The authors of a recent analysis examined 13 studies about nurse-ordered testing at triage. Ten studies were about length of stay or time to diagnosis. The authors of the other three compared tests ordered at triage with tests ordered by emergency physicians. There were some surprising findings.
Northwestern Medicine Lake Forest Hospital in Illinois had attempted to reduce hospital-acquired pressure injuries for years, with some success, but hospital leaders remained unhappy with the rate of pressure ulcers. Making changes stick required a change in culture.
Decision support technology can help case managers improve transitions of care and more easily access patient information necessary for an optimal discharge. The algorithm can collect data on patients’ functional status, cognition, caregiver status, and other important characteristics.
Stress has long been a serious problem for physicians and nurses, but the added burden of COVID-19 is bringing attention to a particular challenge: All too often, clinicians are reluctant to seek the support of their employee assistance programs and other mental health resources available to them. A primary reason they avoid seeking help is that they fear they will face negative repercussions at work, even losing their jobs, according to recent research.
Emergency nurses and physicians may not understand the liability implications of using charts to air grievances. A unified defense is recognized as the best approach for all defendants in ED malpractice claims, but finger-pointing notes make it difficult. Physicians and nurses should meet briefly before each shift to discuss the importance of teamwork, not only regarding patient care but also documentation.
Executive nurse leaders can collaborate with states and professional organizations to advocate for smoke evacuation legislation, and they can create policies at their facilities to mitigate surgical smoke.
It is unclear whether the claims involved IV infiltration, thrombophlebitis, pain caused by multiple sticks, or inadvertent arterial placement. Prevention efforts might include procedural training, integration of ultrasound in IV placement, or escalation of patients with difficult access to providers who specialize in IV access.