Educating Emergency Department Registered Nurses in Screening, Brief Intervention and Referral to Treatment

Mitchel, A.M. et al. International Emergency Nursing. Published online: December 17 2016

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Highlights

  • SBIRT has been shown to be effective in reducing risky alcohol consumption.
  • Patients trust nurses, underscoring nurses’ ability to have a positive impact.
  • EDRNs can increase their knowledge and attitudes to routinely screen patients for risky substance use.
  • SBIRT training and educational reinforcement is key for continued implementation.

Read the full abstract here

Nurses’ Perceptions of Factors Involved in Safe Staffing Levels in Emergency Departments

Wolf, L. A. et al. Journal of Emergency Nursing. Published online: November 8 2016

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Introduction: The emergency department is a unique practice environment in that the Emergency Medical Treatment and Active Labor Act (EMTALA), which mandates a medical screening examination for all presenting patients, effectively precludes any sort of patient volume control; staffing needs are therefore fluid and unpredictable. The purpose of this study is to explore emergency nurses’ perceptions of factors involved in safe staffing levels and to identify factors that negatively and positively influence staffing levels and might lend themselves to more effective interventions and evaluations.

Methods: We used a qualitative exploratory design with focus group data from a sample of 26 emergency nurses. Themes were identified using a constructivist perspective and an inductive approach to content analysis.

Results: Five themes were identified: (1) unsafe environment of care, (2) components of safety, (3) patient outcomes: risky care, (4) nursing outcomes: leaving the profession, and (5) possible solutions. Participants reported that staffing levels are determined by the number of beds in the department (as in inpatient units) but not by patient acuity or the number of patients waiting for treatment. Participants identified both absolute numbers of staff, as well as experience mix, as components of safe staffing. Inability to predict the acuity of patients waiting to be seen was a major component of nurses’ perceptions of unsafe staffing.

Discussion: Emergency nurses perceive staffing to be inadequate, and therefore unsafe, because of the potential for poor patient outcomes, including missed or delayed care, missed deterioration (failure to rescue), and additional ED visits resulting from ineffective discharge teaching. Both absolute numbers of staff, as well as skill and experience mix, should be considered to provide staffing levels that promote optimal patient and nurse outcomes.

Read the abstract here

Workplace aggression as cause and effect

Wolf, L.A. et al. International Emergency Nursing. Published online: November 9, 2016

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  • Fatigue compromises nurses’ personal lives and creates a toxic unit environment.
  • Fatigue compromises safe patient care.
  • Below-adequate staffing levels are a major source of fatigue.
  • Lateral violence (workplace bullying) is both a cause and effect of fatigue.

Read the abstract here

Practical Guidelines for the Use of Electronic Applications by Advanced Practice Nurses in the Emergency Department

Morgan, V.A. Journal of Emergency Nursing. Published online: October 20 2016

email-1345921_960_720Although numerous electronic applications are available to health care providers on enabled devices such as smartphones and tablets, these resources remain underutilized. Available literature suggests that utilizing electronic applications provides a number of benefits, including improved ability to make quick yet accurate decisions, improved knowledge of evidence based practices, a corresponding reduction in error rates, and an increase in quality improvement measures. These benefits translated into a reduction in adverse events and hospital lengths of stay.

Read the abstract here

Active Intervention Can Decrease Burnout In Ed Nurses

Wei, R. et al. Journal of Emergency Nursing. Published online: September 16 2016

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Introduction: The aim of this study was to evaluate whether active intervention can decrease job burnout and improve performance among ED nurses.

Methods: This study was carried out in the emergency departments of 3 hospitals randomly selected from 8 comprehensive high-level hospitals in Jinan, China. A total of 102 nurses were enrolled and randomly divided into control and intervention groups. For 6 months, nurses in intervention groups were treated with ordinary treatment plus comprehensive management, whereas nurses in the control group were treated with ordinary management, respectively. Questionnaires were sent and collected at baseline and at the end of the study. The Student t test was used to evaluate the effect of comprehensive management in decreasing burnout.

Results: All ED nurses showed symptoms of job burnout at different levels. Our data indicated that comprehensive management significantly decreased emotional exhaustion and depersonalization (P < .01).

Discussion: The findings suggest that active intervention with comprehensive management may effectively reduce job burnout in ED nurses and contribute to relieving work-related stress and may further protect against potential mental health problems.

Read the abstract here

Think and Think Again! Clinical Decision Making by Advanced Nurse Practitioners in the Emergency Department

Smith, O. & McCabe, C. International Emergency Nursing. Published online: 8 August 2016

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Image source: Bill McConkey – Wellcome Images // CC BY-NC-ND 4.0

Clinical decision making is a key component of all clinical practice. Over the years many decision making strategies and theories have been developed in order to assist nurses and other healthcare professionals with implementation of appropriate pathways of care for patients.

The decision making capabilities of the novice nurse in comparison to the expert has evoked much opinion and debate over the years (Benner 1985). Recent literature highlights common decision making strategies and the decision making capabilities of nurses in the clinical area.

Read the abstract here

Journal of Emergency Nursing – TOC July 2016

Journal of Emergency Nursing. July 2016. 42(4)

JEN July

Image Source: JoEN

Articles this month include:

  • The Culture of Care Interfacing Internal Validity of Emergency Severity Index
  • Reducing Blood Culture Contaminations in the Emergency Department: It takes a Team
  • Shared Governance and Work Engagement in Emergency Nurses
  • Pediatric Intravenous Medication Administration in the Emergency Department, Part 2: Things We Once Knew

View the full table of contents here