Emergency Department Personnel Research Articles

The Effects of Displaying the Time Targets of the Manchester Triage System to Emergency Department Personnel: Prospective Crossover Study.

The use of triage systems such as the Manchester Triage System (MTS) is a standard procedure to determine the sequence of treatment in emergency departments (EDs). When using the MTS, time targets for treatment are determined. These are commonly displayed in the ED information system (EDIS) to ED staff. Using measurements as targets has been associated with a decline in meeting those targets. This study investigated the impact of displaying time targets for treatment to physicians on processing times in the ED. We analyzed the effects of displaying time targets to ED staff on waiting times in a prospective crossover study, during the introduction of a new EDIS in a large regional hospital in Germany. The old information system version used a module that showed the time target determined by the MTS, while the new system version used a priority list instead. Evaluation was based on 35,167 routinely collected electronic health records from the preintervention period and 10,655 records from the postintervention period. Electronic health records were extracted from the EDIS, and data were analyzed using descriptive statistics and generalized additive models. We evaluated the effects of the intervention on waiting times and the odds of achieving timely treatment according to the time targets set by the MTS. The average ED length of stay and waiting times increased when the EDIS that did not display time targets was used (average time from admission to treatment: preintervention phase=median 15, IQR 6-39 min; postintervention phase=median 11, IQR 5-23 min). However, severe cases with high acuity (as indicated by the triage score) benefited from lower waiting times (0.15 times as high as in the preintervention period for MTS1, only 0.49 as high for MTS2). Furthermore, these patients were less likely to receive delayed treatment, and we observed reduced odds of late treatment when crowding occurred. Our results suggest that it is beneficial to use a priority list instead of displaying time targets to ED personnel. These time targets may lead to false incentives. Our work highlights that working better is not the same as working faster.

Malay Language Translation of an Instrument to Assess Perception of Lean Adoption in Healthcare Service

Based on thorough literature search, Lean in Healthcare Questionnaire (LiHcQ) has not yet been validated in Malay, so the purpose of this study was to create a validated Malay version of LiHcQ for the purpose of assessing perceptions of lean adoption among healthcare workers. The translated LiHcQ could encourage more studies to examine the perception of lean adoption in Malaysia. The translation using forward-backward method was carried according to the established guideline available involving multiple committee members. Ten respondents involved in face validity assessment with universal face validity index was 0.91. Assessment of construct validity was done using 251 Emergency Department personnel which included doctors, nurses and medical assistants. The goodness of fit indices for the four LiHcQ-M factors were good. The composite reliability of the four domains ranged from 0.784 to 0.902 and average variance extracted (AVE) ranged from 0.547 to 0.653. The internal consistency ranged from 0.750 to 0.905 and stability reliability was acceptable. LiHcQ-M is a suitable instrument for measuring the perception of lean adoption among medical staff based on the results of its validity and reliability assessments. It is highly recommended for additional validity study to be carried out in order to validate LiHcQ-M’s credentials.

The effects of mindfulness training for emergency department and intermediate care unit nurses

AimThe aim of this study was to determine the effects of mindfulness and self-compassion skills on the experienced stress and work satisfaction of emergency department (ED) and intermediate care unit employees. MethodsAll ED and intermediate care unit employees in the study hospital were invited to participate in an introductory lecture about mindfulness, compassion, and the intervention in January 2020. After the lecture, it was possible to enroll in training. This training was postponed due to Covid-19 and started in October 2020. ResultsThe most important findings of this study are that instructor-led mindfulness training, and the regular use of a smartphone mindfulness application can significantly reduce stress and burnout and promote mindfulness and well-being of ED and intermediate care unit personnel. ConclusionsThis study shows that compact mindfulness training via innovative digital technology has a positive effect in reducing ED and intermediate care unit employees stress and burnout, while improving mindfulness and well-being, and this is consistent with the wider literature. Key findingsThe regular practice of smartphone-guided mindfulness can reduce stress and burnout, as well as promote mindfulness and well-being among ED and intermediate care unit employees.

Changing the Patient Flow Process for the Green Area of Emergency Department: A Discrete-Event Simulation Approach

The emergency department is important as a fundamental element of the healthcare system. Patient flow processes in emergency departments are a critical factor that determines effective and rapid medical intervention as well as the overall performance of the healthcare system.
 Aim: This study aimed to analyze patient waiting times and hospital stay times by developing a different approach to the current patient flow processes in the green area of a hospital emergency department.
 Methods: Numerical and statistical results were obtained using a discrete event simulation model for the current and new situation of patient flow processes.
 Results: The waiting time decreased from 12.91 minutes in the current simulation model to 12.81 minutes in the proposed simulation model. The length of stay time decreased from 54.72 minutes in the current simulation model to 53.90 minutes in the proposed simulation model. In this case, it is seen that the proposed model provides a reduction in the length of stay and patient waiting time. Conclusion: The result shows that the proposed model provides some improvement in both waiting and length of stay time. This study offers a different approach to patient flow, allowing emergency department personnel to use their resources effectively and minimizing the time spent on patients' treatment or waiting periods. Thus, this study concluded that the effective management of recommended patient flow processes increases the capacity of emergency departments to deal with emergencies and accelerates access to emergency medical services.

Ethical Awareness and Practices Among Emergency Department Personnel in Riyadh's Tertiary Hospitals: A Cross-Sectional Analysis.

Ethical dilemmas in healthcare, particularly in emergency medical services (EMS), present significant challenges for healthcare workers (HCWs), necessitating a profound understanding of ethics and decision-making. This study assesses the ethical awareness and practices among HCWs in emergency departments of tertiary hospitals in Saudi Arabia, aiming to identify areas of strength and opportunities for improvement. A cross-sectional survey was conducted among 256 HCWs, including physicians, nurses, and administrative staff, in emergency departments across tertiary hospitals in Riyadh, Saudi Arabia. The questionnaire evaluated participants' knowledge of healthcare ethics, their experiences with ethical dilemmas, and the sources from which they derived their ethical understanding. The majority of participants exhibited a commendable level of ethical knowledge and practice, with frequent encounters of ethical or legal issues highlighting the pervasive nature of ethical challenges in emergency healthcare settings. Key sources of ethical knowledge included experiential learning and academic lectures, with a notable emphasis on practical experience. Despite the satisfactory level of ethical awareness, areas requiring further educational focus were identified, emphasizing the need for enhanced ethics training tailored to the emergency medical context. The findings underline the critical importance of incorporating ethics into the core of healthcare education and ongoing professional development for HCWs. Establishing a culture of continuous ethical dialogue and learning is essential for fostering patient-centered care and making informed ethical decisions in the fast-paced environment of emergency services. The study advocates for revising current ethics training programs to ensure they are comprehensive, relevant, and accessible, preparing HCWs to effectively address both current and future ethical challenges.

Suicide death and other-cause mortality in psychiatric patients: A South Korean study using nationwide claims data

IntroductionIt is well-known that suicide and excess mortality are high in patients with psychiatric illnesses and this has long been an important issue in the field of mental health. We aim to investigate suicide and other-cause deaths in patients with psychiatric illnesses. MethodsThis retrospective, population-based cohort was based on the National Health Insurance claims data of the first admission with a principal diagnosis of major psychiatric disorder between 2010 and 2011, and followed up to 2020. A total of 95,855 participants were enrolled. Suicide and other-cause mortality were assessed through Log-rank test and Kaplan-Meier curve. ResultsThere were 95,855 patients, with an average age of 48.2 years. The number of suicide deaths and other-cause deaths was 2408 (288.1 per 100,000 person-years) and 15,192 (1817.6 per 100,000 person-years), respectively. The rate of healthcare utilization prior to suicide was 95.0 %, and the rate of utilization prior to one week before suicide was 43.5 %. The risk of suicide was highest in patients with depression, followed by alcohol use disorder, schizophrenia, and bipolar disorder. ConclusionsThis study revealed various factors related to healthcare utilization associated with suicide and other-cause deaths in psychiatric patients. Educating frontline healthcare professionals, psychiatrists, emergency department personnel, and general practice doctors using such as Gatekeeper program is important to prevent suicides.

Burnout in emergency department personnel—A continuing concern post pandemic

AbstractIntroductionHigh incidences of burnout has been reported amongst emergency department (ED) personnel during the COVID‐19 pandemic. Emerging from the pandemic, organisational support for psychological health may dwindle and become secondary to economic priorities. We aimed to ascertain the level of burnout within ED staff at our hospital, identify professional groups, which were more vulnerable and domains, which contributed most towards burnout.MethodsWe conducted a cross‐sectional study approximately 8 months after major moves to remove COVID‐19 restrictions in Singapore. Data was collected via a self‐administered survey employing the Copenhagen Burnout Inventory (CBI). Demographics, occupational details, work satisfaction and motivation to stay in the job were also collected and analysed.ResultsA total of 115 ED staff participated. Overall CBI score was 62.3 ± 22.0. Scores for personal, work‐related and client burnout were 64.9 ± 23.2, 61.6 ± 23.1 and 60.4 ± 26.1, respectively. A total of 44.5% had to take medical leave because of burnout. Nurses had higher overall CBI scores than doctors (67.5 ± 20.5 vs. 54.6 ± 23.0, p = 0.01). Those who were satisfied with their present job had lower overall CBI scores compared to those not satisfied (42.7 ± 17.9 vs. 84.0 ± 14.4, p < 0.001). Overall CBI scores were also lower in those motivated compared with those not motivated to continue in their current job (50.1 ± 16.3 vs. 79.0 ± 15.1, p < 0.001).ConclusionED staff continue to record high rates of burnout as we transit out of the pandemic. Accompanying rates of medical leave and low levels of motivation to remain in the job are serious occupational health concerns. Factors contributing to burnout in at risk groups such as nurses should be further analysed. High mean CBI scores in the personal and work domains indicate that related factors contribute most towards burnout and interventions should be focused accordingly.

ACİL SERVİS PERSONELLERİNİN KİMYASAL, BİYOLOJİK, RADYASYON VE NÜKLEER ACİLLERE HAZIRLIK DÜZEYLERİNİN DEĞERLENDİRİLMESİ

Purpose: The aim of this study is to determine the chemical, biological, radiation, and nuclear (CBRN) emergency preparedness levels of emergency department (ED) personnel. Materials and Methods: This cross-sectional descriptive survey study was conducted with 49 emergency department personnel (emergency medicine specialists, emergency medicine research assistants, nurses, and nursing staffs) working in the ED of a university hospital through face-to-face. The questionnaire was created by the researchers and consisted of 5 demographic and 30 CBRN preparation information, 12 questions questioning the previous practice and educational status of CBRN subjects. The preparedness level of the participants was determined by evaluating the CBRN preparedness level responses. Results: The Cronbach's Alpha reliability index obtained for the CBRN scale was obtained as α=0,856 for the whole scale and this value shows that the reliability of the whole scale is at a good level. The mean preparedness level score of the ED personnel is 59,7 (min-max:24-81). The mean CBRN preparedness level score of emergency medicine specialists (38) was found to be lower than the other groups. The number of those who received training on CBRN situations and medical management of cases during their professional training (bachelor-master- doctorate education) is 18 (36,7%). Most of the participants didn’t participate in any CBRN exercise during their professional life (n=43, 87,8%). Conclusion: ED personnel's preparations for CBRN emergencies are insufficient. Their participation in training and exercises for the medical management of CBRN cases is low. Our study can be used as a tool to determine the CBRN preparations of ED personnel.

Resource Deployment in Response to Trauma Patients.

Background Variance in the deployment of the trauma team to the emergency department (ED) can result in patient treatment delays and excess burden on ED personnel. Characteristics of trauma patients, including mechanism of injury, injury type, and age, have been associated with differences in trauma resource deployment. Therefore, this retrospective, single-site study aimed to examine the deployment patterns of trauma resources, the characteristics of the trauma patients associated with levels of trauma resource deployment, and the deployment impact on ED workforce utilization and non-trauma ED patients. Methodology This was an investigator-initiated, single-institution, retrospective cohort study of all patients designated as a trauma response and admitted to a community hospital's ED from July 01, 2019, through July 01, 2022. Results Resource deployment for trauma patients varied by mechanism of injury (p < 0.001), injury type (p < 0.001), and patient age groups (p < 0.001). Specifically, there was a lower average trauma activation for geriatric trauma patients with a fall as a mechanism of injury compared to all younger patient groups with any mechanism of injury (F(5) = 234.49, p < 0.001). In the subsample, there was an average of 3.35 ED registered nurses (RNs) allocated to each trauma patient. Additionally, the ED RNs were temporarily reallocated from an average of 4.09 non-trauma patients to respond to trauma patients, despite over a third of the trauma patients in the subsample being the trauma patients being discharged home from the ED. Conclusions Trauma activation responses need to be standardized with a specific plan for geriatric fall patients to ensure efficient use of trauma and ED personnel resources.

Knowledge, Awareness, and Understanding of Pediatric Triage Among Nursing Officers in India: A Multicenter Study.

Triage is crucial in patient screening within emergency departments (EDs) worldwide. It is one of the essential and standard medical practices in many developed countries. However, in India, there is a need for improvement in triage utilization, as it is predominantly performed by resident doctors or medical officers, leading to an uneven distribution of clinical skills among healthcare providers (HCPs). A comprehensive analysis incorporating literature review and data collection revealed that while mandatory screening is conducted in most Indian EDs, the formal implementation of standardized triage protocols remains limited. Like in developed countries, registered nurses or nursing officers (NOs) can be effectively trained and directed to play the role of dedicated triage personnel in EDs of most of the healthcare facilities in India. This study aimed to examine the current state of triage utilization and its impact on the distribution of responsibilities among HCPs in Indian EDs. Through this online survey, the investigatorsassessed the knowledge and practical understanding of clinical triaging among NOs, working at various hospitals nationwide. The participants included 5,029 NOs working in various parts of India, predominantly nursing graduates (82.52%), the majority being employed in government healthcare settings (84.01%)and most having over five years of cumulative working experience in the ED (70.77%). Nurses showed inadequate knowledge and awareness about the Pediatric Assessment Triangle (PAT) used for quick initial evaluation (62.18%amongall participants). Concerning the complete triage process applicable, especially in pediatric ED settings, they had even less satisfactory knowledge and understanding, e.g., identifying primary (28.27%) and secondary (22.69%) survey components via focused history and examination, properly using temperature assessment (23.32%) and instant blood glucose level assessment (22.95%) in triage, and knowing various types of internationally accepted triage systems for ED-based health facilities such as the Emergency Severity Index (ESI), Canadian Triage and Acuity Scale (CTAS), and Australasian Triage Scale (ATS) (15.87%). ANOVA and post hoc analysis revealed that the intergroup performance of the study participants with maximum correct responses to the knowledge-determining specified subset of the questionnaire depicts the significantly higher role of graduate nursing degree over diploma such as General Nursing and Midwifery (GNM)/Auxiliary Nursing and Midwifery (ANM) qualification, working in government hospital versus private setup, and ED working experience of >5 years over that of <5 years. Of the participants in the study, 50% were not evaluated for cognitive or psychomotor domains during their assessment examinations. The research illuminated a significant disparity in knowledge and proficiency levels among Indian nurses concerning pediatric triage, especially with the ability to effectively apply the PAT for initial patient evaluations, discern components of primary and secondary surveys, and comprehend various triage systems. This study underscores the importance of comprehensive reform in the Indian healthcare system and teaching curriculum by emphasizing clinical triage training and interprofessional collaboration, and establishing guidelines and regulations to ensure consistent and standardized triage practices across all EDs.

Rates of 30-day revisit to the emergency department among older adults living with dementia: a systematic review and meta-analysis.

Older adults visit emergency departments (EDs) at higher rates than their younger counterparts. However, less is known about the rate at which older adults living with dementia visit and revisit EDs. We conducted a systematic review and meta-analysis to quantify the revisit rate to the ED among older adults living with a dementia diagnosis. We searched MEDLINE, Embase, and CINAHL, as well as gray literature, to identify observational studies reporting on older adults living with dementia that revisited an ED within 30days of a prior ED visit. We calculated pooled rates of 30-day revisit as percentages using random effects models, and conducted stratified analyses by study data source, study population, and study period. We assessed between-studies heterogeneity using the I2 statistic and considered [Formula: see text] > 50% to indicate substantial heterogeneity. All analyses were performed in R software. We identified six articles for inclusion. Percentages of 30-day ED revisit among older adults living with dementia ranged widely from 16.1% to 58.0%. The overall revisit rate of 28.6% showed significant heterogeneity. Between-studies heterogeneity across all stratified analyses was also high. By data source, 30-day revisit percentages were 52.3% (public hospitals) and 20.0% (administrative databases); by study population, revisit percentages were 33.5% (dementia as main population) and 19.8% (dementia as a subgroup). By study period, revisit percentages were 41.2% (5years or greater) and 18.9% (5years or less). Existing literature on ED revisits among older adults living with dementia highlights the medical complexities and challenges surrounding discharge and follow-up care that may cause these patients to seek ED care at an increased rate. ED personnel may play an important role in connecting patients and caregivers to more appropriate medical and social resources in order to deliver an efficient and more rounded approach to care.

Impact of Trauma-Informed Care Training on Attitudes Among Emergency Department Personnel, Staff Advocates, and Nursing Students.

Impact of Trauma-Informed Care Training on Attitudes Among Emergency Department Personnel, Staff Advocates, and Nursing Students.

Impact of Trauma-Informed Care Training on Attitudes Among Emergency Department Personnel, Staff Advocates, and Nursing Students.

Health care providers may risk retraumatizing patients and intensifying patient distress unless they practice trauma-informed care. As the first line of defense in assisting trauma survivors' physical and emotional recovery, health care providers must use a strengths-based framework that promotes resilience and expands on the trauma survivor's existing resources. This study aimed to compare the effect of trauma-informed care training on the attitudes of emergency department personnel, staff advocates, and nursing students toward trauma-informed care. This study used a pretest-posttest design. Assessment of attitudes toward trauma-informed care was done before and after trauma-informed care training. Data collection occurred from February 2021 through August 2021. Participants included three cohorts of emergency department staff, advocates for trauma survivors, and nursing students. Attitudes toward trauma-informed care were measured using the Attitudes Related to Trauma-Informed Care (ARTIC) Scale. A total of 433 participants were studied, including 88 emergency department staff, 123 staff advocates, and 222 nursing students. All three cohorts significantly increased ARTIC Scale scores posttraining (p < .001). At preintervention, all three cohorts significantly differed from each other on ARTIC Scale scores (p < .01). In contrast, postintervention, ARTIC Scale scores did not significantly differ between nursing students and advocates (p = .99). Nursing students showed a significant increase in scores from pre- to postintervention compared with either advocates or emergency department staff. The results strongly suggest that health care providers can improve attitudes toward trauma-informed care after completing training on the principles and application of trauma-informed care.

Saudi Population Perceives Communication Barriers in Emergency Departments in Saudi Arabia

Introduction: Effective communication is one of the most essential aspects of nursing care in the emergency room. In Saudi Arabia, the emergency department must exert considerable effort to surmount communication barriers. Due to the fact that the majority of emergency department personnel in different regions of the United Kingdom are immigrants from other countries who speak other languages, there is a communication barrier that must be surmounted in order to overcome the communication risks in ER. Aims: To determine the perceived communication barrier in Saudi emergency departments. Methods: Samples were extracted from each individual's inter-emergency department for a descriptive community-based survey. Between August and November of 2022, 1507 samples were collected from participants over the age of 18 for the study. The data was collected using a standard, closed-ended questionnaire. Results: According to emergency nurses, environmental factors are the primary barrier to effective nurse-patient communication. The following were elements related to knowledge and psychology. As with younger nurses versus elder nurses, male nurses viewed knowledge-related variables as a greater communication barrier. The influence of languages and educational attainment on environmental factors was also substantial. Conclusion: Language, culture, and educational differences between Saudi patients and foreign nurses have created communication barriers between them. We recommend that nurses participate in ongoing training to enhance their communication abilities.

The Relationship Between Organizational Justice and Job Burnout in Pre-hospital Emergency Nurses

Background: Personnel working in emergency departments are exposed to a lot of burnout due to their nature and occupational factors; therefore, it is very important to pay attention to the factors that cause and aggravate burnout. In the meantime, the existence of organizational justice is an important principle in employee efficiency that can also affect the quality of employee services. Therefore, this study was conducted to investigate the relationship between organizational justice and burnout in emergency department personnel of Tabriz hospitals in 2019. Materials and Methods: The present study is a descriptive cross-sectional correlational study that was performed on 140 pre-hospital emergency personnel in Tabriz, Iran in 2021. The sampling method was census. Data were collected using a three-part questionnaire including participants’ personal demographic information form, Niehoff and Moorman organizational justice questionnaire, and Maslach burnout inventory (MBI). For data analysis, SPSS software, version 22 was used through descriptive statistics and analytical statistics. The significance level was considered at 0.05. Results: The results showed that the level of organizational justice and job burnout of participants was in the moderate range. Also, the results of the correlation statistical test showed that there was a significant reverse relationship between organizational justice and job burnout of pre-hospital emergency personnel (P&lt;0.05). Conclusion: The findings of this study showed that organizational justice is not very desirable from the perspective of pre-hospital emergency personnel and their sense of burnout can be largely related to this situation. Therefore, based on the findings of the present study, it is suggested that managers and officials of pre-hospital medical centers and emergencies by adopting new administrative policies and creating a favorable organizational climate based on human dignity can take positive steps to improve organizational justice and reduce job burnout.

The Impact of Coronavirus Disease 2019 Visitor Restrictions on the Attitudes of Emergency Department Staff

IntroductionDuring the first 2 years of the pandemic, visitors for patients with COVID-19 were prohibited from emergency departments in the United States with few exceptions, leaving patients without their caregivers and advocates. Little is known about emergency nurses and nursing assistive personnel beliefs regarding this issue. Therefore, this study’s purpose was to describe and assess relationships among emergency nursing and assistive personnel attitudes and perceptions regarding emergency department “no-visitor policies” for patients with COVID-19. MethodsThis institutional review board-approved observational study was conducted in a health care system in the Southwestern United States. Nursing personnel (n = 180; 21.74% response rate) working in 11 emergency departments completed the survey during the fall of 2021. Bivariate correlations and multivariable linear regression modeling were performed to explore relationships among survey questions. ResultsMost participants (61%) strongly/very strongly believed that restriction of visitors for patients with COVID-19 was necessary for the protection of staff and patients. In addition, 65% reported strongly/very strongly agreeing that it was unethical and 75% felt upset when these patients died alone. Most (81%) strongly/very strongly agreed that exemptions to the policy should be made in some cases, including imminent death. Respondents’ recognition of patients’ displeasure with visitor policy, recognition that a lack of visitors affected efficiency, and feeling upset when these patients died alone negatively predicted agreement that restriction was necessary. ConclusionAlthough most participants favored visitation restrictions for patients with coronavirus disease 2019, their beliefs were complex. Navigating stringent visitation policies and vulnerable patients’ needs can result in moral distress for ED personnel.

Facilitators and barriers to collaboration between pre-hospital emergency and emergency department in traffic accidents: a qualitative study

BackgroundDeath caused by traffic accidents is one of the major problems of health systems in low- and middle-income countries. Rapid handover of the traffic accident victims and proper collaboration between the pre-hospital and emergency departments (EDs) play a critical role in improving the treatment process and decreasing the number of accidental deaths. Considering the importance of the collaboration between pre-hospital and emergency departments, this study was designed to investigate the facilitators and barriers of collaboration between pre-hospital and emergency departments in traffic accidents.MethodThis research is a qualitative study using content analysis. In order to collect data, semi-structured interviews were used. Seventeen subjects (including pre-hospital and emergency department personnel, emergency medicine specialists, and hospital managers) were selected through purposive sampling and were interviewed. After transcribing and reviewing interviews, data analysis was performed with the qualitative content analysis approach.ResultsThe participants consisted of 17 individuals (15 persons in pre-hospital and emergency departments with at least three years of work experience, one emergency medicine specialist and one hospital manager) who were selected by purposive sampling. The interviews were analyzed and three main categories and seven sub-categories were extracted. The main categories included “individual capabilities”, “development of mutual understanding”, and “infrastructures and processes”.DiscussionProper and practical planning and policymaking to strengthen facilitators and eliminate barriers to collaborate between pre-hospital and emergency departments are key points in promoting collaboration between these two important sectors of health system and reducing the traffic accident casualties in Iran.

The Experience of Families Accompanying a Senior to the Emergency Department: A Scoping Review

IntroductionSeniors are often accompanied by a family member to the emergency department. Families advocate for their needs and contribute to the continuity of care. However, they often feel excluded from care. To improve the quality and safety of care for seniors, it is necessary to consider the experience of families in the emergency department. The aim was to identify and synthesize the available scientific literature dealing with the experience of families accompanying a senior to the emergency department. To identify and synthesize the available scientific literature dealing with the experience of families accompanying a senior to the emergency department. MethodsA scoping review was conducted using the Arksey and O’Malley framework. Six databases were targeted. A description of the identified scientific literature and an inductive content analysis were performed. ResultsOf the 3082 articles retrieved, 19 met the inclusion criteria. Most articles (89%) were published since 2010, were from nursing (63%), and used a qualitative research design (79%). The content analysis identified 4 main categories related to the experience of families accompanying a senior to the emergency department: (1) process leading to the emergency department, families feel uncertainty and ambiguity with the decision to go to the emergency department; (2) staying in the emergency department, families’ experiences are influenced by the triage, the ED environment, and the interactions with ED personnel; (3) discharge from the emergency department, families consider that they should be part of the discharge planning; and (4) recommendations and possible solutions, there is a paucity of recommendations specifically focused on families. DiscussionThe experience of families of seniors in the emergency department is multifactorial and part of a trajectory of care and health services.

Evaluating the Effect of Brief Disaster Education on Emergency Department Staff: Can Short, Low-cost Education Improve Disaster Readiness of Non-DMAT Healthcare Personnel?

Introduction:Some incidents require early deployment of emergency department personnel not designated as disaster medical assistance team (DMAT). Although not as trained as DMAT members, they should be aware of basic disaster response concepts and knowledge. Educating disaster readiness to every healthcare staff in emergency departments would be ideal but it is very costly in both time and expense. To overcome this problem, we tried to evaluate the effectiveness of teaching basic concept and knowledge to non-designated personnel in a short-session and measure the effect.Method:This study is a before-and-after comparison study. From July 2020 to July 2022, a two-hour education was given to volunteers among doctors, nurses, paramedics and administrative staff working in emergency departments across four hospitals in Korea. Educational sessions consisted of basic disaster concept, pre-deployment DMAT preparations, initial actions required on incident site, key elements of incident response (command, control, safety, communication), and triage. Attendees were given a pretest before the session and another test after the session. Chi-square test and Wilcoxon rank test were used to compare the results.Results:Total of 105 volunteers participated in the study. Participants were mostly nurses (62.9%) followed by paramedics (23.8%). Overall knowledge level reported to be increased, including knowledge regarding DMAT deployment (29.5% to 93.3%, p&lt;0.001), DMAT personnel (26.7% to 94.3%, p&lt;0.001), DMAT-designated equipment (23.8% to 60.0%, p&lt;0.001), initial response (27.6% to 69.5%, p&lt;0.001) and patient transport priority (74.3% to 94.3%, p&lt;0.001). Questions testing triage and rate of participants answering every question showed improvement with post-test median score of 67% and rate of 1.0% to post-test median score of 100% and rate of 35.2%, respectively (both p&lt;0.001).Conclusion:Educating non-DMAT personnel in emergency departments with a short session showed significant improvement in basic knowledge of disaster response. It may help institutions with limited resources.

Slipping through the cracks-detection of sex trafficking in the adult emergency department: An integrative review.

Current research estimates that over 24 million individuals experience human trafficking worldwide. There is a growing prevalence of sex trafficking in the United States. An estimated 87% of trafficked persons visit the emergency department during their captivity. Emergency departments across the United States use differing screening methods for sex trafficking. Current screening tools return a high rate of false negatives, and the appropriate use of tools or standardised lists remains unclear. To explore best practices for identifying sex trafficking among adults who visit emergency departments. We sought to answer the practice question: How does the implementation of a multifaceted screening model for sex trafficking, versus the use of a list of standardised screening questions, improve the detection of trafficked persons? We conducted an integrative review of articles published after 2016 in PubMed, CINAHL, Embase, SCOPUS, and Web of Science databases. PRISMA checklist and guidelines were used. Whittemore and Knafl's method was used to review the literature. A final selection of 11 articles were reviewed and appraised using the Johns Hopkins nursing evidence-based practice model. The synthesis of evidence yielded four themes: (1) Provider and personnel education; (2) Protocol establishment; (3) Legal consultation; and (4) Multidisciplinary teamwork. Through this process, we learned the importance of using multifaceted screening tools for identifying persons who are experiencing sex trafficking. In addition to using multifaceted screening tools, detection is improved when all emergency department personnel receive training on sex trafficking. There is a recognised lack of education on sex trafficking recognition nationwide. Notably, emergency department nurses play an essential role in sex trafficking identification due to their maximised interaction with patients and the increased perception of trust that patients have with nurses. Steps include the development of an education program to improve recognition. There was no patient or public involvement in the design or drafting of this integrative review.