Australasian Emergency Nursing Journal

Kate Curtis

Stephen Asha

Annalise Unsworth

Mary Lam

Helen Goldsmith

Mary Langcake

Donovan Dwyer

Nicole Coombs

Joanne Porter

Alison Beauchamp

Kelly Decker

Sharyn Ireland

Lorna O'sullivan

Sue Boucher

Lauren Kite

Deb Rhodes

Mitra Biswadev

To compare advanced musculoskeletal physiotherapists with other health professionals by measuring outcomes for patients presenting to the emergency department with lower limb soft tissue injuries or acute low back pain.A prospective study was conducted (Lower limb soft tissue injury cohort, n=88), (Acute low back pain cohort, n=29) at the emergency departments of two urban hospitals. A univariate analysis was completed for a number of outcome measures: Lower Extremity Functional Scale, Roland Morris Disability Questionnaire, imaging requirements, Patient Satisfaction Questionnaire, Numerical Pain Rating Scale and medication use. Data was obtained at discharge, two weeks and six weeks post-discharge.Advanced musculoskeletal physiotherapists ordered less imaging, had less opioids (lower limb soft tissue injury) administered to patients, and patients' described equal or more satisfaction when compared to another health professional (p<0.05). No significant differences were found between groups for functional or pain related outcomes in both cohorts (p>0.05).Advanced musculoskeletal physiotherapists are less likely to order imaging, obtain similar outcomes regarding pain medications and display equal or more patient satisfaction when compared to other health professionals for patients presenting to the emergency department with lower limb soft tissue injuries or acute low back pain.

Peter Schulz

Jonathan Prescott

Janine Shifman

Julio Fiore

Anne Holland

Paula Harding

Comparing patient outcomes for care delivered by advanced musculoskeletal physiotherapists with other health professionals in the emergency department—A pilot study

比较高级肌肉骨骼物理治疗师与其他急诊科医护人员提供的患者护理结果——一项试点研究

In 2011, Thailand was affected by the one of the worst flood disasters in recent times. Hospitals in Thailand were faced with the challenge of managing the health impacts from this natural disaster. The purpose of this study was to assess flood disaster preparedness among hospitals in the central region of Thailand.A survey questionnaire was given to twenty-seven key people responsible for hospital disaster preparedness that experienced disruptions to health services (severely, moderately and slightly) during the flood disaster in 2011 in the central region of Thailand.Of the twenty-four participating hospitals, not one had satisfied the standards in all the dimensions of flood disaster preparedness. All respondent hospitals were deficiently prepared with regard to surge capacity, the management of healthcare services and the management of the supporting systems. The availability of supplies and equipment were found to be in place but preparations were found to be inadequate in organizing staff at all participating hospitals. Trained staff members regarding disaster response were reported to be present in all respondent hospitals. Hospitals that experienced slightly disruptions to their health services did not elect to do any exercises to meet the set standards. None of the hospitals that experienced slightly disruptions to their health services performed any evaluation and improvement in terms of disaster preparedness.Many hospitals were not up to standard in terms of disaster preparedness. Hospitals should prioritize disaster preparedness to fulfill their responsibility during crisis situations and improve their flood disaster preparedness.

Kanittha Rattanakanlaya

Achara Sukonthasarn

Suparat Wangsrikhun

Chawapornpan Chanprasit

A survey of flood disaster preparedness among hospitals in the central region of Thailand

泰国中部地区医院洪水灾害准备情况调查

Disaster management is critical, as its insight could diminish the impact of a disaster, and participation of emergency medical personnel is crucial. This study explores emergency medical personnel's knowledge, attitude and practice towards disaster management.This study utilised a cross-sectional study design, and the data collected from 194 emergency nursing and medical personnel (staff nurses, doctors and assistant medical officers), using a questionnaire.Majority of the personnel had an adequate knowledge and practices, and portrayed a positive attitude towards disaster management. Amongst the sociodemographic factors studied, gender and education level were significantly associated with increased knowledge and practice scores. Working experience, involvement in disaster response and attended disaster training had a significant association with higher practice scores. None of the sociodemographic factors studied had an effect on attitude scores.Despite the diversity of their backgrounds, respondents exhibited their adequate knowledge and practice, and had positive attitudes towards disaster management. It is substantial for emergency nursing and medical personnel, to inhibit the severity of the impacts of the disasters. Their knowledge, attitude and practice studies could assist in the implementation of programmes relevant to disaster management to ensure their preparedness to assist the affected communities.

Nurul’Ain Ahayalimudin

Nor Naimah Saidah Osman

Disaster management: Emergency nursing and medical personnel’s knowledge, attitude and practices of the East Coast region hospitals of Malaysia

灾害管理：马来西亚东海岸地区医院急诊护理和医务人员知识、态度与实践

Understanding of clinical deterioration of emergency department patients is rapidly evolving. The aim of this study was to investigate the frequency and nature of vital sign collection and clinical deterioration in emergency care.A descriptive exploratory approach was used. Data were collected from the records of 200 randomly selected adults with presenting complaints of abdominal pain, shortness of breath, chest pain and febrile illness from 1 January to 31 December 2014 at a 22 bed emergency department in Melbourne, Australia.When controlled for length of stay, heart rate was the most frequently assessed vital sign per hour (median=0.9) whilst Glasgow Coma Score was the least frequently assessed vital sign per hour (median=0.5). Clinical deterioration (one or more vital signs fulfilling hospital medical emergency team activation criteria during emergency department care) occurred in 14.5% of patients. Of the 5466 vital sign measures, 19.6% were abnormal, 1.9% indicated clinical deterioration.Clinical deterioration occurred in one in seven patients, and one in five vital signs documented were outside of accepted normal ranges. Thus, emergency department physiological status has implications for patient safety and nursing practice, in particular clinical handover for patients requiring hospital admission.

Katherine Lambe

Judy Currey

Julie Considine

Frequency of vital sign assessment and clinical deterioration in an Australian emergency department

澳大利亚急诊科生命体征评估频率与临床恶化的关系

Shannon Bakon

Tracey Millichamp

Chris Kingswell

Ramon Shaban

Julia Crilly

Sharyn Plath

Mary Wright

Julia _________________

Margaret Fry

Steve Kay

Rosalind _________________

Helen Rawson

Paul Bennett

Cherene Ockerby

Alison Hutchinson

Julie ______________________

Karen Hammad

Paul Arbon

Kristine Gebbie

Alison Hutton

Background We experience our lives as a series of memorable moments, some good and some bad. Undoubtedly, the experience of participating in disaster response, is likely to stand out as a memorable moment in a nurses' career. This presentation will describe five distinct moments of nursing in the emergency department (ED) during a disaster response. Methods A Hermeneutic Phenomenological approach informed by van Manen underpins the research process. Thirteen nurses from different countries around the world participated in interviews about their experience of working in the ED during a disaster. Thematic analysis resulted in five moments of disaster response which are common to the collective participant experience. Results The 5 themes emerge as Notification (as a nurse finds out that the ED will be receiving casualties), Waiting (waiting for the patients to arrive to the ED), Patient Arrival (the arrival of the first patients to the ED), Caring for patients (caring for people affected by the disaster) and Reflection (the moment the disaster response comes to an end). Conclusion This paper provides an in-depth insight into the experience of nursing in the ED during a disaster response which can help generate awareness and inform future disaster preparedness of emergency nurses.

Karen S. Hammad

Moments of disaster response in the emergency department (ED)

急诊科灾难响应时刻

Background Patients arriving at the Emergency Department (ED) via ambulance can experience a delay in receiving definitive care. In Australia, this phenomenon is referred to as 'Ambulance Ramping', 'Patient Off Stretcher Time Delay' or 'Offload Delay'. As a direct consequence of crowding, and in the context of a worldwide increase in ED and ambulance usage, hospital and ambulance service function is hampered. The aim of this review was to synthesize the literature with respect to the conceptualisation, meaning, antecedents and consequences of Ambulance Ramping. Methods This was a scoping review and synthesis of the literature. Six search terms were employed: emergency medical technician; paramedic; ambulance; hospital emergency services; delay; and ambulance ramping. Journal articles that discussed Ambulance Ramping (or similar terms), and were published in English between 1983 and March 2015 were included. PubMed and CINAHL Plus databases were searched, with secondary searches of reference lists and grey literature also undertaken. Results Thirteen papers were selected and inform this review. Several terms are used internationally to describe phenomena similar to Ambulance Ramping, where there is a delay in patient handover from paramedics to ED clinicians. Antecedents of Ambulance Ramping included reduction/limitation of ambulance diversion, patient acuity, the time of day, the day of the week, insufficient ED staff, insufficient ED beds, and high ED workload. Consequences of Ambulance Ramping include: further delays in patients' ability to receive definitive care and workforce stressors such as missed meal breaks, sick leave and staff attrition. Conclusion While the existing research literature indicates that Ambulance Ramping is problematic, little is known about the patient's experience of Ambulance Ramping; this is required so that an enhanced understanding of its implications, including those for emergency nurses, can be identified.

Ramon Z. Shaban

Concepts, antecedents and consequences of ambulance ramping in the emergency department: A scoping review

急诊科救护车滞留的概念、前因与后果：范围综述

Emergency department presentations by older people associated with mental health and drug and alcohol related conditions are increasing. However, the characteristics of presentations by older people in Australia are largely unknown. The aim of this research was to explore the characteristics of older people presenting with mental health and drug and alcohol conditions.We used a retrospective electronic medical record audit to explore all emergency department presentations by older people 65 years and over for mental health and drug and alcohol related conditions over a 12 month period. Data were described using descriptive statistics.There were 40,093 presentations; 2% (n=900) were related to mental health or drug and alcohol related conditions. Presentations were mainly associated with primary mental or medical symptoms. The majority were female (n=471; 53%). Predominate conditions were cognitive impairment (n=234; 26%) and affective disorders (n=233; 26.0%). Sixty-three percent of patients were admitted to a hospital ward. Over the study period 106 patients (242 episodes of care) represented.Given the ageing population and increasing prevalence for mental health and drug and alcohol conditions, strategies are required to better recognise these conditions to reduce the burden on the health care system and improve health for older people.

Rosalind M. Elliott

Emergency department presentations by older people for mental health or drug and alcohol conditions: A multicentre retrospective audit

老年人因精神健康或药物酒精问题到急诊科就诊：一项多中心回顾性审计

The effective handover of patient health data from the emergency department to other hospital units is integral for the continuity of patient care. Yet no handover process has been identified as superior to others within this context.This study within a regional Australian hospital employed mixed methods approach including focus groups and key stakeholder consultation to develop a handover form appropriate for patient transfer from the emergency department to a variety of clinical areas. Paper-based surveys and audits were then employed to evaluate the implementation and understand staff perceptions of the form.The implementation of a patient handover form within the emergency setting was well received. Participants indicated that the form is clear, well designed and easy to navigate. It provided prompts to standardise their clinical handover and increased their accountability and responsibility within this process.To deliver an optimal nursing handover from the emergency department to various wards handovers should be structured and provide standardised content. The positive reception and use of this form provides evidence that a structured handover process can ensure standardisation of emergency department to ward nursing handovers.

Optimising the emergency to ward handover process: A mixed methods study

优化急诊至病房交接流程：一项混合方法研究

Publication Information	Publisher: Elsevier B.V.，Publishing cycle: ，Journal Type: journal，Open Access Journals: No
Basic data	Year of publication: 2005，Proportion of original research papers: ，Self Citation Rate:， Gold OA Rate:

Australasian Emergency Nursing Journal

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