ED Nursing 2009-01-01

Is your next stroke patient outside treatment window? Don't be so sure

A patient reports stroke symptoms that began four hours ago outside the window for treatment with intravenous tissue plasminogen activator (IV tPA). Read More

Clinical Tips: Do neuro assessment with oncoming nurse

If you're the off-going nurse "handing off" a stroke patient, take the oncoming nurse to the bedside for a brief neurological exam, advises Tia Moore, RN, CEN, clinical nurse educator for the ED at University of California San Diego Medical Center. Read More

Cut delays by taking these actions for stroke

Even with the possibility of a 4½-hour window for treatment of stroke patients, you should always act with a sense of urgency, stresses Stacey Claus, RN, BSN, CNRN, clinical instructor for the Department of Nursing at Cleveland Clinic. Read More

Do this to prepare if your patient might get tPA

If your patient is a possible candidate for tissue plasminogen activator (tPA), past medical/surgical history, allergies, and medications need to be reviewed, says Joyce McIntyre, RN, MSN, clinical nurse specialist for the ED at Massachusetts General Hospital in Boston. Read More

ED's protocol covers all heparin recommendations

Anticoagulant safety is in the spotlight. A recent Sentinel Event Alert issued by The Joint Commission says that 59,316 medication errors involving blood thinners were reported between 2001 and 2006 to a database run by U.S. Pharmacopoeia, a nonprofit public health organization that supports research and development of patient safety initiatives. Of those, about 1,700 resulted in patient harm or death. Read More

3 ways to avoid anticoagulant errors

At Northeast Baptist Hospital in San Antonio, ED nurses are given training to prevent anticoagulant errors during orientation and during advanced certification training, says Wendi Deleon, RN, MS, assistant chief nursing officer and former director of the ED. Here are three ways to avoid problems: Read More

Study finds unacceptable delays in ED pain meds

If you would like to use standing orders for pain management in your ED, a new study's findings give you powerful evidence to share. Read More

Clinical Tips: Don't put patient in sudden withdrawal

An ED physician prescribes nalbuphine or butorphanol for pain, thinking that the patient might have less severe drowsiness than from other pain medications, but doesn't check to see if the patient is chronically on a narcotic for pain control. Read More

CMS says yes, ED nurses can use standing orders

Were you concerned that your ability to use standing orders at triage was in jeopardy? A February 2008 interpretive guideline from the Centers for Medicare & Medicaid Services (CMS) alarmed emergency nurses by requiring patient-specific practitioner approval for standing orders prior to treatment. Read More

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January 1, 2009

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