BACKGROUND: For emergency department(ED) patients, risk assessment, prophylaxis, early diagnosis and appropriate treatment of venous thromboembolism(VTE) are essential for preventing morbidity and mortality. This stud...BACKGROUND: For emergency department(ED) patients, risk assessment, prophylaxis, early diagnosis and appropriate treatment of venous thromboembolism(VTE) are essential for preventing morbidity and mortality. This study aimes to investigate knowledge amongst emergency medical staff in the management of VTE. METHODS: We designed a questionnaire based on multiple scales. The questionnaire was distributed to the medical and nursing clinical staff in the large urban ED of a medical center in Northern China. Data was described with percentages and the Kruskal-Wallis test was used to compare ranked data between different groups. The statistical analysis was done using the SPSS 22.0 software.RESULTS: In this survey, 180 questionnaires were distributed and 174 valid responses(response rate of 96.67%) were collected and analyzed. In scores of VTE knowledge, no signifi cant differences were found with respect to job(doctor vs. nurse), the number of years working in clinical medicine, education level, and current position, previous hospital experience and nurses' current work location within the ED. However, in pair wise comparison, we found participants who worked in ED for more than 5 years(n=83) scored signifi cantly higher on the questionnaire than those under 5 years(n=91)(95.75 vs. 79.97, P=0.039). There was a signifi cant difference in some questions based on gender, age, job, and nurse work location, number of working years, education level, and different ED working lifetime.CONCLUSION: Our survey has shown defi ciencies among ED medical staff in knowledge and awareness of the management of VTE. We recommend several changes be considered, such as the introduction of an interdisciplinary workshop for medical staff; the introduction of a standardized VTE protocol; a mandatory study module on VTE for new physicians and nurses; the introduction of a mandatory reporting system for adverse events(including VTE).展开更多
Study Aim: Descriptions of the direct services of a psychologist (i.e. clinical psychology intern) in an accident and emergency department (AED) are provided as a new and rare area of professional practice. Method: Da...Study Aim: Descriptions of the direct services of a psychologist (i.e. clinical psychology intern) in an accident and emergency department (AED) are provided as a new and rare area of professional practice. Method: Data were collected in a large, Hong Kong, government hospital over an eighteen-month period. Recipients included 281 patients, 150 medical staff members, and 44 relatives of patients. Results: Interventions with patients and their family members centered on crisis management, diagnostic assessment, psychoeducation, and consultations regarding long-term adjustment to medical infirmities. The majority of staff members sought consultations regarding work related stress such as burnout symptoms and coping with vicarious trauma experiences. Frequency tables provide information on utilization of specific services while case vignettes contextualize psychological interventions. Conclusion: There are many potential benefits of psychological service for AED patients and staff.展开更多
目的:探讨临床护理人员突发公共卫生事件应急能力的影响因素,为提高临床护士突发公共卫生事件应急能力提供科学依据。方法:计算机检索PubMed、中国知网、Web of Science、维普数据库、the Cochrane Library、中国生物医学文献服务系统、...目的:探讨临床护理人员突发公共卫生事件应急能力的影响因素,为提高临床护士突发公共卫生事件应急能力提供科学依据。方法:计算机检索PubMed、中国知网、Web of Science、维普数据库、the Cochrane Library、中国生物医学文献服务系统、Embase和万方数据库中关于临床护理人员突发公共卫生事件应急能力影响因素研究的文献,检索时限为建库至2023年5月31日。采用澳大利亚学者循证护理中心研制横断面研究偏倚风险评价标准进行文献质量评分。根据I 2值和P值对文章进行异质性判断,并选用相应的效应模型;观察通过去除任意1项研究后其合并效应量的稳定性来进行敏感性分析。结果:共纳入8篇横断面研究,提取6个相关的影响因素。Meta分析结果显示,性别[SMD=0.46,95%CI(0.34,0.58)]、职称[SMD=-0.17,95%CI(-0.22,-0.13)]、突发公共卫生事件培训课程[SMD=0.74,95%CI(0.57,0.92)]、灾害救援活动经历[SMD=0.49,95%CI(0.43,0.54)]、突发公共卫生事件演练[SMD=0.61,95%CI(0.41,0.82)]是影响临床护理人员应急能力的影响因素(P<0.05)。敏感性分析结果显示,Meta分析结果相对稳定。漏斗图提示纳入文献的发表偏倚风险较低。结论:我国临床护士突发公共卫生事件应急能力仍需提升,护理管理者可根据不同的影响因素制订针对性干预措施,从而更好地提升护士突发公共卫生事件应急能力,储备突发公共卫生事件应急人员。展开更多
Background:Overcrowding in Emergency Departments(EDs)is a significant global concern with negative consequences for patients,healthcare staff,and healthcare systems.The use of EDs by parents of children with non-urgen...Background:Overcrowding in Emergency Departments(EDs)is a significant global concern with negative consequences for patients,healthcare staff,and healthcare systems.The use of EDs by parents of children with non-urgent conditions is associated with overcrowding,higher healthcare costs,lower quality of care,and longer waiting times.Research in this area has largely been conducted in high-income countries,with a dearth of work originating in middle and low-income regions.The aim of this study was to explore the reasons for parents attending EDs with their child for non-urgent conditions in Turkey.Method:Semi-structuredinterviews wereconductedwith 13parents,15 EDstaff,and10GeneralPractitioners(GPs)in2 regions of Turkey between March and May 2017.Data were analyzed using the principles of grounded theory.Results:The findings were classified into 5 core categories:(1)parents’feelings,knowledge,and perceived inability to provide self-care;(2)perceived limitationsofhealthcare services,system,and staff;(3)parents’preferencesforhospital andED services;(4)adverse impact on ED services;and(5)perceived needs for care.Conclusion:This is the first study conducted in a middle-income country regarding parental reasons for using the ED for non-urgent conditions.Greater efforts must be made to reduce unnecessary visits to the ED to better meet service user needs and to increase the satisfaction of both parents and healthcare staff.The findings of this study may inform healthcare providers,policymakers,healthcare staff,and researchers to design interventions in order to mitigate overcrowding in the ED.展开更多
文摘BACKGROUND: For emergency department(ED) patients, risk assessment, prophylaxis, early diagnosis and appropriate treatment of venous thromboembolism(VTE) are essential for preventing morbidity and mortality. This study aimes to investigate knowledge amongst emergency medical staff in the management of VTE. METHODS: We designed a questionnaire based on multiple scales. The questionnaire was distributed to the medical and nursing clinical staff in the large urban ED of a medical center in Northern China. Data was described with percentages and the Kruskal-Wallis test was used to compare ranked data between different groups. The statistical analysis was done using the SPSS 22.0 software.RESULTS: In this survey, 180 questionnaires were distributed and 174 valid responses(response rate of 96.67%) were collected and analyzed. In scores of VTE knowledge, no signifi cant differences were found with respect to job(doctor vs. nurse), the number of years working in clinical medicine, education level, and current position, previous hospital experience and nurses' current work location within the ED. However, in pair wise comparison, we found participants who worked in ED for more than 5 years(n=83) scored signifi cantly higher on the questionnaire than those under 5 years(n=91)(95.75 vs. 79.97, P=0.039). There was a signifi cant difference in some questions based on gender, age, job, and nurse work location, number of working years, education level, and different ED working lifetime.CONCLUSION: Our survey has shown defi ciencies among ED medical staff in knowledge and awareness of the management of VTE. We recommend several changes be considered, such as the introduction of an interdisciplinary workshop for medical staff; the introduction of a standardized VTE protocol; a mandatory study module on VTE for new physicians and nurses; the introduction of a mandatory reporting system for adverse events(including VTE).
文摘Study Aim: Descriptions of the direct services of a psychologist (i.e. clinical psychology intern) in an accident and emergency department (AED) are provided as a new and rare area of professional practice. Method: Data were collected in a large, Hong Kong, government hospital over an eighteen-month period. Recipients included 281 patients, 150 medical staff members, and 44 relatives of patients. Results: Interventions with patients and their family members centered on crisis management, diagnostic assessment, psychoeducation, and consultations regarding long-term adjustment to medical infirmities. The majority of staff members sought consultations regarding work related stress such as burnout symptoms and coping with vicarious trauma experiences. Frequency tables provide information on utilization of specific services while case vignettes contextualize psychological interventions. Conclusion: There are many potential benefits of psychological service for AED patients and staff.
基金PhD funding was provided by the Republic of Turkey’s Ministry of National Education.
文摘Background:Overcrowding in Emergency Departments(EDs)is a significant global concern with negative consequences for patients,healthcare staff,and healthcare systems.The use of EDs by parents of children with non-urgent conditions is associated with overcrowding,higher healthcare costs,lower quality of care,and longer waiting times.Research in this area has largely been conducted in high-income countries,with a dearth of work originating in middle and low-income regions.The aim of this study was to explore the reasons for parents attending EDs with their child for non-urgent conditions in Turkey.Method:Semi-structuredinterviews wereconductedwith 13parents,15 EDstaff,and10GeneralPractitioners(GPs)in2 regions of Turkey between March and May 2017.Data were analyzed using the principles of grounded theory.Results:The findings were classified into 5 core categories:(1)parents’feelings,knowledge,and perceived inability to provide self-care;(2)perceived limitationsofhealthcare services,system,and staff;(3)parents’preferencesforhospital andED services;(4)adverse impact on ED services;and(5)perceived needs for care.Conclusion:This is the first study conducted in a middle-income country regarding parental reasons for using the ED for non-urgent conditions.Greater efforts must be made to reduce unnecessary visits to the ED to better meet service user needs and to increase the satisfaction of both parents and healthcare staff.The findings of this study may inform healthcare providers,policymakers,healthcare staff,and researchers to design interventions in order to mitigate overcrowding in the ED.
