ED Nursing Archives – January 1, 2009
January 1, 2009
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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). -
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. -
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. -
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. -
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. -
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: -
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. -
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. -
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. -
ED nurses say care is quicker and safer
Standing orders used by emergency nurses not only speeds patient care; it also "adds a measure of safety in that they are standardized," says Gayle Walker-Cillo, RN, MSN/Ed, CEN, an ED clinician at Morristown (NJ) Memorial Hospital. -
New non-invasive test can ID internal bleeding in ED
If your patient is bleeding internally, you can know this in seconds instead of waiting for blood test results to come back by using a new non-invasive test for hemoglobin, developed by Irvine, CA-based Masimo. -
These patients can benefit from ED hemoglobin test
Here are three scenarios in which noninvasive hemoglobin measurements could affect an ED patient's care: -
ED makes big changes to med reconciliation process
At Beth Israel Deaconess Medical Center in Boston, ED nurses "made some huge changes" to their medication reconciliation process, reports Shelley Calder, RN, CEN, MSN, clinical nurse specialist for the ED. -
What ED nurses can expect from Obama
Although it's impossible to know what an Obama administration means for emergency nurses, there is reason to be encouraged, according to Denise King, RN, MSN, CEN, president of the Emergency Nurses Association (ENA).