THE POTENTIAL FOR PHARMACISTS TO MANAGE CHILDREN ATTENDING EMERGENCY DEPARTMENTS

2016 ◽  
Vol 101 (9) ◽  
pp. e2.1-e2 ◽  
Author(s):  
David Terry ◽  
Konstantinos Petridis ◽  
Matt Aiello ◽  
Anthony Sinclair ◽  
Chi Huynh ◽  
...  
Keyword(s):  
Emergency Department ◽  
Community Pharmacist ◽  
Emergency Departments ◽  
Hospital Pharmacist ◽  
General Medicine ◽  
Clinical Group ◽  
Medical Team ◽  
Additional Training ◽  
Paediatric Patients ◽  
Impact Index

AimThere have been concerns about maintaining appropriate clinical staff levels in Emergency Departments in England.1 The aim of this study was to determine if Emergency Department attendees aged from 0–16 years could be managed by community pharmacists or hospital independent prescriber pharmacists with or without further advanced clinical practice training.MethodA prospective, 48 site, cross-sectional, observational study of patients attending Emergency Departments (ED) in England, UK was conducted. Pharmacists at each site collected up to 400 admissions and paediatric patients were included in the data collection. The pharmacist independent prescribers (one for each site) were asked to identify patient attendance at their Emergency Department, record anonymised details of the cases—age, weight, presenting complaint, clinical grouping (e.g. medicine, orthopaedics), and categorise each presentation into one of four possible categories: CP, Community Pharmacist, cases which could be managed by a community pharmacist outside an ED setting; IP—cases that could be managed at ED by a hospital pharmacist with independent prescriber status; IPT, Independent Prescriber Pharmacist with additional training—cases which could be managed at ED by a hospital pharmacist independent prescriber with additional clinical training; and MT, Medical Team only—cases that were unsuitable for the pharmacist to manage. An Impact Index was calculated for the two most frequent clinical groupings using the formula: Impact index=percentage of the total workload of the clinical grouping multiplied by the percentage ability of pharmacists to manage that clinical group.Results1623 out of 18,229 (9%) attendees, from 45 of the 48 sites, were children aged from 0 to 16 years of age (median 8 yrs, range 0–16), 749 were female and 874 were male. Of the 1623 admissions, 9% of the cases were judged to be suitable for clinical management by a community pharmacist (CP), 4% suitable for a hospital pharmacist independent prescriber (IP), 32% suitable for a hospital independent pharmacist prescriber with additional training (IPT); and the remaining 55% were only suitable for the Medical Team (MT). The most frequent clinical groups and impact index for the attendees were General Medicine=10.78 and orthopaedics=10.60.ConclusionPaediatric patients attending Emergency Departments were judged by pharmacists to be suitable for management outside a hospital setting in approximately 1 in 11 cases, and by hospital independent prescriber pharmacists in 4 in 10 cases. With further training, it was found that the total proportion of cases that could be managed by a pharmacist was 45%. The greatest impact for pharmacist management occurs in general medicine and orthopaedics.

P1 The potential for pharmacists to manage young patients attending emergency departments

2018 ◽  
Vol 103 (2) ◽  
pp. e2.2-e2
Author(s):  
David Terry ◽  
Chi Huynh ◽  
Konstantinos Petridis ◽  
Matthew Aiello ◽  
Anthony Sinclair ◽  
...  
Keyword(s):  
Emergency Department ◽  
Community Pharmacist ◽  
Emergency Departments ◽  
Hospital Pharmacist ◽  
Young Patients ◽  
General Medicine ◽  
Community Pharmacists ◽  
Medical Team ◽  
Additional Training ◽  
Impact Index

BackgroundThere have been concerns about maintaining appropriate clinical staff levels in Emergency Departments in England.1 One possible solution to alleviating the workforce pressure is the extension of clinical activity performed by non-medical staff – including pharmacists.2Aims and objectivesTo determine if Emergency Department attendees aged from 10–25 years (adolescents) could be clinically managed by community pharmacists or hospital pharmacist independent prescribers with or without further advanced clinical practice training.MethodA prospective 49 site cross-sectional observational study of patients attending Emergency Departments (ED) in England, UK. Each site was requested to collect data for 400 admissions of all ages. Pharmacist independent prescribers (one for each site) were asked to identify patient attendance at their Emergency Department, record anonymised details of the cases – age, weight, presenting complain, clinical grouping (e.g. medicine, orthopaedics) and categorise each one into one of four possible categories: CP, Community Pharmacist, cases which could be managed by a community pharmacist outside an ED setting; IP – cases that could be managed in ED by a hospital pharmacist with independent prescriber status; IPT, Independent Prescriber Pharmacist with additional training – cases which could be managed in ED by a hospital pharmacist independent prescriber with additional clinical training; and MT, Medical Team only – cases that were unsuitable for the pharmacist to manage. An Impact Index was calculated for the two most frequent clinical groupings using the formula: Impact index (I)=proportion of the total workload of the clinical grouping (w) multiplied by the percentage ability of pharmacists to manage that clinical group (a). I=wa. The higher the Impact Index the greater potential for pharmacists to support the clinical workload related to that group.Results2993 out of 18 613 (16%) attendees were young patients aged from 10 to 25 years of age (median 20 years, interquartile range 17–22 years) of which 1530 were female and 1463 were male. Of the 2993 patients, 6% of the cases were judge to be suitable for the community pharmacist (CP), 5% suitable for a hospital pharmacist independent prescriber (IP), 37% were deemed as suitable for a hospital independent prescriber with additional training (IPT) and the remaining 52% were only suitable for the medical team (MT). The most frequent clinical groups and Impact Index were general medicine=16.97 and orthopaedics=15.51.ConclusionEmergency Department attendees who were young patients were judged by independent prescriber pharmacists to be suitable for clinical management by community pharmacists outside a hospital setting in approximately 1 in 16 admissions, and by a hospital independent prescriber pharmacists in 1 in 20 cases. With further training, it was found that the total proportion of cases that could potentially be managed by a pharmacist (CP, IP or IPT) came to 48%. The greatest potential impact for pharmacist management occurs in general medicine and orthopaedics.ReferencesPaw RC. Emergency Department Staffing in England and Wales. Emer Med J 2008;24:420–23.Hughes E, et al. Future enhanced clinical role of pharmacists in Emergency Departments in England: Multi-site observational evaluation. Int J Clin Pharm 2017;39:960–968.

The impact of GP referrals on overcrowding in emergency departments and acute medicine

2021 ◽  
Vol 27 (2) ◽  
pp. 1-6
Author(s):  
Ayaz A Abbasi ◽  
Shams Khan ◽  
Victor Ameh ◽  
Ilyas Muhammad
Keyword(s):  
Emergency Department ◽  
Emergency Departments ◽  
Patient Flow ◽  
General Medicine ◽  
Service Evaluation ◽  
Urgent Care ◽  
Ambulatory Assessment ◽  
Acute Medicine ◽  
Number Of Patients ◽  
The Impact

Background/Aims A long-standing issue common to most emergency departments worldwide is overcrowding, and the UK is no exception. Overcrowding can have many adverse consequences, such as increased medical errors, decreased quality of care and poor patient outcomes. This service evaluation aimed to review the number of patients referred to acute specialties by their GPs and to evaluate the impact of these referrals on the flow of patients in and out of the emergency department and acute medicine. Methods GP referral letters were collected at an emergency department in Greater Manchester, England, between 15 May 2019 and 28 May 2019. A proforma was used by a consultant in acute medicine and a consultant in emergency medicine to evaluate each letter. Result A total of 139 GP referrals were received by the emergency department, of which 43 were to general medicine and 96 to other specialties. Of the latter, 54 cases were directed to the emergency department, 20 were directed to a different specialty and 23 did not have a specialty clearly specified. The majority of referrals were for gastrointestinal conditions or abdominal pain, with the next largest category being chest infections. Most of these patients were eventually seen in the trust's ambulatory assessment area to relieve pressure on the emergency department. Conclusions Planned and specific use of urgent care centres and ambulatory assessment areas can help to relieve pressure on emergency departments, but appropriate intervention at the primary care level is also necessary to improve patient flow.

scholarly journals 140. Symptoms and Situations Predispose Patients to Use Antibiotics Without Medical Advice

2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S200-S200
Author(s):  
Michael Hansen ◽  
Barbara Trautner ◽  
Roger Zoorob ◽  
George Germanos ◽  
Osvaldo Alquicira ◽  
...  
Keyword(s):  
Primary Care ◽  
Emergency Department ◽  
Emergency Departments ◽  
Primary Care Clinic ◽  
Antibiotic Use ◽  
Safety Net ◽  
Care Clinic ◽  
Primary Care Clinics ◽  
Primary Care Patients ◽  
Emergency Department Patients

Abstract Background Use of antibiotics without a prescription (non-prescription use) contributes to antimicrobial resistance. Non-prescription use includes obtaining and taking antibiotics without a prescription, taking another person’s antibiotics, or taking one’s own stored antibiotics. We conducted a quantitative survey focusing on the factors that impact patients’ decisions to use non-prescription antibiotics. Methods We surveyed patients visiting public safety net primary care clinics and private emergency departments in a racially/ethnically diverse urban area. Surveys were read aloud to patients in Spanish and English. Survey domains included patients’ perspectives on which syndromes require antibiotic treatment, their perceptions of health care, and their access to antibiotics without a prescription. Results We interviewed 190 patients, 122 from emergency departments (64%), and 68 from primary care clinics (36%). Overall, 44% reported non-prescription antibiotic use within the past 12 months. Non-prescription use was higher among primary care clinic patients (63%) than the emergency department patients (39%, p = 0.002). The majority felt that antibiotics would be needed for bronchitis (78%) while few felt antibiotics would be needed for diarrhea (30%) (Figure 1). The most common situation identified “in which respondents would consider taking antibiotics without contacting a healthcare provider was “got better by taking this antibiotic before” (Figure 2). Primary care patients were more likely to obtain antibiotics without prescription from another country than emergency department patients (27% vs. 13%, P=0.03). Also, primary care patients were more likely to report obstacles to seeking a doctor’s care, such as the inability to take time off from work or transportation difficulties, but these comparisons were not statistically significant. Figure 1. Patients’ agreement that antibiotics would be needed varied by symptom/syndrome. Figure 2. Situations that lead to non-prescription antibiotic use impacted the two clinical populations differently Conclusion Non-prescription antibiotic use is a widespread problem in the two very different healthcare systems we included in this study, although factors underlying this practice differ by patient population. Better understanding of the factors driving non-prescription antibiotic use is essential to designing patient-focused interventions to decrease this unsafe practice. Disclosures All Authors: No reported disclosures

Emergency Intubation For Paediatric Patients At The Emergency Departments

2021 ◽  
Author(s):  
Yi Hui To ◽  
Yong‐Kwang Gene Ong ◽  
Shu‐Ling Chong ◽  
Peck Har Ang ◽  
Nur Diana Bte Zakaria ◽  
...  
Keyword(s):  
Emergency Departments ◽  
Emergency Intubation ◽  
Paediatric Patients

Finding the path of least resistance: Locally adapting the MITIGATE toolkit in emergency departments and urgent care centers

2021 ◽  
pp. 1-3
Author(s):  
Joanne Huang ◽  
Zahra Kassamali Escobar ◽  
Todd S. Bouchard ◽  
Jose Mari G. Lansang ◽  
Rupali Jain ◽  
...  
Keyword(s):  
Primary Care ◽  
Emergency Department ◽  
Antimicrobial Stewardship ◽  
Emergency Departments ◽  
Urgent Care ◽  
Complex Data ◽  
University Of Washington ◽  
Primary Care Clinics ◽  
Urgent Care Centers ◽  
The University

Abstract The MITIGATE toolkit was developed to assist urgent care and emergency departments in the development of antimicrobial stewardship programs. At the University of Washington, we adopted the MITIGATE toolkit in 10 urgent care centers, 9 primary care clinics, and 1 emergency department. We encountered and overcame challenges: a complex data build, choosing feasible outcomes to measure, issues with accurate coding, and maintaining positive stewardship relationships. Herein, we discuss solutions to challenges we encountered to provide guidance for those considering using this toolkit.

The Model of Hospital Emergency Departments in 2,000 Bed Hospital in Hungary

1986 ◽  
Vol 2 (1-4) ◽  
pp. 116-117
Author(s):  
Attila Csepanyi ◽  
Mihaly Sebestyen
Keyword(s):  
Emergency Department ◽  
Research Program ◽  
Emergency Departments ◽  
County Hospital ◽  
Hospital Emergency ◽  
Ministry Of Health ◽  
Ground Floor ◽  
Hospital Emergency Departments

The first emergency department in Hungary was established in Hetenyi Geza County Hospital in 1976. It was organized as part of a research program commissioned by the Ministry of Health. Initially, the hospital had 1400 beds which have now increased to 2,000.The Emergency Department is located on the ground floor of a new building and occupies 1,100 square meters of surface. The operation of the department is divided into three main areas.

Routine Emergency Department Use for Sick Care by Children in the United States

PEDIATRICS ◽  
1996 ◽  
Vol 98 (1) ◽  
pp. 28-34 ◽  
Author(s):  
Neal Halfon ◽  
Paul W. Newacheck ◽  
David L. Wood ◽  
Robert F. St Peter
Keyword(s):  
High School ◽  
Emergency Department ◽  
Child Care ◽  
Emergency Departments ◽  
Primary Care Physicians ◽  
The United States ◽  
Health Maintenance ◽  
Well Child Care ◽  
Usual Source ◽  
Us Children

Background. The use of the emergency departments as a regular source of sick care has been increasing, despite the fact that it is costly and is often an inappropriate source of care. This study examines factors associated with routine use of emergency departments by using a national sample of US children. Methods. Data from the 1988 National Health Interview Survey on Child Health, a nationally representative sample of 17 710 children younger than 18 years, was linked to county-level health resource data from the Area Resource File. Bivariate and multivariate analyses were used to assess the association between children's use of emergency departments as their usual sources of sick care and predisposing need and enabling characteristics of the families, as well as availability of health resources in their communities. Results. In 1988 3.4% or approximately 2 million US children younger than 18 years were reported to use emergency departments as their usual sources of sick care. Significant demographic risk factors for reporting an emergency department as a usual source of sick care included black versus white race (odds ratio [OR], 2.08), single-parent versus two-parent families (OR, 1.53), mothers with less than a high school education versus those with high school or more (OR, 1.76), poor versus nonpoor families (OR, 1.76), and living in an urban versus suburban setting (OR, 1.38). Specific indicators of need, such as recurrent health conditions (asthma, tonsillitis, headaches, and febrile seizures), were not associated with routine use of emergency departments for sick care. Furthermore, health insurance status and specifically Medicaid coverage had no association with use of the emergency department as a usual source of sick care. Compared with children who receive well child care in private physicians' offices or health maintenance organizations, children whose sources of well child care were neighborhood health centers were more likely to report emergency departments for sick care (OR, 2.01). Children residing in counties where the supply of primary care physicians was in the top quintile had half the odds (OR, 0.50) of reporting emergency departments as usual sources of sick care.

Factors Associated with Moral Distress and Caring Behavior of Nurses Working in Emergency Departments of Mazandaran University of Medical Sciences During COVID-19 Pandemic

2021 ◽  
Vol 15 (5) ◽  
pp. 1545-1550
Author(s):  
F. Talebian ◽  
T. Yaghoubi ◽  
R. Marzband
Keyword(s):  
Emergency Department ◽  
Emergency Departments ◽  
Moral Distress ◽  
Final Conclusion ◽  
Validity And Reliability ◽  
Medical Sciences ◽  
Caring Behaviors ◽  
Factors Associated ◽  
Caring Behavior ◽  
Medical Centers

Introduction: Moral distress is one of the prevalent problems of nursing which causes stress, that leads to nurses being unable to show a proper moral function in the critical situations. Moreover, due to the stressful conditions in emergency department, caring behaviors of nurses is of great importance. This study aimed to determine the factors associated with moral distress and caring behaviors of nurses working in emergency departments in educational-medical centers of Mazandaran University of Medical Sciences during COVID-19 pandemic. Methodology: This study was descriptive-analytical which was conducted through stratified and convenience sampling, and by participation of 188 nurses working in emergency departments in 5 educational-medical centers of Mazandaran University of Medical Sciences in 2020. Data was collected through standard three-section questionnaire of demographic information, Corley moral distress and Wolf caring behaviors of nurses, and its validity and reliability was confirmed. Data was analyzed by using descriptive (mean and standard deviation, frequency and percentage) and analytical statistics (Mann–Whitney, Kruskal-Wallis, and Spearman correlation coefficient). Finding: Moral distress mean score of nurses working in emergency was 20/97±101/60 and they had 92/4% of average moral distress. Caring behavior of nurses was 8/62±101/60. Gender and marital status variables had a significant relation with caring behavior, in a way that male nurses and married nurses had a lower score (p<0.05). the relation between moral distress and caring behavior was NOT statistically significant. Final conclusion: Nursing staff must have a good command of their caring behavior so that caring will be presented in high quality, and patients and help-seekers’ satisfaction who come to the emergency, especially in COVID-19 pandemic, will be met. Thus, it is necessary that health and medical system managers provide educational programs to draw nurses’ attention to their caring behavior dimensions, especially in emergency departments. Key words: moral distress, caring behavior, emergency department nurse, COVID-19 pandemic

scholarly journals Skåne Emergency Department Assessment of Patient Load (SEAL)—A Model to Estimate Crowding Based on Workload in Swedish Emergency Departments

PLoS ONE ◽  
2015 ◽  
Vol 10 (6) ◽  
pp. e0130020 ◽  
Author(s):  
Jens Wretborn ◽  
Ardavan Khoshnood ◽  
Mattias Wieloch ◽  
Ulf Ekelund
Keyword(s):  
Emergency Department ◽  
Emergency Departments ◽  
Patient Load

A national survey of telemedicine use by US emergency departments

2018 ◽  
Vol 26 (5) ◽  
pp. 278-284 ◽  
Author(s):  
Kori S Zachrison ◽  
Krislyn M Boggs ◽  
Emily M Hayden ◽  
Janice A Espinola ◽  
Carlos A Camargo
Keyword(s):  
Emergency Department ◽  
Emergency Departments ◽  
Multivariable Analysis ◽  
Clinical Applications ◽  
Future Research ◽  
Emergency Medical Care ◽  
Adults And Children ◽  
Annual Total ◽  
National Emergency ◽  
Total Visit

Objective Telemedicine has the potential to improve the delivery of emergency medical care: however, the extent of its adoption in United States (US) emergency departments is not known. Our objective was to characterise the prevalence of telemedicine use among all US emergency departments, describe clinical applications for which it is most commonly used, and identify emergency department characteristics associated with its use. Methods As part of the National Emergency Department Inventory-USA survey, we queried all 5375 US emergency departments open in 2016. Multivariable logistic regression analyses identified characteristics associated with emergency department receipt of telemedicine services. Results Overall, 4507 emergency departments (84%) responded to our survey, with 4031 responding to both telemedicine questions (75%). Although 1694 emergency departments (42%) reported no telemedicine in 2016, most did: 1923 (48%) emergency departments received telemedicine services, 149 (4%) emergency departments received telemedicine services and were in hospitals that provided telemedicine, and 265 emergency departments (7%) did not receive telemedicine but were in hospitals that provided telemedicine services. Among emergency departments receiving telemedicine, the most common applications were stroke/neurology (76%), psychiatry (38%), and paediatrics (15%). In multivariable analysis, telemedicine-receiving emergency departments had higher annual total visit volume for adults and lower annual total visit volume by children; were less likely to be academic or freestanding; and varied by region. In multivariable analysis, emergency departments in telemedicine-providing hospitals had higher annual total visit volume for adults and children, were more likely to be academic and were less likely to be freestanding. Conclusion In 2016, telemedicine was used in most US emergency departments (58%), especially for stroke/neurology and psychiatry. Future research is needed to understand the value of telemedicine for different clinical applications, and the barriers to its implementation.

Sign in / Sign up

Export Citation Format

Share Document