scholarly journals S4 Asthma in the emergency department. Outcome from specialist nurse intervention

2021 ◽  
Author(s):  
E Sadler ◽  
F Rands ◽  
S Hanson ◽  
M Doherty
Keyword(s):  
Emergency Department ◽  
Specialist Nurse ◽  
Nurse Intervention

81 Integrating A Front Door Frailty Service in the Emergency Department: Results of A Pilot Study

2021 ◽  
Vol 50 (Supplement_1) ◽  
pp. i12-i42
Author(s):  
L Dunnell ◽  
A Shrestha ◽  
E Li ◽  
Z Khan ◽  
N Hashemi
Keyword(s):  
Emergency Department ◽  
Hospital Admissions ◽  
Admission Rate ◽  
Community Services ◽  
Service Improvement ◽  
Specialist Nurse ◽  
Front Door ◽  
Medication Changes ◽  
Health Service Improvement

Abstract Introduction Increasing old age and frailty is putting pressure on health services with 5–10% of patients attending the emergency department (ED) and 30% of patients in acute medical units classified as older and frail. National Health Service improvement mandates that by 2020 hospital trusts with type one EDs provide at least 70 hours of acute frailty service each week. Methodology A two-week pilot (Monday–Friday 8 am-5 pm) was undertaken, with a “Front Door Frailty Team” comprising a consultant, junior doctor, specialist nurse and pharmacist, with therapy input from the existing ED team. They were based in the ED seeing patients on arrival, referrals from the ED team and patients in the ED observation ward—opposed to the usual pathway of referral from the ED team to medical team. Data was captured using “Cerner” electronic healthcare records. A plan, do, study, act methodology was used throughout with daily debrief and huddle sessions. Results 95 patients were seen over two weeks. In the over 65 s, average time to be seen was 50 minutes quicker than the ED team over the same period, with reduced admission rate (25.7% vs 46.5%). The wait between decision to admit and departure was shortened by 119 minutes. Overall, this led to patients spending on average 133 minutes less in the ED. 64 patients were discharged, of which 44 had community follow-up (including 37.5% of 64 referred to acute elderly clinic and 25% to rapid response). 47 medications were stopped across 25 patients. Conclusion The pilot shows that introduction of an early comprehensive geriatric assessment in the ED can lead to patients being seen sooner, with more timely decisions over their care and reduction in hospital admissions. It allowed for greater provision of acute clinics and community services as well as prompt medication review and real time medication changes.

scholarly journals Randomised controlled trial of specialist nurse intervention in heart failure

BMJ ◽  
2001 ◽  
Vol 323 (7315) ◽  
pp. 715-718 ◽  
Author(s):  
L. Blue ◽  
E. Lang ◽  
J. J V McMurray ◽  
A. P Davie ◽  
T. A McDonagh ◽  
...  
Keyword(s):  
Heart Failure ◽  
Randomised Controlled Trial ◽  
Controlled Trial ◽  
Specialist Nurse ◽  
Randomised Controlled ◽  
Nurse Intervention

scholarly journals Specialist nurse for organ donation in an emergency department will increase organ donation

Critical Care ◽  
2013 ◽  
Vol 17 (S2) ◽  
Author(s):  
T Neill ◽  
J Millar ◽  
P O'Connor ◽  
P Glover
Keyword(s):  
Emergency Department ◽  
Organ Donation ◽  
Specialist Nurse

scholarly journals A prospective, randomised controlled trial of an aged care nurse intervention within the Emergency Department

2005 ◽  
Vol 29 (1) ◽  
pp. 51 ◽  
Author(s):  
David Basic ◽  
David A Conforti
Keyword(s):  
Emergency Department ◽  
Randomised Controlled Trial ◽  
Health Care Providers ◽  
Controlled Trial ◽  
Functional Decline ◽  
Aged Care ◽  
Care Providers ◽  
Care Nurse ◽  
Randomised Controlled ◽  
Nurse Intervention

The aim of this randomised controlled trial involving 224 elderly patients was to determine whether early geriatric assessment (in the form of an aged care nurse intervention based in the emergency department) reduced admission to the hospital, length of inpatient stay (LOS), or functional decline during the hospitalisation. Baseline geriatric assessments were recorded in the medical files of intervention patients (n = 114). The nurse also liaised with the patients? carers and health care providers, organised referrals for out-of-hospital assessment and support services, and assisted in the care of those admitted as inpatients by documenting suggestions for assessment and referral. Assessment data from control patients (n = 110) were withheld, and the nurse had no further involvement in their inpatient or outpatient care. One hundred and seventy-one patients (76%) were admitted to the hospital, for a median LOS of 10 days. The nurse successfully identified those needing admission (odds ratio [OR], 14.0; 95% confidence interval [CI], 2.6? 75.1). Thirty-nine of 160 inpatients with available data (24%) had a functional deterioration during the hospitalisation. The intervention had no significant effect on admission to the hospital (OR, 0.7; CI, 0.3?1.7), LOS (hazard ratio, 1.1; CI, 0.7?1.5) or functional decline during the hospitalisation (OR, 1.3; CI, 0.5?3.3).

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