Violence against nurses working in the emergency department

Workplace violence (WPV) in healthcare organizations can lead to serious consequences that negatively affect nurses’ lives and patient care | International Emergency Nursing

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Highlights:

  • Nurses who experience WPV complain of mental and physical health problems.
  • Nurses’ social and professional lives were affected negatively after facing WPV.
  • WPV consequences negatively impact nurses and the entire healthcare organization.
  • The serious consequences of WPV ultimately harm patient care.
  • Preventing violence will ensure a safe workplace and safer patient care.

Full reference: Hassankhani, H. et al. (2017) The consequences of violence against nurses working in the emergency department: A qualitative study. International Emergency Nursing. Published online: 31 July 2017

Triaging the emergency department, not the patient

Triage, as it is understood in the context of the emergency department, is the first and perhaps the most formal stage of the initial patient encounter | Journal of Emergency Nursing

Bottlenecks during intake and long waiting room times have been linked to higher rates of patients leaving without being seen. The solution in many emergency departments has been to collect less information at triage or use an “immediate bedding” or “pull until full” approach, in which patients are placed in treatment areas as they become available without previous screening. The purpose of this study was to explore emergency nurses’ understanding of—and experience with—the triage process, and to identify facilitators and barriers to accurate acuity assignation.

Full reference: Wolf, L.A. et al. (2017) Triaging the emergency department, not the patient: United States emergency nurses’ experience of the triage process. Journal of Emergency Nursing. Published online: 24 July 2017

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