Emergency Medicine General
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An ED-Friendly Screening Tool to Identify Potentially Violent Patients
Considering violence is a continuing concern in the emergency setting, there is high interest in new mechanisms that can identify potentially violent patients at the front end of their care encounters. This way, safeguards or preventive measures can be activated to keep providers and other patients safe. However, any such tool needs to be brief and easily integrated into the workflow of a busy ED.
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The Case for a Team Approach to Manage Agitated Patients
While many EDs have instituted mechanisms to quickly trigger security staff, a Connecticut hospital created a unique team-based protocol that includes security and clinicians. Everyone works together to protect staff and prevent the need for restraints, sedatives, or other potentially harmful interventions. After three years, staff report they feel safer, and new data show the approach is associated with a lower rate of physical restraint use.
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Remain Vigilant for Signs of Monkeypox
Emergency clinicians should include the possibility of monkeypox in any patient presenting with early symptoms suggestive of the illness and certainly for those with a new rash and epidemiological risk factors.
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Call Patients to Reinforce Discharge Instructions, Stress Need for Follow-Up Care
Follow-up calls to patients after they have been discharged may be far down on the priority list for busy EDs. However new data suggest such calls can ensure patients understand their discharge instructions and prevent repeat visits.
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New Checklist Offers Roadmap for Improved Diagnostic Performance
Researchers created 10 high-priority practices they maintain are key to promoting diagnostic excellence.
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Documentation Mistakes Lead to Significant Malpractice Awards
Ensure charts are generated honestly, and check to make sure key care decisions are carefully documented regarding consent.
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Legally Protective Charting Sticks to the Facts
Charts containing emotional statements, accusations, and speculations might be compelling reading, but they are legally problematic.
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Misconceptions About Homelessness Put Patients, EDs at Risk
Engage these patients in care plans the same as anyone else. Ensure the patient understands the treatment plan, and can carry it out if discharged.
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Many Charge Nurses Receive Little, if Any, Training
Charge nurses are responsible for patient flow, moving them from the waiting room to appropriate disposition. To be effective, these nurses must understand the clinical conditions of the patients in the waiting room. This informs good decision-making on which patients to bring in, in collaboration with the triage nurse, and which nurses to assign those patients.
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Emergency Providers Uneasy About Recording Visits
Clinicians might need more information, such as specifics on who would record the discharge instructions, whether it would be recorded on the patient’s personal smartphone, and what safeguards could be required to ensure patient privacy. Combined with possible involvement of the hospital’s legal department, this might make providers more comfortable with the idea.