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EDs Can Make Discharges Against Medical Advice Safer
Recognizing a discharge as higher risk could encourage physicians and care providers to engage in risk assessment and risk reduction.
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Many Pediatric Patients Leave EDs Without Being Seen
As pediatric patients become more medically complex, inpatient pediatric beds across the country continue to consolidate, and pediatric EDs are expecting to see higher volumes of children. Healthcare leaders must build these considerations into their staffing and patient flow approaches if they hope to prevent more patients from leaving without before they are seen.
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Was Child Brought to ED by EMS? Medication Dosages May Be Incorrect
ED personnel should ensure a good handoff report is received from EMS providers, and that the dose of any medications administered by EMS is recorded. ED personnel should be mindful in carrying out weight-based dosing calculations, and should follow recommendations of national guidelines.
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Onsite Pharmacies Can Boost Medication Access to Patients, Surrounding Communities
There are some other possible workarounds, such as leveraging electronic prescribing from the ED so providers will know quickly whether medications are available in a specific outpatient pharmacy, administering first antibiotic doses in the ED, and providing a few days’ worth of medication to patients about to be discharged.
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Irritable Patient Behavior Affects Emergency Nursing Assessments
For encounters during which the patient exhibited irritable behavior, nurses reported more anger and unease. They also judged the patients as likely to exaggerate pain, as poorer historians, and less likely to cooperate and return to work and recover. In their documentation, nurses were more likely to use negative descriptions of patients and more likely to omit information, such as whether tests were ordered.
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Is ED Patient Rude or Insulting? Risk Mitigation Needed
Patients who behave in this manner could be at risk for a missed diagnosis caused by poor communication with the treatment team. They may be so difficult to tolerate that they receive less attention and nursing care than they would have otherwise. The best approach is to recognize the risks with these types of patients and mitigate them.
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Emergency Medicine Residents Should Be Aware of Legal Exposure
To alleviate malpractice risks involving residents, attendings should implement a reasonable and adequate plan for the patient along with the resident; review the patient’s lab and imaging results; and, ultimately, be the decision-maker as to the patient’s ultimate disposition.
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Ensuring Compliance in Case Management Is Critical
Many compliance issues in the CMS Conditions of Participation for utilization review and discharge planning need attention. Ensuring compliance is critical for improving patient care, preventing financial penalties or sanctions, and avoiding trouble with governmental authorities by identifying and correcting compliance issues early.
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Consider the Burden for Those Caring for Older Trauma Patients
Family caregivers of older people who have experienced a serious fall or another traumatic event sometimes are unprepared for the role. The authors of a recent study found close to one-third of family caregivers of older trauma patients experience high caregiver burden up to three months after the patient’s discharge.
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Pandemic-Era Care Transitions Led to ED Overcrowding
Researchers found that adult patients who visited EDs in a North Carolina health system between March 1, 2020, and March 1, 2022, faced significantly longer stays if they were transitioned from the ED directly to a skilled nursing facility (SNF) instead of transitioning to a hospital bed and then to a SNF.