| Records |
| Author |
Blackmore, L.A. |
| Title |
Triaging patients away from the emergency department: A review of the issues |
Type |
|
| Year |
2006 |
Publication |
|
Abbreviated Journal |
Victoria University of Wellington Library |
| Volume |
|
Issue |
|
Pages |
|
| Keywords |
Emergency nursing |
Abstract  |
With the intention of decreasing emergency department demand, there has been a focus on determining those patients who do not require the services of the emergency department so they can be redirected away to an alternative health care provider or facility. Co-locating an after-hours primary health care facility near to the emergency department is a model under consideration in some district health boards. This model suggests that a substantial proportion of the patients currently managed in the emergency department can be assessed and managed in a general practice setting. It is envisaged that by redirecting the lower acuity patients away from the emergency department, overcrowding will be relieved. This is despite evidence demonstrating that low acuity patients are not the cause of emergency department overcrowding. Moreover, being treated at the emergency department is the only safety net for many people in the community who cannot afford alternative care. This research report discusses the literature regarding the practice of referring or redirecting patients away from the emergency department and the issues associated with this model. In doing this, it looks at the Australasian Triage Scale, the system used to ensure patients are seen in order of clinical urgency, because it has been suggested that this system could be used as a tool to refer patients away from the emergency department. The author concludes that even though some people could be seen by another health care provider, the triage system is not an appropriate tool for achieving this. While it is tempting to believe that patients in the lower triage categories are prime candidates for being referred away, there is evidence from hospital statistics that patients in these categories have a high number of hospital admissions and in-hospital death rates. Additionally, to complicate matters, there is no universal definition of what constitutes an 'appropriate' emergemcy department presentation and no consensus of opinion amongst health professionals in deciding patients' 'appropriateness'. For these reasons it is unethical to expect nurses who administer the triage system to use it for the purpose of referring people away from the emergency department. |
| Call Number |
NRSNZNO @ research @ |
Serial |
736 |
| Permanent link to this record |
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| Author |
Rudd, J. |
| Title |
From triage to treatment: An exploration of patient flow systems in emergency departments |
Type |
|
| Year |
2005 |
Publication |
|
Abbreviated Journal |
ResearchArchive@Victoria |
| Volume |
|
Issue |
|
Pages |
|
| Keywords |
Emergency nursing; Hospitals; Risk management; Patient safety |
| Abstract |
To find an effective approach to managing or reducing waiting times for lower triage category patients processed through one particular metropolitan emergency department, an extensive search of the literature revealed several different patient flow processes. These approaches are discussed, in relation to suitability for the particular emergency department. The history of triage, including how and why it evolved, plus the realities of triage today are explored. Included are case examples of two patients on a journey through the department the way it is presently, and how it could be if particular approaches are introduced. Extending nursing practice by introducing nurse-initiated x-rays at triage and the introduction of a separate stream for minor category patients in a dedicated ambulatory care area is one approach that could improve waiting times for these patients. There would be the added advantage of improving triage compliance figures for category three patients. The additional costs involved in such a process could be offset by improved efficiency in terms of waiting times, improved triage compliance figures, happier patients and clinical staff, and an emptier waiting room. |
| Call Number |
NRSNZNO @ research @ |
Serial |
1209 |
| Permanent link to this record |
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| Author |
Gabolinscy, B. |
| Title |
Triage codes: A predictor of nursing care time in the emergency department |
Type |
|
| Year |
2005 |
Publication |
|
Abbreviated Journal |
|
| Volume |
|
Issue |
|
Pages |
|
| Keywords |
Emergency nursing; Time factors |
| Abstract |
This thesis explores triage code as a predictor of direct nursing care time, thus its potential usefulness in a model for calculating and allocating nurse requirements in emergency departments. A framework for nursing work is proposed. This framework is based on the works of O'Brien-Pallas, Irvine, Peereboom, and Murray (1997) and Houser (2003). It suggests that the structures of environmental complexity, nursing characteristics, patient nursing complexity, and patient medical condition and severity, impact on the processes of direct and indirect nursing care to affect patient outcomes. A prospective, non-experimental study was undertaken to examine the relationship between direct nursing care time and triage code. Six potential confounding variables were selected for this study: length of stay, age, ethnicity, sex, complaint type, and discharge category. Data were collected for 261 visits over a three day period in one New Zealand emergency department. Patient visits averaged 200 minutes. The mean direct nursing care time per visit was 49 minutes. On average, patients with more urgent triage codes, longer length of stay, or who were not discharged, received more direct nursing care. The model developed predicted 49% of variation in direct nursing care time (p < .05) related to triage code (16%), length of stay (31%) and disposition category (2%). The author suggests that further exploration of the proposed framework has potential to develop a model allowing managers to identify nurse staffing required for optimal nursing care in emergency departments. |
| Call Number |
NRSNZNO @ research @ 481 |
Serial |
468 |
| Permanent link to this record |
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| Author |
Little, S. |
| Title |
An exploration of vicarious traumatisation in emergency nurses |
Type |
|
| Year |
2002 |
Publication |
|
Abbreviated Journal |
Victoria University of Wellington Library |
| Volume |
|
Issue |
|
Pages |
|
| Keywords |
Emergency nursing; Occupational health and safety; Nursing research; Stress |
| Abstract |
This thesis explores the theoretical notions of suffering and caring within the nurse patient relationship in the context of emergency nursing. It includes a small pilot study that aimed to assess the feasibliity of a major research project, by describing the impact of vicarious traumatisation in emergency nurses, specifically in relation to their self capacities. This pilot study utilised a descriptive, correlational design. Data was collected by using the Inner Experience Questionnaire (IEQ) a twenty four-item questionnaire developed by Dr Pearlman (1995), and a profile sheet which identified demographic details. Twenty-seven emergency nurses participated in this pilot study. The IEQ was assessed for internal reliability by applying the Cronbachs alpha and utilising a focus group to gain insight into the usability and relevance of the questions. The internal reliability of the IEQ suggests that it may be an appropriate tool to measure disruption of self capacities in the population of emergency nurses. Although the results are limited, and conclusions cannot be drawn, findings suggest a correlation between the variables of age, experience, nursing qualifications and a history of personal trauma and the IEQ. There is evidence that emergency nurses are affected psychologically when caring for the victims of trauma in emergency departments and the IEQ has the potential as a tool to be integrated into future emergency nursing studies. A multidimensional methodological approach is recommended to capture the many contours of the complex phenomena of vicarious traumatisation and the emergency nurse. |
| Call Number |
NRSNZNO @ research @ |
Serial |
1249 |
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| Author |
McKerras, R. |
| Title |
Waiting in the emergency department – it doesn't have to take all day |
Type |
|
| Year |
2005 |
Publication |
|
Abbreviated Journal |
Victoria University of Wellington Library |
| Volume |
|
Issue |
|
Pages |
|
| Keywords |
Emergency nursing |
| Abstract |
This thesis explores the nature of the emergency department environment as it continues to challenge emergency nurses to meet the health needs of an increasingly complex emergency department population. The emergency nurse is also facing conflict and challenge with regard to workplace safety and patient rights. The author suggests that, until recently, very little debate or consideration has been given to the moral dilemmas raised in the ability of emergency department staff to deliver timely and appropriate care in an overcrowded environment. She goes on to say that, in New Zealand, there is no national consistency with regard to the waiting crisis, no national guidelines and no national consensus putting the emergency nurse at risk. This thesis argues the need to acknowledge waiting times as a significant safety issue at a national level as increasing waiting times continue to impact on patient outcomes and nursing practice. It challenges current practice, in particular the role of the emergency nurse and the potential to legitimise expansion of the role to improve the patient experience of waiting in the emergency department. |
| Call Number |
NRSNZNO @ research @ |
Serial |
512 |
| Permanent link to this record |
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| Author |
Rolls, S. |
| Title |
An exploration of workplace violence in the emergency department: Are emergency nurses safe? |
Type |
|
| Year |
2006 |
Publication |
|
Abbreviated Journal |
Victoria University of Wellington Library |
| Volume |
|
Issue |
|
Pages |
|
| Keywords |
Workplace violence; Emergency nursing; Guidelines |
| Abstract |
This thesis arises from the author's experience of several years of working in the emergency department and being exposed to workplace violence from patients and their families. Emergency nurses in New Zealand experience workplace violence every day. Registered nurses and the institutions in which they work manage workplace violence to varying degrees and in an ad hoc manner. The author notes that New Zealand has no national guidelines, or consensus on the management of workplace violence in the health sector. This research explores emergency nurses' encounters during their work when they have experienced workplace violence. The purpose of this study is to demonstrate the experience and the consequences when nurses are confronted with episodes of violence while working in the emergency department. The essence of this research is gaining an understanding of how registered nurses have managed workplace violence and the impact of that violence on themselves, their colleagues, and the patients in the emergency department. Recommendations are made regarding nationally consistent guidelines, education on the management of workplace violence, improved security, and emergency department design. The discussion concludes with suggestions for further research on workplace violence in the health sector |
| Call Number |
NRSNZNO @ research @ |
Serial |
492 |
| Permanent link to this record |
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| Author |
MacGeorge, J.M.; Nelson, K. |
| Title |
The experience of the nurse at triage influences the timing of CPAP intervention |
Type |
Journal Article |
| Year |
2003 |
Publication |
Accident & Emergency Nursing |
Abbreviated Journal |
|
| Volume |
11 |
Issue |
4 |
Pages |
234-238 |
| Keywords |
Emergency nursing; Clinical decision making; Hospitals; Quality of health care |
| Abstract |
This study used a non-experimental correlational design to research the relationship between the experience of the nurse, with the application of continuous positive airway pressure therapy (CPAP) to patients presenting to a metropolitan emergency department with cardiogenic pulmonary oedema (CPO), and to establish what difference, if any, CPAP made to outcomes. A retrospective audit of records was used to extract data on all 54 patients that received CPAP over a 12-month period. The primary outcome measures were off CPAP within two hours, transfer to intensive care unit or cardiac care unit, and secondary outcome measures were length of hospital stay and death. There was a trend towards more experienced nurses attending patients who required immediate treatment or treatment within 10 minutes. These patients were more likely to be recognised at triage as requiring CPAP therapy. The early application of CPAP reduced hospital mortality, length of stay, and the need for intubation and ventilation. Attention needs to be given on how best to educate nurses so that more patients presenting with acute respiratory failure can benefit from nurses' decision-making regarding the commencement of CPAP. |
| Call Number |
NRSNZNO @ research @ |
Serial |
847 |
| Permanent link to this record |
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| Author |
Richardson, S. |
| Title |
Emergency departments and the inappropriate attender: Is it time for a reconceptualisation of the role of primary care in emergency facilities? |
Type |
Journal Article |
| Year |
1999 |
Publication |
Nursing Praxis in New Zealand |
Abbreviated Journal |
|
| Volume |
14 |
Issue |
2 |
Pages |
13-20 |
| Keywords |
Emergency nursing; Primary health care |
| Abstract |
This paper reviews currently identified issues concerning emergency department attendance, and examines the core question of the role of primary care in the emergency department. Asks whether this is an appropriate use of emergency department resources, and if so, what the implications are for the role of the emergency nurse. Suggests the establishment of Minor Injury Units in New Zealand like those in the UK. |
| Call Number |
NRSNZNO @ research @ |
Serial |
641 |
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| Author |
Blair, K.M. |
| Title |
Recognising the sick patient: An emergency nurses view: A research paper |
Type |
|
| Year |
2006 |
Publication |
|
Abbreviated Journal |
Victoria University of Wellington Library |
| Volume |
|
Issue |
|
Pages |
|
| Keywords |
Emergency nursing; Patient safety; Diagnosis; Training; Clinical decision making |
| Abstract |
This paper reports on a literature review that examines how health professionals (mainly nurses) recognise the signs of physical deterioration in their patients. It includes discussion of how nurses' clinical decision making skills influence how physical deterioration is identified and determines what changes in the delivery of care could have an impact on emergency department patients at risk of life threatening deterioration. |
| Call Number |
NRSNZNO @ research @ |
Serial |
467 |
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| Author |
Hamer, H.P.; McCallin, A. |
| Title |
Cardiac pain or panic disorder? Managing uncertainty in the emergency department |
Type |
Journal Article |
| Year |
2006 |
Publication |
Nursing & Health Sciences |
Abbreviated Journal |
|
| Volume |
8 |
Issue |
4 |
Pages |
224-230 |
| Keywords |
Emergency nursing; Clinical assessment; Diagnosis |
| Abstract |
This paper presents research findings from a New Zealand study that explored emergency nurses' differentiation of non-cardiac chest pain from panic disorder and raised significant issues in the nursing assessment and management of such clients. The data were gathered from focus group interviews and were analysed thematically. Three themes, prioritising time, managing uncertainty and ambiguity, and the life-threatening lens, were identified. The findings confirm that a panic disorder is not always diagnosed when biomedical assessment is used in isolation from a psychosocial assessment. Emergency nurses are pivotal in reversing the cycle of repeat presenters with non-cardiac chest pain. Recommendations for assessing and managing this complex condition are presented. |
| Call Number |
NRSNZNO @ research @ |
Serial |
689 |
| Permanent link to this record |
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| Author |
Mortensen, A.; Young, N. |
| Title |
Caring for refugees in emergency departments in New Zealand |
Type |
Journal Article |
| Year |
2004 |
Publication |
Nursing Praxis in New Zealand |
Abbreviated Journal |
|
| Volume |
20 |
Issue |
2 |
Pages |
24-35 |
| Keywords |
Emergency nursing; Culture; Mental health; Health status |
| Abstract |
This paper outlines some of the special health needs of people from refugee backgrounds who present in the emergency department, and the role of emergency department nurses in improving care for refugee and migrant peoples. Refugees and asylum seekers represent a significant proportion of attendees in emergency departments in Auckland Hospitals. Culture and ethnicity are a major factor to be considered in addressing the health care needs of this population. Other factors such as the physical and psychological sequelae of the refugee experience, health care experience prior to arrival in New Zealand, poverty, language, and the trauma of resettlement also have a major impact on health care seeking behaviours. |
| Call Number |
NRSNZNO @ research @ 557 |
Serial |
543 |
| Permanent link to this record |
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| Author |
Topliss, J. |
| Title |
Nursing by telephone in mental health emergency settings: What underpins and informs clinical practice? |
Type |
Miscellaneous |
| Year |
2005 |
Publication |
|
Abbreviated Journal |
Bill Robertson Library, Otago Polytechnic |
| Volume |
|
Issue |
|
Pages |
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| Keywords |
Mental health; Emergency nursing |
| Abstract |
This dissertation is an exploration of what underpins and informs clinical nursing practice by telephone in mental health emergency settings. A critical review of the literature provides the foundation for discussion. Points of reflection explore links between the literature and the author's own experience and thoughts about clinical practice. Findings are presented within three main sections. 'Historical Context' considers the development and function of mental health emergency service telephone work. Practical aspects are discussed under `Service Provision Context.' 'Nursing Context' explores the fundamental skills involved in clinical reasoning and the preparation of staff for telephone work. Whilst 'Best practice' in the area of nursing by telephone is yet to be well defined, this work aims to provide a foundation for further inquiry, research and dialogue. |
| Call Number |
NRSNZNO @ research @ 676 |
Serial |
662 |
| Permanent link to this record |
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| Author |
Vernon, R.A. |
| Title |
Clinical case study: Acute traumatic head injury |
Type |
Journal Article |
| Year |
2001 |
Publication |
Vision: A Journal of Nursing |
Abbreviated Journal |
|
| Volume |
7 |
Issue |
12 |
Pages |
3-9 |
| Keywords |
Trauma; Emergency nursing; Nursing specialties; Quality of health care |
| Abstract |
This clinical case study takes an integrated approach to investigation and critical analysis of the complex physiological and pathophysiological treatment modalities instigated when a patient presents following acute traumatic head injury. A broad overview of the developmental physiology of the brain and an explanation of the mechanism of traumatic brain injury as it relates to alterations in cerebral blood flow, intracranial pressure and cerebral metabolism is presented. The author describes in narrative form the clinical presentation of a patient, her symptoms and initial treatment rationale. It concludes with analysis of the patients initial treatment priorities and symptom management during the first 48 hours of her care. |
| Call Number |
NRSNZNO @ research @ |
Serial |
1281 |
| Permanent link to this record |
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| Author |
Horner, C. |
| Title |
Emergency health provision and maintaining competency |
Type |
Book Chapter |
| Year |
2008 |
Publication |
Jean Ross (Ed.), Rural nursing: Aspects of practice (pp. 125-136) |
Abbreviated Journal |
Ministry of Health publications page |
| Volume |
|
Issue |
|
Pages |
|
| Keywords |
Rural nursing; Professional competence; Emergency nursing |
| Abstract |
This chapter focuses on issues associated with rural nursing and the provision of emergency care for patient(s) located remotely from secondary hospital services. All emergencies have diverse characteristics, but the rural practitioner also contends with having sole practice, professional and geographical isolation, and the lack of regular experience. The chapter reviews the PRIME (Primary Response in Medical Emergency) recommendations and training, and looks in particular at the issues around the maintenance of competency for the rural nurse providing emergency on call health care that includes managing medical and accident emergencies in the absence of a medical practitioner. |
| Call Number |
NRSNZNO @ research @ |
Serial |
756 |
| Permanent link to this record |
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| Author |
Ward, J. |
| Title |
High acuity nursing |
Type |
Journal Article |
| Year |
2001 |
Publication |
Vision: A Journal of Nursing |
Abbreviated Journal |
|
| Volume |
7 |
Issue |
12 |
Pages |
15-19 |
| Keywords |
Nurse-family relations; Emergency nursing; Technology |
| Abstract |
This article looks at the role of technology in nursing, and the interaction between it and human compassion and caring. The interface between critical care technologies and caring is explored, along with the social and political issues facing critical care areas. |
| Call Number |
NRSNZNO @ research @ 1298 |
Serial |
1283 |
| Permanent link to this record |
