ED Management – April 1, 2022
April 1, 2022
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As Opioid Epidemic Continues Unabated, EDs Mobilize to Save Lives
Investigators have made remarkable progress in identifying patients with opioid use disorder when they present to the ED, and convincing frontline providers to initiate these patients on medication-assisted treatment. Further, they have been regularly documenting their ongoing improvement efforts to offer other EDs a potential roadmap for how to improve in this area and sustain that progress.
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Emergency Nurses Aim to Improve Care of OUD Patients
When armed with appropriate screening questions, nurses can better identify and assist patients with opioid use disorder. Because nurses often are the first care team member a patient sees, an interdisciplinary approach makes sense to ensure all components of a patient’s health are addressed.
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Understanding Each COVID-19 Test’s Strengths and Weaknesses
Considering that testing over multiple days is not practical in the ED, clinicians with access to relatively rapid RT-PCR testing probably will opt for the more sensitive test. However, the antigen test offers a good option to urgent care centers or EDs that lack access to a sophisticated lab.
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Integrate Youth Violence Prevention into Busy ED Workflow
There is an opportunity to intervene with young patients when they present to the ED for treatment of violence-related injuries. However, much less is known about how facilities can effectively seize this opportunity, considering the often-frantic pace of a busy department.
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Legal Exposure if EMS Are Noncompliant with Stroke Guidelines
If clinicians miss a stroke diagnosis or delay care for that condition, plaintiff attorneys are going to scrutinize everything ED providers could have done differently. However, whatever problems there are or were all could have started well before the patient arrived at the facility. In fact, most patients receive prehospital stroke care from EMS that is noncompliant with American Stroke Association guidelines.
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Patients Do Not Know if They Are Seeing an APP or an EP
Many patients do not realize the type of medical professional who handled their care. There are numerous unreliable, subjective ways patients may presuppose the credentials of the members of their care team, including individual partialities, along with personal and cultural experiences.
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Youth Spend Days in EDs Waiting for Psychiatric Inpatient Care
Negative care outcomes, treatment delays, risk of injury (to patients, family, or staff), and poor satisfaction are undesirable outcomes resulting from boarding.
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Crowding Linked to Higher Risk of Children Leaving Without Assessment
Researchers argue leave without being seen rates should no longer be considered an isolated problem, but rather a costly consequence of ED crowding resulting from poor patient flow through the hospital and across the system.
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Noncompliance with Sepsis Measures Used to Prove Care Was Negligent
Along with growing general awareness, there are several positive developments in ED sepsis care, including laboratory tests helpful in diagnosing sepsis cases that have improved substantially. Also, there are new biomarkers of sepsis that are promising, and new molecular tests allow a lab to identify blood-borne infections in hours instead of the days formerly required for blood cultures to grow.
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Time-to-Disposition Delays Are Possible if Patient Is Seen Early
Recent study findings reflect the different types of work occurring during an ED shift. At the beginning of a shift, providers prioritize seeing new patients and initiating workups. At the end of a shift, providers transition to following up on lab or imaging results, and making decisions on whether to admit or discharge.