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Is your patient telling you, "It's probably something I ate," "It's nothing," "There isn't any heart history in my family," or "I'm way too young to have a heart problem?"
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Would you think to tell a receiving nurse that your ED patient has a dog at home she's worried about? That may be the reason she's refusing admission, says Pat Clutter, RN, MEd, CEN, FAEN, an ED nurse at St. John's Lebanon (MO) Hospital.
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At St. Joseph Hospital in Nashua, NH, ED nurses do at least 90% of bedside dysphagia screens while the patient is still in the ED, says Susan L. Barnard, MS, APRN, CCRN, trauma coordinator.
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You, and other ED nurses, may have been taking care of a patient for hours without realizing he or she has an infection that requires isolation. The fast-paced ED environment is an added challenge in preventing ED-acquired infections, according to Susan Gray, RN, BSN, CEN, an ED nurse at Greater Baltimore (MD) Medical Center. "Staff are in and out of rooms often," she adds.
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If you fail to confirm that neurological deficits are a normal baseline for your elder patient, this may be a dangerous assumption. To avoid this mistake, ask others about the patient's baseline, advises Nadya Valdovinos, RN, TNCC, an ED nurse at Northwestern Memorial Hospital in Chicago, and read past medical notes and transfer records.
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Weather forecasters had much of the Southeast on high alert for dangerous storms on Wednesday, April 27, but the clinical and administrative staff at Cullman Regional Medical Center (CRMC) in Cullman, AL, got a particularly vivid view of what these storms were capable of at about 3 o'clock in the afternoon.
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In 2008, there was plenty of evidence that things weren't working very well in the ED at St. Vincent's Medical Center in Bridgeport, CT. The leave-without-being-seen (LWBS) rate was at 5%, the average wait time to see a physician was over two hours, patient satisfaction was in the single digits, and the hospital recorded eight serious safety events in that one year alone.
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With Medicare's new value-based purchasing (VBP) program set to begin impacting payments to most acute-care hospitals in October 2012, providers have been put on notice that the fee-for-service payment methodology is being gradually replaced by payment formulas that reward quality.
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Knee dislocations have the potential to result in significant morbidity and mortality if not correctly diagnosed and optimally managed. Early identification and treatment of neurovascular injury and compartment syndrome may avert disaster for the patient.
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Much attention has been given to injuries of the cervical spine, but injuries to the thoracolumbar region are actually more common. Because of the anatomy involved, these injuries are often accompanied by multiple serious injuries to other areas of the body and may be overlooked during resuscitation and stabilization.
