Assessment of healthcare buildings in terms of spatial requirements in disaster cases together with healthcare professionals: Adana city hospital emergency department during the Covid-19 pandemic

Each year approximately 1,000,000 people die by suicide, accounting for nearly 3% of all deaths and more than half (56%) of all violent deaths in the world (Krug, Dahlberg, Mercy, Zwi, & Lozano, 2002). Suicide ideation and suicide attempts are strongly linked to death by suicide and powerfully predict further suicidal behavior (Institute of Medicine, 2002). There are an estimated 100–200 suicide attempts for each completed suicide in young people, and 4 attempts for each completed suicide in the elderly (Institute of Medicine, 2002). Emergency departments (EDs) are the most important site, epidemiologically speaking, for treating those who make suicide attempts. EDs in the United States, for example, record over 500,000 suicide-related visits annually (Larkin, Smith, & Beautrais, 2008). The majority of suicide attempt patients are discharged after medical stabilization and psychosocial evaluation, but carry a significant risk of recidivism (Larkin, Smith, & Beautrais, 2008). Similarly, ED patients who present with suicide ideation (without attempt) have risks of returning to the ED with further ideation or with suicide attempts which are as high as those who present with attempts (Larkin, Beautrais, Gibb, & Laing, 2008). In addition, a significant fraction of those who present to EDs for nonmental health reasons often have occult or silent suicide ideation (estimated at 8–12%) (Claassen & Larkin, 2005). The worldwide economic tsunami and sky-rocketing healthcare costs have ensured that mental health-related visits and presentations for suicidal behavior will continue to rise in the foreseeable future. The closure of psychiatric inpatient facilities, reductions in inpatient beds, moves to treat people in the community, and increased costs of general practitioner visits have coincided with – and likely account for – increased ED attendances by psychiatric and suicidal patients who previously might have been admitted or seen in primary care. The ED is now the default, de facto option for urgent and acute contact for suicidal patients within the health system – and in many countries the ED is the only access to 24/7 healthcare (Fields et al., 2001).

Cutting-edge Discussions of Management, Policy, and Program Issues in Emergency Care

Review Questions/Objectives This systematic review seeks to synthesise the evidence on the experiences of care received by elderly patients in the emergency department in the hospital setting. Review questions The specific review questions to be addressed are: What is the evidence on elderly patients’ experiences of the overall care received in the emergency department? What is the evidence on elderly patients’ experiences of the nursing care received in the emergency department? What is the evidence on the needs identified by elderly patients in the emergency department? Inclusion Criteria Types of participants The review will consider studies that include male and female patients of all ethnic groups who are 65 years old and above, and admitted into the emergency department with urgent as well as non-urgent health-related issues. Phenomena of interest The review will consider studies that include the following phenomena of interest: elderly patients’ experiences of care at an emergency department. Context The review will consider studies that will include contexts such as the emergency department in the acute care hospital settings in all countries. Outcomes of Interest The outcomes of interest include but are not restricted to the following: Experiences of overall care received by elderly patients in the emergency department. Experiences of nursing care received by elderly patients in the emergency department. Identified needs of elderly patients when receiving care in the emergency department.

Cutting-edge Discussions of Management, Policy, and Program Issues in Emergency Care

The objective was to characterize the medical, social, and psychiatric correlates of frequent emergency department (ED) use among released prisoners with human immunodeficiency virus (HIV). Data on all ED visits by 151 released prisoners with HIV on antiretroviral therapy (ART) were prospectively collected for 12 months. Correlates of frequent ED use, defined as having two or more ED visits postrelease, were described using univariate and multivariate models and generated medical, psychiatric, and social multimorbidity indices. Forty-four (29%) of the 151 participants were defined as frequent ED users, accounting for 81% of the 227 ED visits. Frequent ED users were more likely than infrequent or nonusers to be female; have chronic medical illnesses that included seizures, asthma, and migraines; and have worse physical health-related quality of life (HRQoL). In multivariate Poisson regression models, frequent ED use was associated with lower physical HRQoL (odds ratio [OR] = 0.95, p = 0.02) and having not had prerelease discharge planning (OR = 3.16, p = 0.04). Frequent ED use was positively correlated with increasing psychiatric multimorbidity index values. Among released prisoners with HIV, frequent ED use is driven primarily by extensive comorbid medical and psychiatric illness. Frequent ED users were also less likely to have received prerelease discharge planning, suggesting missed opportunities for seamless linkages to care.

11 Implementation of a Hospice Transition Protocol in an Emergency Department to Facilitate End-of-Life Care

340 The Accuracy of Predictive Analytics in Forecasting Emergency Department Volume Pre- and Post-COVID Pandemic

Serial Inebriate Programs: What to do About Homeless Alcoholics in the Emergency Department

Telemedicine and eConsults for Hospitalized Patients During COVID-19

4 COVID-19 Vaccine Messaging Platforms Increase Vaccine Acceptance and Uptake in Unvaccinated Emergency Department Patients: A Cluster Randomized Controlled Trial

Objective: The fight against the Covid-19 pandemic has not only been limited to physical risks but has also led to profound psychological impacts. Secondary traumatic stress (STS) is an important concept reflecting the effects of traumatic experiences frequently encountered by healthcare workers. This study aims to investigate the levels of STS experienced by emergency department healthcare workers during the Covid-19 pandemic. The research aims to provide insights into the impact on the mental health of healthcare workers during and after the Covid-19 pandemic. Furthermore, the analysis of the data obtained will yield important conclusions for understanding the long-term effects of the pandemic and preparing healthcare systems for such crises. Method: The study population consisted of doctors, nurses, and other healthcare personnel (health officers, midwives, technicians, paramedics, aides, etc.) working in emergency departments. The study covered 239 participants from various provinces within the authors’ network. Results: The study found no significant variation in STS based on whether participants lived in a major city or not. However, significant differences were identified based on gender. Additionally, significant differences were observed in the "avoidance," "arousal" subscales, and total score of STS based on the job categories of emergency department staff. Furthermore, STS scores varied significantly based on years of service among emergency department staff. Moreover, the study identified significant differences in STS scores based on the frequency of encounters with Covid-19 patients during the pandemic. Conclusion: According to the data obtained, factors such as gender, years of service, and professional experience need to be considered to support the mental health of emergency department staff. It is also important to develop support programs and coping strategies specifically for female employees. Additionally, training and mentoring programs can be developed to enhance the coping skills of new emergency department staff with occupational stress. Given that the frequency of encounters with Covid-19 patients during the pandemic affects the STS levels of emergency department staff, ensuring psychosocial support for healthcare workers during this period is crucial. Moreover, in extraordinary situations like the Covid-19 pandemic, it is essential to strengthen coping strategies for traumatic experiences among emergency department staff and facilitate access to supportive resources. This approach can ensure the sustainability of healthcare services and preserve the health and well-being of emergency department staff.

Reimagining health preparedness in the aftermath of COVID-19

This analysis identified factors associated with emergency department recidivism among pediatric psychiatric patients and factors that may differentiate repeat and one-time visits. The researchers examined six-month recidivism among a sample of 509 patients of ages four to 18 years who made mental health visits to an urban pediatric emergency department in 2004. Patients who made repeat visits were more likely to be involved in mental health and social services than patients who did not return to the emergency department. Repeat visitors were also more likely to be African American, have a history of psychiatric hospitalization, and present with suicidal or disruptive behaviors. These results suggest that the emergency department is being used as part of the continuum of care for patients already in treatment, particularly those displaying disruptive behavior. Additional research is needed to determine whether this recidivism is clinically indicated or reflects a lack of available or appropriate care in community settings.

Behavioral Health Patients in the Emergency Department

What Are the True Costs of Emergency Department Services?