奥运门急诊护理管理体会

探讨大型综合医院门急诊护理管理者在应对如北京奥运会的大型活动医疗护理服务保障管理方法。     

Audit of pain management in the emergency department

Pain management in Malaysian Emergency Departments has not been studied well. Convenience sampling was used to recruit 402 patients who presented with acute pain over a 2-week period. The 11-point Numerical Rating Scale was used to quantify pain. Pain relieving medications were prescribed to 178 patients (44.3%) in the Emergency Department. These patients had a median pain score of 7 on arrival. Nonsteroidal anti inflammatory drugs were the most commonly prescribed class of analgesic. Pain was found to be inadequately treated.     

The new role of the hospital emergency department

The volume of medical services delivered within hospital emergency departments in the City of Saskatoon is increasing rapidly. These probably are not “new” medical services but rather represent a transfer of “old” services to the emergency departments from other sites where they were previously rendered. The visit to the emergency department is initiated more often by the patient than the doctor and once there the patient is treated in a relatively short period of time. The illnesses so managed do not have a diagnostic, therapeutic or prognostic uniformity but rather are characterized by their acute and totally unexpected onset. This acute and non-programmable nature of the illness makes it difficult to deliver the service in a physician's office where the appointment system prevails and efficiently deals with the great majority of his patients. Data to determine whether or not this is a desirable development have not yet been obtained but it is clear that in its present usage the emergency department must be thought of as a facility which not only provides exceptional diagnostic and therapeutic equipment but as one which also provides a treatment facility without prior appointment available at any hour of the day or night.     

Non-admitted elderly in the accident and emergency department

The aim of the study was to identify the functional disabilities and support needs of elderly people who presented but were not admitted to a Dublin Accident & Emergency (A & E) department within a 1 month period. Semi-structured interviews were conducted with 19 per cent (100/532) of the non-admitted elderly within 2 weeks of the A & E visit. Injury related complaints were apparent in 51 per cent of the patients with 3 per cent requiring hospital admission within 2 weeks of the A & E visit. Increased dependency in 1 or more Activities of Daily Living (ADL) occurred in 10 per cent while 28 per cent had increased dependency in 1 or more Instrumental Activities of Daily Living (IADL). Increased family support following discharge was received by 45 per cent of the elderly. The most commonly needed statutory service which was not provided was the home-help service. This study provides baseline data on the non-admitted elderly in one Dublin A & E department and should assist planning of future services.     

Application of clinical indicators in the emergency department

Clinical indicators were developed and used to assess the quality of patient care resulting from the system of shared responsibility between emergency department (ED) and radiology department faculty physicians for interpretation of ED roentgenograms. The first indicator--all discrepancies in roentgenogram interpretation between ED and radiology department faculty--measured an overall discrepancy rate of 3.3% (776 films). Three hundred fifty-two apparent discrepancies were not related to the accuracy with which ED faculty interpreted films, resulting in a revised overall discrepancy rate of 1.8%. The second indicator--undesirable patient care outcomes as a result of delayed accurate radiological diagnosis--measured an occurrence rate of 0 after clinical reevaluation of more than 99% of patients within 24 hours of initial ED evaluation. Aspects of the development and use of clinical indicators are discussed in relationship to the broader monitoring and evaluating process necessary for the continuous improvement of patient care.     

急诊科急救设备的配置与管理

文章简要介绍了急诊科医疗设备的配置与日常管理,以期对急救设备的配置形成一个相对比较合理完善的布局和管理体系,在投资不变的前提下,尽量为急诊科医生提供一个更加有效的支持.