Blood Withdrawal from Intravenous Catheters by ED Nurses: Comparison of Two Practices

Nazaretian, H.H. et al. Journal of Emergency Nursing | Published online: 25 April 2017

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Problem: Laboratory tests are essential to diagnosis and treatment in the emergency department, but they can result in prolonged waiting times for patients, multiple needle pricks, and complaints about pain and discomfort. The goal of this project is to assess if a change in the blood collection process will lead to any improvement and benefit in care delivered with regard to time, patient comfort, and cost.

Implications for Practice: Allowing registered nurses to withdraw blood with the start of a peripheral intravenous line will significantly reduce length of stay and costs and enhance patient experience in the emergency department at American University of Beirut Medical Center.

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Patient experience of different regional models of urgent and emergency care

Foley, C. et al. (2017) BMJ Open. 7:e013339

Objectives: To compare user experiences of 8 regional urgent and emergency care systems in the Republic of Ireland, and explore potential avenues for improvement.

Conclusions: No consistent relationship was found between the type of urgent and emergency care model in different regions and patient experience. Scale-level data may not offer a useful metric for exploring the impact of system-level service change.

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Resiliency and quality of life trajectories after injury

Zarzaur, B. et al. Journal of Trauma and Acute Care Surgery. Published online: 23 February 2017

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Background: Injury can greatly impact patients’ long-term quality of life. Resilience refers to an individual’s ability to positively adapt after facing stress or trauma. The objective of this study was to examine the relationship between pre-injury resiliency scores and quality of life after injury.

Conclusion: Patient resiliency predicts quality of life after injury in regards to mental health with over 25% of patients suffering poor mental health outcome trajectories. Efforts to teach resiliency skills to injured patients could improve long-term mental health for injured patients. Trauma centers are well positioned to carry out such interventions.

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Palliative Care in the Emergency Department

Cooper, E. et al. (2016) Emergency Medicine Journal 33:919-920

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Objectives & Background: Emergency departments (EDs) receive a variety of patients: those with unexpected injuries or trauma, chronic disease exacerbation or progression and existing advanced disease or terminal illness. Thus expectations of attendees can vary greatly. However the primary focus of EDs is acute management.The provision of tailored palliative care (PC), that meets the unique needs of people with advanced disease, is often difficult in the ED. The main objective of this qualitative synthesis was to increase understanding of the ED experience of people with advanced disease, their relatives and healthcare professionals.

 

Conclusion: This synthesis has provided a greater breadth of insight to enable recurring themes regarding the potential conflicts between emergency care and PC to be identified with a view to overcoming the challenges faced. Significantly recognising the need for educating ED physicians in the scope and components of PC, improving interdisciplinary working and enabling better understanding of patients and carers about their likely disease progression and the opportunities open to them. Further research should focus on the best ways to provide such education, the specific reasons for shortfalls in communication and how these could be overcome.

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