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At Loma Linda (CA) University Medical Center, ED nurses have decreased door-to-EKG time to 11 minutes from almost an hour a year ago, reports Teri D. Reynolds, RN, BSN, clinical educator in the Department of Emergency Services.
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When a woman came to the ED at Christiana Care Health System in Wilmington, DE, complaining of nausea, vomiting, and diarrhea, she was initially triaged as low acuity. "But when the ED nurse saw how uncomfortable the patient was, she decided to do an EKG on her," says Kelly Powers, RN, an ED nurse at the hospital.
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Do all pediatric asthma patients receive relievers, corticosteroids, and a home management plan in your ED? These are three measures of care for which The Joint Commission is collecting data.
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ED nurses at the University of California Medical Center Irvine use a protocol for handoffs that involves giving verbal reports to the accepting unit using the SBAR (Situation-Background-Assessment-Recommendation) format. Sanna K. Henzi, RN, MSN, trauma injury prevention coordinator, gives this example of an incomplete report:
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A patient involved in a motor vehicle accident was alert with stable vital signs when he arrived at an ED. Three hours later, a nurse from the step-down unit came to transfer the patient for continued monitoring. She saw that he no longer was opening his eyes and didn't respond to verbal commands.
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Make sure staff wash their hands consistently. It sounds simple enough, and it's necessary to comply with The Joint Commission's National Patient Safety Goal to prevent deadly health care-associated infections due to multiple drug-resistant organisms. But it's anything but easy for most EDs to do this.
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Here are three steps to take to prevent hospital-acquired infections in your ED:
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Overcrowding, higher-acuity patients being held in hallways, and The Joint Commission's new National Patient Safety Goals (NPSGs) for 2009: It's the "perfect storm" to put hospital-acquired infections on the top of any ED nurse's priority list.
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As the effective response of the ED at Mercy Medical Center in Cedar Rapids, IA, to the recent floods demonstrates, the extra dollars required to invest in top-notch communications systems are well worth it, according to Rich Head, director of information services.