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1.
Rev Lat Am Enfermagem ; 27: e3241, 2019.
Artigo em Inglês, Português, Espanhol | MEDLINE | ID: mdl-31826170

RESUMO

OBJECTIVE: to evaluate the degree of reliability, accuracy and timing to perform the Manchester Triage System in electronic and manual records. METHOD: exploratory-descriptive research. Case series corresponded to a total of 20 validated simulated clinical cases applied to a sample of 10 nurses. For data collection each participant received 4 clinical cases in 2 different phases of the study, using manual and electronic registration. The variables related to the triage were: incomplete data filling, discriminator, flowchart, priority level, vital signs and triage timing. RESULTS: moderate reliability for choosing flowcharts and substantial reliability for determining discriminators in both records; substantial and moderate, for priority, respectively, in manual and electronic registration. For vital signs, it was weak in manual recording and substantial in electronic. Accuracy showed a statistically significant difference related to vital signs. The average timing on triage was shorter with the use of electronic registration. CONCLUSION: the use of electronic registration has advantages regarding reliability, accuracy and timing to perform the triage, pointing to the importance of adopting technologies in the management and care work process in health services.


Assuntos
Enfermagem em Emergência/normas , Triagem/métodos , Adulto , Confiabilidade dos Dados , Enfermagem em Emergência/métodos , Serviço Hospitalar de Emergência/organização & administração , Serviço Hospitalar de Emergência/estatística & dados numéricos , Feminino , Humanos , Masculino , Informática Médica , Pessoa de Meia-Idade , Reprodutibilidade dos Testes
2.
J Emerg Nurs ; 45(5): 512-516, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31445627

RESUMO

INTRODUCTION: Vascular access procedures are among the most commonly performed procedures in the emergency department. The objective of the current study was to compare the contrast extravasation rate for ultrasound-guided peripheral intravenous (USGPIV) catheter placement by emergency nurses with peripheral intravenous catheters placed by standard landmark techniques. METHODS: A retrospective chart review of all ED patients at our urban tertiary-care institution who underwent contrasted computed tomography examination and suffered contrast extravasation events was performed. A logbook of all ED patients who underwent USGPIV placement and an institution-wide electronic patient safety incident-reporting system was reviewed for all contrast extravasation events between May 2014, and February 2017. Data were analyzed using descriptive statistics, Student t-tests for continuous data, and χ2 or Fisher's exact test for categorical data. RESULTS: One thousand five hundred USGPIV catheters were placed by 27 emergency nurses. Contrast material was administered 29,508 times, and, of these, 291 were administered via USGPIV placement. There were 74 peripheral IV lines with documented contrast extravasations (0.25%) as reported in the safety-event database; 12 (4.1%) were from the USGPIV population, and 62 (0.21%) occurred in the standard landmark technique population. Relative risk of contrast extravasation events with USGPIV placement was 19.4 (95% confidence interval [CI], 10.6-35.6), and the absolute risk difference was 3.9% (95% CI 1.6%-6.2%). DISCUSSION: USGPIV placement by trained emergency nurses has higher rates of contrast extravasation than with standard landmark technique placement.


Assuntos
Cateterismo Periférico/métodos , Enfermagem em Emergência/métodos , Extravasamento de Materiais Terapêuticos e Diagnósticos/epidemiologia , Ultrassonografia de Intervenção/métodos , Humanos , Recursos Humanos de Enfermagem no Hospital , Estudos Retrospectivos
3.
J Emerg Nurs ; 45(5): 517-522.e6, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31445628

RESUMO

INTRODUCTION: Health literacy can create barriers for ED staff attempting to communicate important information to patients. Video discharge instructions may address some of these barriers by improving patients' comprehension of medical information and addressing health literacy challenges. METHODS: One hundred ninety-six patients diagnosed with either hypertension, asthma, congestive heart failure, or diabetes were randomly assigned to 1 of 2 interventions: watching video medical information followed by reviewing written discharge instructions or written instructions first, followed by video education. After the interventions, patients from both groups completed surveys assessing their preferences for receiving medical information. RESULTS: We found that 44% (n = 86/196) of ED patients preferred receiving medical information in video format, whereas 18% (n = 35/196) favored the written format, and 38% (n = 75/196) of the sample preferred receiving both formats. Fifty-five percent of men (n = 38/69) preferred the video format, whereas 42% (n = 51/122) of women indicated a preference for both video and written formats. Learning something new from the video was associated with patient preference for receiving medical instructions, (χ2 [1] = 9.39, P = 0.01) and the desire to watch medical videos or read information at home via the Internet (χ2 [1] = 18.46, P < 0.001). DISCUSSION: The majority of ED patients in this study preferred medical information in video or video plus written formats, compared with written-only format.


Assuntos
Enfermagem em Emergência/métodos , Serviço Hospitalar de Emergência , Comunicação em Saúde/métodos , Alfabetização em Saúde , Alta do Paciente/estatística & dados numéricos , Preferência do Paciente/estatística & dados numéricos , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Distribuição Aleatória , Inquéritos e Questionários , Adulto Jovem
4.
Emerg Nurse ; 27(2): 16-20, 2019 Mar 04.
Artigo em Inglês | MEDLINE | ID: mdl-31468801

RESUMO

The aim of this article is to review the literature on pre-hospital assessment of pain in paediatric patients. Many articles highlight the under-treatment of pain in paediatrics by pre-hospital clinicians, showing that this is an area falling short of best practice. This article evaluates the effectiveness of two established pain assessment tools authorised for the pain assessment of children in pre-hospital environments.


Assuntos
Enfermagem em Emergência/métodos , Serviço Hospitalar de Emergência , Medição da Dor/métodos , Dor/diagnóstico , Adolescente , Criança , Pré-Escolar , Humanos
5.
Emerg Nurse ; 27(2): 27-31, 2019 Mar 04.
Artigo em Inglês | MEDLINE | ID: mdl-31468803

RESUMO

Recent incidents in the UK and the alleged chemical attacks in Syria by the Bashar al-Assad regime have brought the subject of chemical weapons back into the public domain. To date these types of event have been relatively rare because terrorist plans to harm large numbers of people have mostly been thwarted. This is the first part of a two-part article on nerve agents. Part one gives an overview of these agents, their historical background and manufacture, and how the agents affect physiology. Part two, which will appear in the next issue, considers the pre-hospital response to the use of nerve agents, including effective triage and decontamination, and in-hospital treatment.


Assuntos
Enfermagem em Emergência/métodos , Serviço Hospitalar de Emergência , Agentes Neurotóxicos/efeitos adversos , Humanos , Guias de Prática Clínica como Assunto , Reino Unido
6.
Prehosp Disaster Med ; 34(4): 376-384, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31258107

RESUMO

BACKGROUND: Within out-of-hospital emergencies, primary health care (PHC) nurses must face life-threatening emergencies (LTEs), which are defined as "a situation associated with an imminent life risk that entails the start-up of resources and special means to resolve the situation." OBJECTIVES: The objectives of this study were to know the training received for out-of-hospital LTEs by PHC nurses of Asturias, Spain and the perception they have about their theoretical knowledge and practical skills in a series of emergency procedures or techniques used in LTE emergencies; as well as to analyze the differences according to the geographical area of their work. DESIGN: Cross-sectional, descriptive, and observational study was conducted in 2018 of a sample of PHC service nurses of Asturias, Spain. METHODS: A total of 236 nurses from PHC service centers of Asturias, Spain, from among the total of 730 nurses who make up the staff of nurses of the PHC service of Asturias, between April and May 2018, were surveyed. The survey was designed ad hoc using the Doctrinal Body of Emergency Nursing (DBEN) proposed by the Spanish Society of Emergency Medicine (SEMES; Madrid, Spain), which indicates the theoretical and practical procedures that must be acquired by the PHC nurses. It is composed of 37 procedures or techniques employed in LTEs using an 11-point Likert scale rating to detect their self-perception about theoretical knowledge and practical skills from zero ("Minimum") to ten ("Maximum"). RESULTS: There were significant differences in the mean of theoretical knowledge and practical skills in many procedures or techniques studied, depending on the different areas of work. CONCLUSIONS: All PHC nurses must be perfectly trained to provide initial quality assistance to the LTE, with both theoretical and practical knowledge of the different techniques, so that it can continue to be attended by the corresponding Emergency Service.


Assuntos
Competência Clínica , Enfermagem em Emergência/métodos , Tratamento de Emergência/enfermagem , Atenção Primária à Saúde/métodos , Autoimagem , Inquéritos e Questionários , Adulto , Estudos Transversais , Serviços Médicos de Emergência/métodos , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Espanha
7.
Australas Emerg Care ; 22(2): 119-125, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-31042531

RESUMO

BACKGROUND: With the rise of patients with sepsis presenting to emergency departments, emergency nurses, as frontline healthcare workers, require current clinical knowledge of sepsis. The aim of this study was to assess emergency department registered nurses' knowledge of sepsis and their perspectives of caring for patients with sepsis. METHODS: A descriptive cross-sectional survey was used to survey Registered Nurses from four emergency departments in a western Canadian city (N=312). RESULTS: The majority of nurses scored poorly on questions examining knowledge of systemic inflammatory response syndrome variables associated with sepsis, and sepsis definitions, general knowledge, and treatment (mean score 51.8%). Nurses acknowledged their lack of knowledge and indicated a desire for further sepsis education. Challenges in providing sepsis-related care concerned perceived heavy workloads and clinical implications related to the patient's status. CONCLUSIONS: Educational programs and coaching approaches that maximize nurses' abilities to enhance their decision-making with regards to early assessment and appropriate intervention for persons with sepsis are needed. Such multifaceted approaches would acknowledge nurses' existing knowledge and provide practical supports to help nurses extend and mobilize their knowledge for everyday decision-making within the complex clinical environment of the emergency department.


Assuntos
Competência Clínica/normas , Sepse/enfermagem , Adulto , Colúmbia Britânica , Competência Clínica/estatística & dados numéricos , Estudos Transversais , Avaliação Educacional/métodos , Enfermagem em Emergência/métodos , Enfermagem em Emergência/normas , Serviço Hospitalar de Emergência/organização & administração , Serviço Hospitalar de Emergência/estatística & dados numéricos , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Enfermeiras e Enfermeiros/normas , Enfermeiras e Enfermeiros/estatística & dados numéricos
8.
Int Emerg Nurs ; 45: 17-24, 2019 07.
Artigo em Inglês | MEDLINE | ID: mdl-31053392

RESUMO

BACKGROUND: Research exploring multi-disciplinary emergency department (ED) clinicians' perceptions of their working environment is limited, although exposure to occupational stressors is frequent. This study describes ED clinicians' perceptions of their working environment, occupational stressors and their use of coping strategies. METHODS: A cross-sectional descriptive study was conducted in 2017 at two Australian public hospital EDs. Nursing and medical staff completed a print-based survey of 100 items, which included three scales and a demographic questionnaire. Responses were analysed using descriptive statistics and regression analysis. RESULTS: Doctors and nurses (n = 241) completed the survey (response rate 45%). Workload featured as a major factor in perception of the working environment and was a frequently occurring stressor. Death or sexual abuse of a child was the highest rated stressor, despite relative infrequency of exposure. When coping strategies were adjusted for sex, female respondents were more likely to use negative strategies such as blaming themselves (Odds Ratio, OR 4 [1.6-9.7]; p < 0.01) and less likely to use positive strategies such as exercise (OR 0.2 [0.1-0.6]; p < 0.01). CONCLUSIONS: While stressors were similarly rated among the diverse group of clinicians, the ways in which they reported coping varied. Further research is required to facilitate design of staff support strategies.


Assuntos
Adaptação Psicológica , Pessoal de Saúde/psicologia , Estresse Ocupacional/psicologia , Adulto , Estudos Transversais , Medicina de Emergência/métodos , Medicina de Emergência/tendências , Enfermagem em Emergência/métodos , Enfermagem em Emergência/tendências , Serviço Hospitalar de Emergência/organização & administração , Serviço Hospitalar de Emergência/estatística & dados numéricos , Feminino , Pessoal de Saúde/estatística & dados numéricos , Humanos , Satisfação no Emprego , Masculino , Pessoa de Meia-Idade , Estresse Ocupacional/terapia , Razão de Chances , Inquéritos e Questionários , Local de Trabalho/psicologia , Local de Trabalho/normas
9.
J Emerg Nurs ; 45(5): 538-544.e1, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-30987773

RESUMO

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 , Humanos
10.
J Clin Nurs ; 28(15-16): 2801-2812, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-30946498

RESUMO

AIMS AND OBJECTIVES: To generate insights about what matters and is valued by family members of older people with dementia in the emergency department. To explore the experiences of emergency nurses looking after older people with dementia in an episode of care. BACKGROUND: In the emergency department, older people with dementia are at risk of suboptimal care. Little is known of the experiences of family members of being with an older person with dementia in the emergency department or the experiences of emergency nurses looking after older people with dementia in this environment. DESIGN AND METHODS: Phase 1 Data Analysis of the Discovery Phase of an Appreciative Inquiry study. Study participants were family members of older people with dementia and emergency nurses. Data collection methods included interviews with family members of older people with dementia and 30 hr of participant observation working alongside emergency nurses. This study was guided by the Standards for Reporting Qualitative Research. RESULTS: Two themes emerged from the analysis: What matters to family members with four subthemes and challenges for family members and nurses in the emergency department with two subthemes. CONCLUSION: This study demonstrates that some emergency nurses are connecting with family members even in the briefest of clinical encounters. It is feasible for more emergency nurses to do the same more of the time. RELEVANCE TO CLINICAL PRACTICE: The older person with dementia must be given a triage category of no less than 3 (to be seen by the doctor within the hour) on arrival in the department. Further education is needed to assist emergency nurses to establish rapport and incorporate family member insights as part of care planning and assessment of the needs of the older person with dementia.


Assuntos
Demência/enfermagem , Enfermagem em Emergência/métodos , Serviço Hospitalar de Emergência/normas , Família/psicologia , Relações Profissional-Família , Idoso , Feminino , Humanos , Masculino , Pesquisa Qualitativa
11.
Br J Anaesth ; 123(2): e284-e292, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-30916038

RESUMO

OBJECTIVE: Pain undertreatment, or oligoanalgesia, is frequent in the emergency department (ED), with major medical, ethical, and financial implications. Across different hospitals, healthcare providers have been reported to differ considerably in the ways in which they recognise and manage pain, with some prescribing analgesics far less frequently than others. However, factors that could explain this variability remain poorly understood. Here, we used neuroscience approaches for neural signal modelling to investigate whether individual decisions in the ED could be explained in terms of brain patterns related to empathy, risk-taking, and error monitoring. METHODS: For 15 months, we monitored the pain management behaviour of 70 ED nurses at triage, and subsequently invited 33 to a neuroimaging study involving three well-established tasks probing relevant cognitive and affective dimensions. Univariate and multivariate regressions were used to predict pain management decisions from neural activity during these tasks. RESULTS: We found that the brain signal recorded when empathising with others predicted the frequency with which nurses documented pain in their patients. In addition, neural activity sensitive to errors and negative outcomes predicted the frequency with which nurses denied analgesia by registering potential side-effects. CONCLUSIONS: These results highlight the multiple processes underlying pain management, and suggest that the neural representations of others' states and one's errors play a key role in individual treatment decisions. Neuroscience models of social cognition and decision-making are a powerful tool to explain clinical behaviour and might be used to guide future educational programs to improve pain management in ED.


Assuntos
Encéfalo/fisiopatologia , Tomada de Decisão Clínica/métodos , Serviço Hospitalar de Emergência , Empatia , Manejo da Dor/métodos , Medição da Dor/métodos , Adulto , Analgésicos , Erros de Diagnóstico/prevenção & controle , Enfermagem em Emergência/métodos , Feminino , Hospitais , Humanos , Masculino , Dor , Triagem
12.
Int Emerg Nurs ; 44: 8-13, 2019 05.
Artigo em Inglês | MEDLINE | ID: mdl-30902617

RESUMO

BACKGROUND: The emergency department is a highly demanding work environment, considered by high workload and stress. The impact of work-related factors on musculoskeletal disorders (MSDs) in emergency nurses (ENs) are not yet well understood. We investigated the association of MSDs and workload with work schedule (permanent day and night work) and job satisfaction in ENs. METHOD: Data were collected through a questionnaire including individual and work-related factors, workload (National Aeronautics and Space Administration-Task Load Index [NASA-TLX]) and MSDs (Standardized Nordic Questionnaire) from 380 ENs in five hospitals. RESULTS: The findings revealed that work schedule and job satisfaction levels were significantly associated with the MSDs in different body regions. Work schedule was significantly related to physical demand, performance, frustration, and overall workload, whereas it was not to the mental and temporal demands and effort. Job satisfaction level was negatively associated with mental demand and frustration. A high prevalence of musculoskeletal problems, particularly in knees, upper back, lower back, neck and shoulders were found. CONCLUSION: MSDs are highly prevalent among ENs involved in night work and with low job satisfaction levels. The results are discussed in terms of their implications for emergency hospital nurses. The findings can help to better understand the working conditions and emphasize the need for ergonomic interventions in order to reduce MSDs and workload. Also, the study findings highlight the importance of mental aspects of workload in this occupational group.


Assuntos
Satisfação no Emprego , Doenças Musculoesqueléticas/psicologia , Enfermeiras e Enfermeiros/psicologia , Carga de Trabalho/normas , Adulto , Estudos Transversais , Enfermagem em Emergência/métodos , Enfermagem em Emergência/normas , Serviço Hospitalar de Emergência/organização & administração , Serviço Hospitalar de Emergência/estatística & dados numéricos , Feminino , Humanos , Irã (Geográfico) , Masculino , Doenças Musculoesqueléticas/epidemiologia , Admissão e Escalonamento de Pessoal/normas , Prevalência , Inquéritos e Questionários , Carga de Trabalho/psicologia
13.
J Emerg Nurs ; 45(5): 531-537, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-30853122

RESUMO

INTRODUCTION: Poor comprehension of ED discharge instructions has been reported. Discharge instructions often include written information. Identification of home-care practices that were different from recommended discharge instructions among multiple clients led nurses at a community emergency department to evaluate health literacy among specific clients. METHODS: A bilingual translator administered the Newest Vital Sign-a 6-item validated scale that assesses health care literacy-to 150 English and Spanish-speaking parents of pediatric patients admitted to the fast-track area. RESULTS: Although mean scores for both groups indicated participants were, on average, "at risk" for health literacy problems, English speakers had a significantly higher mean total score (3.82, standard deviation [SD] = 1.60) than did Spanish speakers (2.61, SD = 1.71), indicating better literacy. DISCUSSION: Study findings of low levels of health literacy in many parents led to a practice change of using nurse-developed pictographs, along with discharge instructions, for specific common ED diagnoses. Postdischarge calls to parents or patients receiving the pictographs documented positive postdischarge client feedback. The pictograph strategy is transferable to other institutions.


Assuntos
Enfermagem em Emergência/métodos , Alfabetização em Saúde/métodos , Alta do Paciente , Educação de Pacientes como Assunto/métodos , Alfabetização em Saúde/estatística & dados numéricos , Humanos , Linguagem , Pais
14.
J Emerg Nurs ; 45(5): 561-566, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-30827577

RESUMO

PROBLEM: Emergency departments throughout the nation are experiencing crowding related to increased patient volumes and decreased hospital inpatient bed capacity. As a result of lengthy wait times, patients are leaving without having medical treatment, and satisfaction is poor. The purpose of this quality improvement initiative was placing a provider in triage to complement the existing split-flow process aimed to decrease wait times to see a provider, length of stay (LOS), left without being seen (LWBS) rates, and improve patient satisfaction. METHODS: A multiprofessional team was established. Nurses, advanced practice providers, and physicians collaborated on a project to place a provider in triage to assist in seeing patients as soon as possible and begin care or treatment. RESULTS: The outcomes of the initiative were positive for ED LOS metrics and patient satisfaction. Door-to-provider time decreased from a high of 56 minutes to a low of 13 minutes. The percentage of patients LWBS decreased from a high of 12% to a low of 1.62%. DISCUSSION: The project showed that the evidence-based practice of a combined split-flow and provider-in-triage model resulted in improvements in throughput for patients who were treated and released from the emergency department.


Assuntos
Enfermagem em Emergência/métodos , Serviço Hospitalar de Emergência , Pessoal de Saúde , Melhoria de Qualidade , Triagem/métodos , Humanos , Tempo de Internação/estatística & dados numéricos , Satisfação do Paciente/estatística & dados numéricos , Médicos
15.
Int Emerg Nurs ; 45: 50-55, 2019 07.
Artigo em Inglês | MEDLINE | ID: mdl-30797732

RESUMO

BACKGROUND: Emergency department personnel are exposed to high risk of workplace violence (WPV) and nurses are the main victims. Few researchers have investigated the effects of WPV on job satisfaction and turnover intention among nurses. AIMS: To describe WPV, job satisfaction and turnover intention of emergency nurses and clarify the relationship between them. METHODS: A cross-sectional study was used to collect data on WPV, job satisfaction and turnover intention among 385 nurses working in emergency department in 13 general hospitals in Beijing. Structural equation modeling was used to test the relationship between them. RESULTS: Among them, 89.9% had experienced WPV in the previous year. WPV had short-term and long-term impacts on over 80% of them. The score of job satisfaction and turnover intention was 2.48 ±â€¯0.49, 2.75 ±â€¯0.58 respectively. WPV had significant direct effect on turnover intention (ß = 0.105) and job satisfaction (ß = -0.161). Job satisfaction had a significant negative effect on turnover intention (ß = -0.604) and it mediated the relationship between WPV and turnover intention. CONCLUSION: Emergency nurses in China are at great risk of WPV. Their job satisfaction is low and turnover intention is high. Job satisfaction plays the mediator role between WPV and turnover intention among emergency nurses.


Assuntos
Intenção , Satisfação no Emprego , Enfermeiras e Enfermeiros/psicologia , Reorganização de Recursos Humanos/estatística & dados numéricos , Violência no Trabalho/psicologia , Adulto , Estudos Transversais , Enfermagem em Emergência/métodos , Enfermagem em Emergência/normas , Enfermagem em Emergência/estatística & dados numéricos , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Enfermeiras e Enfermeiros/estatística & dados numéricos , Inquéritos e Questionários , Violência no Trabalho/estatística & dados numéricos
16.
Int Emerg Nurs ; 43: 113-118, 2019 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-30711435

RESUMO

INTRODUCTION: Suicide in older people is a public health concern. Emergency nurses are ideally placed to identify suicide risk. Therefore, the aim of this research was to explore emergency nurses' knowledge, confidence and attitudes about suicide in older people. METHODS: This descriptive exploratory study was conducted in four emergency departments in Sydney, Australia. Data were collected using a 28-item survey from a convenience sample of emergency nurses. Descriptive quantitative statistics and conventional content analysis were performed. Ethics approval was provided. RESULTS: The response rate was 58% (n = 136); the majority were female with an average of seven years emergency experience. The majority (n = 124, 91%) reported that they frequently managed suicidal behaviour and recognized suicide as a common event (80%). 51% (n = 69) recognized that suicide was a common event for older people. Only 16% (n = 22) reported receiving suicide prevention training with 11% feeling confident in managing suicidal behaviour. CONCLUSION: The findings contribute to the discourse on how suicide in older people is recognised by emergency nurses. Few nurses considered it a problem for older people and were not confident about their knowledge. There is a need for suicide prevention training as a priority particularly to identify risks in older people.


Assuntos
Enfermagem em Emergência/normas , Geriatria/normas , Conhecimentos, Atitudes e Prática em Saúde , Suicídio/psicologia , Adulto , Idoso , Idoso de 80 Anos ou mais , Enfermagem em Emergência/métodos , Serviço Hospitalar de Emergência/organização & administração , Feminino , Geriatria/métodos , Geriatria/tendências , Humanos , Entrevistas como Assunto/métodos , Masculino , Pessoa de Meia-Idade , Pesquisa Qualitativa , Queensland , Inquéritos e Questionários
19.
J Emerg Nurs ; 45(5): 523-530, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-30655007

RESUMO

INTRODUCTION: As health care becomes increasingly patient centered, organizations strive to improve patients' ratings of satisfaction with care. Communication with nurses and providers drives overall satisfaction, yet little evidence exists to guide them in ensuring effective communication in the emergency department. METHODS: A semistructured interview guide based on the Hospital Consumer Assessment of Healthcare Providers survey was used to elicit qualitative data from 30 patients seen in the emergency department and fast track regarding communication with nurses and providers. Data were analyzed using content analysis methodology. RESULTS: Two types of overarching themes emerged. Foundational themes include behaviors that convey courtesy and respect and are required for participants to view their interactions with nurses and providers as positive. Interactive themes describe humanistic ways in which nurses and providers conveyed courtesy and respect, reassurance through careful listening, attentiveness, and explaining things in an understandable way. DISCUSSION: The findings underscore existing evidence regarding patients' perceptions of being treated with courtesy and respect via nurses' and providers' use of positive verbal phrasing and nonverbal body language. They reveal new insights into the importance of specific communication behaviors used by nurses and providers during interactions. Treating patients as individuals amidst a fast-paced care environment, proactively recognizing and responding to patients' fears and concerns, and explaining information clearly to ensure understanding were critical.


Assuntos
Enfermagem em Emergência/métodos , Serviço Hospitalar de Emergência , Comunicação em Saúde/métodos , Satisfação do Paciente , Assistência Centrada no Paciente/métodos , Adolescente , Adulto , Idoso , Feminino , Humanos , Entrevistas como Assunto , Masculino , Pessoa de Meia-Idade , Recursos Humanos de Enfermagem no Hospital , Adulto Jovem
20.
J Emerg Nurs ; 45(1): 16-23, 2019 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-29779623

RESUMO

INTRODUCTION: Hospitalization is one of the few circumstances in which the lives of trafficking victims intersect with the general population. Based on survivor testimonies, the majority of human trafficking victims may receive medical treatment in a hospital's emergency department while in captivity. With evidenced-based training, ED personnel have a better opportunity to screen persons who are being trafficked and intervene on their behalf. METHODS: This project examined the efficacy of an innovative, evidence-based online training module (HTEmergency.com) created by the project team. Participants completed a pre-survey to determine learning needs and a post-survey to determine the effectiveness of the online education. The learning module contained a PowerPoint presentation, identification and treatment guidelines, and 2 realistic case studies. RESULTS: Data were collected among ED personnel in 2 suburban hospitals located near a northeast metropolitan city. Seventy-five employees participated in the survey and education. Staff completing the education included nurses, physicians, nurse practitioners/physician assistants, registration, and ED technicians. Results indicated that 89% of participants had not received previous human trafficking training. Less than half of the participants stated that they had a comprehensive understanding of human trafficking before the intervention, with an increase to 93% after education. The training module significantly increased confidence in identification (from an average confidence level of 4/10 to 7/10) and treatment (from an average confidence level of 4/10 to 8/10) of human trafficking victims within the emergency department; 96% found the educational module to be useful in their work setting. DISCUSSION: Participants reported that they are more confident in identifying a possible trafficking victim and are more likely to screen patients for human trafficking after participation in the online training module. The proposed general guideline for care provided ED personnel with a useful tool in perpetuity. The results of this project, coupled with the growth of worldwide human trafficking, highlights the need for focused human trafficking education within the hospital setting.


Assuntos
Instrução por Computador/métodos , Vítimas de Crime , Serviço Hospitalar de Emergência , Tráfico de Pessoas/prevenção & controle , Capacitação em Serviço/métodos , Recursos Humanos em Hospital/educação , Enfermagem em Emergência/métodos , Medicina de Emergência Baseada em Evidências/educação , Medicina de Emergência Baseada em Evidências/métodos , Humanos
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