas. 2. Programación de los algoritmos y vínculos de enlace a partir de las entradas de datos para obtener las salidas de información esperadas. 3. Obtención de versión tentativa del VEUPAP informatizado, puesta a punto y prueba piloto de su funcionamiento con las modificaciones y ajustes hasta lograr su versión definitiva. RESULTADOS: VEUPAP en versión informática para ordenador personal en entorno operativo Windows Microsoft NT Professional, con la visión general de los campos de valoración que lo conforman, especificidades de entradas de cada campo e informe clínico tipo de salida. CONCLUSIONES: VEUPAP computarizado con incorporación a la historia clínica informatizada de Atención Primaria hace transparentes y accesibles todos los datos del proceso de la actividad clínica enfermera en cuidados pediátricos urgentes, permitiendo que sean conocidos y puedan ser empleados por todos los profesionales de la atención primaria. La huella de información generada por VEUPAP permite seguir su evolución y valorar su impacto en el manejo enfermero de las urgencias pediátricas en atención primaria, con la consiguiente evaluación de la posibilidad de su extensión a nuevos campos. La implementación de VEUPAP automatizado en la práctica diaria permitiría protocolizar y desarrollar áreas de atención enfermera finalista e incorporar sistemas taxonómicos enfermeros que, en función de la prioridad asignada y considerando el diagnóstico concreto del paciente, posibiliten gradar las intervenciones específicas que permitan alcanzar los resultados óptimos en cuidados enfermeros esperados

OBJECTIVE: Design of the informatic version of the VEUPAP system (Nurse Pediatric Emergency Assessment of Primary Care). DESIGN: The development of computer application VEUPAP followed three stages: 1. Design outputs and inputs necessary to the system to ensure those outings. 2. Data entry procedures and their programming algorithms to obtain the expected outputs. 3 Getting initial computerized version for VEUPAP, its set-up and pilot proof with modifications and adjustments to achieve final version. RESULTS: Automatized VEUPAP on personal computer with Microsoft Windows NT Professional operating system, with a general overview of the fields that comprise valuation, specificities of entries in each field and clinical report type output. CONCLUSIONS: Computerized VEUPAP linked with clinical history of primary care allows that all data process of nurse clinical activity in urgent pediatric care be transparent and accessible, allowing be known and be used by all professionals in primary care. The footprint of information generated by VEUPAP allows monitor progress and assess their impact on the nursing management of pediatric emergencies in primary care, with subsequent evaluation of the possibility of its extension to new fields. The implementation of automated VEUPAP in daily practice allows to develop areas of care nurse finalist and incorporate nursing taxonomic systems, depending on the assigned priority and considering the specific diagnosis of the patient, enable to graduate specific interventions to achieve optimal results in nursing care

Análisis de las competencias específicas de la Enfermería de urgencias pre-hospitalarias en España / Analysis of the specific skills of pre-hospital emergency nurses in Spain

OBJETIVO: explorar la importancia que los profesionales de Enfermería de urgencia pre-hospitalaria otorgan a las competencias del puesto, así como a la formación necesaria para adquirir dichas competencias. MÉTODO: estudio descriptivo transversal sobre profesionales de Enfermería de asistencia pre-hospitalaria de las gerencias de emergencias de toda España. Se diseñó, atendiendo a la literatura y al criterio de expertos, un cuestionario autoadministrado ad hoc online, compuesto por 60 competencias distribuidas en 10 dominios (cada competencia era valorada en una escala Likert de 1 a 5 [mejor valoración]). Variables independientes: edad, sexo, tipo de recurso en el que desarrolla su actividad asistencial, nivel formativo en urgencias, duración del título de postgrado y experiencia laboral. Análisis bivariante con pruebas no paramétricas (U de Mann-Whitney y el test de Kruskal-Wallis). RESULTADOS: se obtuvieron 91 respuestas. Las tres competencias mejor valoradas fueron "Ejecutar maniobras de soporte vital" (media: 4,85), "Poseer una actitud de cooperación para el trabajo en equipo" (media: 4,77) y "Exigencia de formación y actualización profesional permanente" (media: 4,74). La importancia atribuida mostró diferencias significativas según sexo en ocho competencias, según tipo de recurso asistencial en el que desempeña su actividad profesional en siete competencias, y según la duración de la formación de postgrado en cuatro competencias. El nivel formativo de postgrado se perfiló como imprescindible. CONCLUSIONES: la importancia atribuida combina, con mayor puntuación, la competencia técnica de ejecutar maniobras de soporte vital, la competencia no técnica de actitud cooperativa con el equipo y la exigencia de formación permanente. La eficacia en el desempeño exige formación de nivel superior al Grado

OBJECTIVE: to explore the importance assigned by pre-hospital emergency nursing professionals to competence in their position, as well as to the training needed to acquire said skills. METHOD: a descriptive cross-sectional study on pre-hospital care nursing professionals from the emergency managements throughout Spain. An ad-hoc self-administered online questionnaire was designed, considering literature and criteria by experts, and consisting of 60 skills distributed into 10 domains (each skill was valued through a Likert scale from 1 to 5 (best valued)). Independent variables: age, gender, type of setting where the activity of care is conducted, training level in emergencies, duration of the post-graduate degree, and work experience. Bivariate analysis was conducted with non-parametric tests (Mann-Whitney's U and Kruskal-Wallis test). RESULTS: in total, 91 answers were retrieved. The three best valued skills were: "Conducting life support manoeuvres" (mean: 4.85), "Having a cooperative attitude for team work"" (mean: 4.77) and "Demand for permanent professional training and update" (mean: 4.74). The importance assigned showed significant differences according to gender in eight skills, depending on type of care setting where they conducted their professional activity in seven skills, and according to the duration of postgraduate training in four skills. Postgraduate training level was considered essential. CONCLUSIONS: the importance assigned combines, with a higher score, the technical skill of conducting life support manoeuvres, the non-technical skill of a cooperative attitude with the team, and the demand for permanent training. Efficacy in performance demands training beyond Degree

Update: AHA guidelines for CPR and emergency cardiovascular care.

Continuous review of current research and practice has resulted in updates to the American Heart Association guidelines for CPR and emergency cardiovascular care. This article examines the recommendations and their implementation into current healthcare practice.

La perspectiva de la formación universitaria sobre la Enfermería de urgencias y emergencias: la opinión del alumnado / The perspective of university education on Emergency Care Nursing: the opinion by students

OBJETIVO: conocer la percepción de los egresados sobre su formación en servicios de urgencias y emergencias y las competencias adquiridas con ella; valorar su satisfacción con la formación recibida y estimar la intención de cursar una hipotética especialidad en Enfermería de Urgencias y Emergencias (EUE) en caso de que estuviese reglada. MÉTODO: estudio descriptivo transversal realizado entre 2017 y 2019 cuya población diana fueron los estudiantes de último curso de Enfermería de las universidades españolas. Se diseñó un cuestionario ad hoc autoadministrado que incluyó variables sociodemográficas, relacionadas con la formación teórica y práctica y con la intención de cursar la Especialidad de Urgencias y Emergencias si existiese. Se realizaron análisis uni y bivariantes. RESULTADOS: participaron 1.529 estudiantes. El 65,9% cursó alguna asignatura relacionada con urgencias y emergencias. La valoración global de la duración de las estancias clínicas, entre quienes las efectuaron, fue de 3,9 sobre 7 en el caso de la rotación hospitalaria y de 3,6 en la rotación extrahospitalaria. Un 28% de los estudiantes refirió no haber adquirido competencias suficientes para trabajar en el primer caso y un 35,9% en el segundo. Cuanto mayor es la duración de la estancia clínica, mayor es la valoración de los alumnos en cuanto a la adquisición de las competencias. Un 53% elegiría la "hipotética" especialidad de EUE vía Enfermera Interna Residente como primera opción sobre resto de opciones actuales. CONCLUSIONES: es necesario un análisis profundo de la aplicación de los planes de estudios del Grado en Enfermería. Los recién egresados tendrían entre sus expectativas la realización de una especialidad en EUE

OBJECTIVE: to understand the perception of graduated students about their education on Emergency Care and the skills acquired through it; to assess their satisfaction with the training received, and estimate their willingness to follow a hypothetical specialty on Emergency Care Nursing (ECN), in case this was regulated. METHOD: a cross-sectional descriptive study conducted between 2017 and 2019; its target population was the last-year students of the Nursing Degree in Spanish universities. A self-administered ad hoc questionnaire was designed, which included sociodemographical variables, as well as variables regarding theoretical and practical training, and about the willingness to follow the Emergency Care specialty if available. Univariate and bivariate analyses were conducted. RESULTS: the study included 1,529 patients; 65.9% of them studied some subject associated with Emergency Care. The overall assessment of the duration of clinical stays, between those involved, was 3.9 out of 7 in the case of hospital rotation, and 3.6 in case of extra-hospital rotation. In total, 28% of students reported that they had not acquired enough skills to work in the first case, and 35.9% in the second case. The longer the duration of the clinical stay, the higher the score assigned by students to the skills acquired. Of these students, 53% would choose the "hypothetical" ECN through Internal Nursing Resident as their first option over the rest of current options. CONCLUSIONS: deep analysis is required regarding the implementation of the education plans for the Nursing Degree. Recent graduates would have an ECN specialty among their education expectations

Herramientas de detección para identificar el maltrato al anciano en los servicios de urgencias / Screening tools for detecting elder abuse at Emergency Units

OBJETIVO: describir los métodos de identificación, detección y diagnóstico del maltrato a ancianos y valorar su aplicabilidad en el ámbito del servicio de urgencias. MÉTODO: revisión narrativa mediante búsqueda bibliográfica en las bases de datos: PubMed, Cochrane Library, Biblioteca Virtual de Salud y ScienDirect. Se seleccionaron artículos publicados entre 2009-2019, en español e inglés, disponibles a texto completo. Se incluyeron todos aquellos trabajos que tratasen aspectos relacionados con el objetivo principal de este estudio. RESULTADOS: se revisaron un total de 286 referencias bibliográficas. Se seleccionaron un total de 11 manuscritos, con distintos diseños. Se identificaron tres métodos para detectar el maltrato al anciano: reconocer los factores de riesgo, los signos clínicos e indicadores de sospecha más habituales, y la utilización de cuestionarios dirigidos a la víctima y al cuidador. De los instrumentos de detección revisados solo tres fueron validados específicamente para el ámbito de urgencias. CONCLUSIÓN: las herramientas identificadas en este estudio pueden ser de aplicación en el servicio de urgencias, atendiendo a sus características y limitaciones de uso y validez

OBJECTIVE: to describe the methods for screening, detecting and diagnosing elder abuse, and assess their potential implementation in the Emergency Unit setting. METHOD: a narrative review through bibliographic search in the databases: PubMed, Cochrane Library, Biblioteca Virtual de Salud and ScienDirect. Articles published between 2009 and 2019 were selected, in Spanish and English, with full text available. The review included all those articles dealing with aspects associated with the primary objective of the study. RESULTS: in total, 286 bibliographic references were reviewed. Eleven (11) manuscripts were selected in total, with different designs. Three methods to detect elder abuse were identified: detecting the risk factors, the most usual clinical signs and suspicion indicators, and the use of questionnaires targeted to the victim and the caregiver. Only three of the screening tools reviewed had been validated specifically for the Emergency setting. CONCLUSION: the tools identified in this study can be implemented at the Emergency Unit, addressing its characteristics and limitations for use and validity

Using Geographic Information System Mapping in Emergency Management: Expanding the Role of Nurses in Home Based Primary Care.

The Veterans Health Administration Home Based Primary Care (VHA-HBPC) program serves Veterans with complex, chronic conditions. Emergency management is a concern for VHA-HBPC programs. Geographic information system (GIS) mapping has been implemented for local program operations in 30 locations. An evaluation assessed GIS mapping as a tool in emergency management, including frontline nurses' and nurse leaders' experiences. Nurses' roles included making and using maps for preparedness and response. Maps provided valuable information, including locations of vulnerable patients (eg, ventilator dependent), community emergency resources, and environmental threats (eg, hurricane). Nurses' willingness to embrace this new technology and skill set was notable.