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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.
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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.
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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.
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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:
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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.
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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.
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Clinical Assistant Professor of Medicine, Division of Infectious Diseases and Geographic Medicine, Stanford University School of Medicine
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When critical illness occurs, the primary goal is to assist patients to survive the acute threat to their lives. This goal is commonly achieved with 75%-90% of patients who are admitted to an intensive care unit (ICU) surviving to discharge.