ED Management
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Hospital Leverages Pharmacists, Trained Technicians to Reduce Medication History Errors
To reduce the high number of medication errors observed in the medication lists of medically complex patients who are admitted to the hospital from the ED, Cedars-Sinai Medical Center in Los Angeles developed an intervention whereby pharmacists or trained pharmacy technicians review and prepare medication histories rather than rely on usual care for this task.
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ED-based Intervention Connects Frequent Users With Program to Address Underlying Needs
Grady Memorial Hospital in Atlanta established a Chronic Care Clinic (CCC) to take over the care of high-needs patients who frequent the ED. Navigators intervene with these patients when they present to the ED and connect them to the CCC, which offers an array of services to meet several social and medical needs. The goal of the program is to eventually transition these patients to primary care so their underlying needs can be addressed.
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Opioid Crisis Affects Sickle Cell Patients Presenting With Related Pain
Experts note that opioids are still a first-line therapy for patients with sickle cell disease, but providers are reluctant to prescribe opioids in the current climate.
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Medical Home Within ED Serves Needs of Sparsely Populated Region
North Carolina facility serves as one model for healthcare delivery redesign in rural communities where outcomes have not kept pace with their urban counterparts.
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How to Respond to an Unusual Hepatitis A Outbreak
Recently, several regions in the United States have experienced unusual outbreaks of hepatitis A (HAV). The most severe of these outbreaks is in San Diego, where emergency providers have taken extra steps to identify patients with HAV promptly and to offer vaccinations to patient groups deemed most at risk.
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Revised Standards on Pain Assessment and Management Reflect Concerns About Opioid Epidemic
As of Jan. 1, 2018, The Joint Commission will judge accredited hospitals according to newly revised standards for pain assessment and management. The standards are intended to address some of the unintended consequences of a nationwide focus on the under-treatment of pain, reflected in earlier versions. The revised standards push practitioners to offer alternatives to opioids when appropriate, and to engage patients in treatment planning for their pain so that realistic expectations are established.
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Two-stage Screening Tool Improves Identification of Young Sepsis Patients in ED
Investigators at Children’s Hospital of Philadelphia have developed a two-stage process to better identify children with sepsis while also minimizing alert fatigue. The approach includes an electronic alert tool that flags children with abnormal vital signs, but includes screening questions that enable clinicians to eliminate patients with no sign of infection. This approach is paired with a sepsis huddle to bring clinician judgment into the equation.
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Electronic Tool, Clinical Judgment Replace Electronic Severity Index Triage System
Johns Hopkins Hospital in Baltimore has replaced a widely used triage system with a new decision-support tool that enables nurses at triage in the ED to better differentiate patients based on acuity level. The electronic tool, dubbed e-triage, is able to quickly factor in a patient’s medical history, vital signs, and chief complaint, and compare this information to thousands of other patients.
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How Las Vegas Hospitals Responded to Nation’s Deadliest Mass Shooting
Las Vegas medical professionals describe their experience responding to the nation's deadliest mass shooting that occurred in October. These providers also emphasize the importance of developing a versatile emergency response process that can be deployed in any type of mass casualty event.
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Shocking Nurse Arrest Prompts Discussions About Working With Police Officers
Hospital workers and law enforcement officers often drill together, and they generally work cooperatively to ensure safety and security. Consequently, while disputes are not unheard of, the well-publicized arrest of a Utah nurse who refused to comply with a police detective’s request for a blood sample is a reminder that frontline providers must be well-versed in how to handle such requests.