急诊高血钾患者描述性流行病学研究

目的:描述急诊患者高血钾的发生率、诊断率、治疗率、治疗模式和复查率。方法:利用全军合理用药监测网数据管理中心数据库,提取并关联2015年至2017年急诊血钾检测、诊断和用药记录。纳入至少有一次血钾检测记录的18岁以上急诊患者。对如下指标进行了描述性分析：所有患者以及慢性肾脏病、心力衰竭、糖尿病和高血压患者中高血钾发生率...     

身份腕带在急诊科中的应用

总结了身份腕带在急诊科中的应用情况,包括完善急诊、重症、手术室、产房等关键环节的患者身份识别措施,建立"腕带"识别制度,作为实施操作、用药、输血等诊疗活动识别病人的有效手段,认为身份腕带的使用可以有效地提高医务人员对病人识别的准确性,值得临床推广使用.     

Information and communication in the emergency department

BackgroundEffective communication between healthcare providers and patients represents an important caveat in healthcare, both nationally and internationally. Providing information to patients about their care and condition can be challenging, particularly in demanding, time-pressured environments such as the Emergency Department (ED). Understanding the process of communication and information between patients and staff in the ED is essential to ensuring patients are satisfied with their treatment and care.AimThis study aimed to develop a holistic understanding of the informational and communicational requirements of patients and staff in the ED.MethodsAction Research involving patient qualitative interviews and a staff focus group were used.ResultsFifteen patient and family interviews identified four main themes associated with information and communication in the ED. Six ED staff participated in the focus group, which identified three emergent themes echoing some findings from the patient qualitative interviews.DiscussionMeaningful and informative interactions between patients and healthcare providers are an imperative and pragmatic component of a positive patient experience. Establishing communicative procedures that are practical, functional and reflective of the service can improve communications between patients and staff and have implications for practice on a local, national and international level.     

系统思维在急诊临床护理带教的应用

目的探讨如何将系统思维应用于急诊临床护理带教。方法将急诊临床护理带教视作一个开放的系统,通过有效的反馈机制,充分了解系统各部分之间的相互影响、相互作用,从而有利于协调开展带教工作。结果实现了带教系统的整体优化。结论将系统思维应用于临床护理带教,提高了教学质量,增加了带教满意度。     

分组管理在急诊科护理工作中的应用

目的 探讨急诊科实施分组管理的护理效果.方法 根据我院急诊科情况和护士的知识、技能特点,按照急诊种类对31名护士进行分组管理.随机抽样调查方法调查急诊医生对诊治过程中护理工作及患者的满意度,对比实施分科分组前后护理人员的专科业务考核情况,评价分组前后的护理效果.结果 实施分组管理后,急诊科医生及患者对急诊科护理人员工作的满意度显著增高(P＜0.05),护理人员专科考核的得分显著高于分组前(P＜0.001).结论 实施分组管理有利于急诊科护理质量、护士整体素质的提高,有利于急诊科机能的优化发挥,值得推广应用.     

Alternatives to opioids for pain management in the emergency department decreases opioid usage and maintains patient satisfaction

Objective

The objective of this study was to assess opioid use in an emergency department following the development and implementation of an alternative to opioids (ALTO)-first approach to pain management. The study also assessed how implementation affected patient satisfaction scores.

The influence of crowding on clinical practice in the emergency department

Background

This study aimed to clarify the association between the crowding and clinical practice in the emergency department (ED).

Invasive ventilation in the emergency department: Part 2: Implications for patient safety

The use of mechanical ventilation in the Emergency Department requires adequate resources in order to maintain patient safety and avoid potential risks. Moreover, developments in technology require increased knowledge of mechanical ventilation techniques to address the complexity of decision-making involved. Organisational issues and system factors have the potential to negatively impact on the ability of the emergency service to provide optimum care to patients receiving mechanical ventilation. These issues include staffing and skill-mix, demand on emergency services, role-delineation, scope of practice, and current mechanisms for monitoring of quality and safety. Furthermore, in response to advances in ventilator technology, current education programs for both nursing and medical staff require review to ensure that they provide comprehensive information about the types of ventilation techniques now available and the relative risks and benefits associated with their application.This article is the second in a two-part series and explores the educational and organisational factors that impact upon safety and quality of care delivered to patients receiving mechanical ventilation in the emergency department. Recommendations for future policy development, curriculum review and reporting mechanisms to support further research in the application of mechanical ventilation in the emergency department are made.     

Clinician perspectives of a mental health consumer flow strategy in an emergency department

Background

The increasing number of presentations to hospital emergency departments has seen the implementation of a variety of strategies in an effort to enhance care delivery and care continuity. One such strategy was designed and implemented to improve the transition of mental health consumers presenting to an Australian emergency department and admitted to a hospital mental health ward.

急诊科患者健康教育需求的调查分析

目的 探讨急诊科患对健康教育知识的需求。方法 对156例急诊科患进行了问卷调查，由急诊科护士在患就诊期间根据调查内容进行询问，内容包括患对就诊知识的需求及自我保健知识需求等8项。结果 急诊患对健康教育知识的内容最迫切需求有：就诊顺序及方法为96．2%，合理用药知识为96．2%。结论 根据急诊患的需求，制定适合急诊科患的健康教育方法，实施有效的教育内容，达到健康教育的目的。     

Headache patients in the emergency department of a Greek tertiary care hospital

The aim of this study was to record the demographic and epidemiological data on adult patients with headache who attend the emergency department (ED) and the diagnoses that made by the neurologists in the ED of a tertiary care hospital in metropolitan Thessaloniki (Greece). In an open prospective study, demographic and epidemiological data were collected on all patients who reported headache (as chief complaint or not) and presented to the ED of Papageorgiou Hospital between August 2007 and July 2008. Headache patients accounted for 1.3% of all ED patients and for 15.5% of patients primarily referred to the ED neurologist. Tension type headache was the most frequent diagnosis, followed by secondary headaches and migraine. The large number of patients without final ED diagnosis and ward admission for further evaluation sheds a light on the immense workload of Greek ED physicians. Furthermore, we found evidence for the misuse of Emergency Medical Services by chronic headache patients. These findings indicate shortcomings in the pre-hospital (primary care) management of headache patients in the Greek National Health System to an extent unreported so far.     

全程健康教育在心力衰竭患者中的应用

目的 评价心力衰竭患者实施全程跟踪式健康教育的应用效果。 方法 将118例心力衰竭患者随机分为观察组与对照组。观察组60例,按照护理程序实施全程跟踪式健康教育|对照组58例,进行常规入院时与出院前健康教育。 结果 观察组知识掌握度、满意度、遵医嘱情况等均好于对照组,再入院率和死亡率低于对照组。 结论 对心力衰竭患者实施全程跟踪式健康宣教,能够纠正患者的不良生活习惯,减少心力衰竭患者的再次入院率,提高患者对护理服务满意度。     

Treatment of acute heart failure in the emergency department

Millions of patients are hospitalized for acute heart failure (AHF) every year throughout the world. Despite tremendous advances in cardiovascular care, morbidity and mortality for AHF remain high, consuming billions of health care dollars. With the aging of the population, the incidence and prevalence of HF is projected to increase. Yet, initial treatment of AHF today is similar to 40 years ago. Multiple studies have yielded new insights regarding initial management, with regards to both treatment and strategies of care. These advances will be reviewed in the context of initial or early AHF management. There remains, however, an unmet need to improve outcomes for AHF patients.     

深化急诊科健康教育工作的做法和成效

为了深化急诊科的健康教育工作．制定了急诊科健康教育工作的具体措施和激励制度,将健康教育工作与个人月质量考评分及奖金挂勾,实施9个月取得了良好的效果。提高了科内护士整体健康教育水平．促进了患健康知识水平及满意度提高．明确了急诊科下一步健康教育工作的方向。提示健康教育工作的落实和深化,关键在于护理管理与护士的共同努力;良好的健康教育工作措施和制度,能促进健康教育工作持续、稳定、有效地开展．     

Recognition of psychological and cognitive impairments in the emergency department

Ninety-six patients presenting to a university hospital emergency department were screened before triage for psychological symptoms or cognitive impairment using the General Health Questionnaire (GHQ) and Mini-Mental State examination (MMS). Charts were reviewed for demographic information and emergency physicians' recognition of psychological symptoms or cognitive dysfunction. Of the patients studied, 38% had positive results on the GHQ, and 18% had positive results on the MMS. Psychological symptoms or cognitive impairments were recognized by the emergency physicians in only 8% of those with positive GHQ results and 6% of those with positive MMS results. The usefulness of screening measures for psychological symptoms and cognitive impairment of emergency department patients is discussed.     

程序化管理对提高急诊护理质量的效果评价

目的 探讨护理质量程序化管理在急诊护理管理中的应用效果.方法 选择近2年急诊科实施护理质量程序化管理后接诊的861例患者作为研究对象,与实施护理质量程序化管理前的850例患者作对比,观察实施护理质量程序化管理前后的护理质量.结果 实施护理质量程序化管理后护理人员的接诊时间、出车时间、输液差错次数及护患纠纷次数较实施前显著减少;而专科考核得分、抢救成功率及患者对护理工作的满意度较实施前显著提高.结论 在急诊护理管理中应用护理质量程序化管理,可有效提高护理质量及工作效率.     

Pilot testing of the effectiveness of nurse-guided,patient-centered heart failure education for older adults

Heart failure (HF) is the most common cause of hospitalization and rehospitalization among those 65 years and older. Effective HF self-management is recommended for reducing readmissions. This pilot study, through a one-group, pretest-posttest design, examines the effects of nurse-guided, patient-centered HF education on readmissions among older adults (n?=?26) in a post-acute care unit. All selected participants received 3 sessions of tailored patient education. Their knowledge and self-care skills were measured pre- and post-intervention with the Atlanta Heart Failure Knowledge Test (A-HFKT) and the Self-Care of Heart Failure Index (SCHFI). Patients' HF-related knowledge and self-care skills showed statistically significant improvements, and only 1 patient was rehospitalized for any HF-related reason within 30 days post-discharge. These results suggest that HF rehabilitation teams could support better patient outcomes by assigning nursing staff to provide individualized patient education, as this can help ensure that patients understand discharge instructions for effective self-care.