scholarly journals The Experience of Patient-Related Violence Against Emergency Department Nurses in the United States: A Phenomenological Pilot Study

2020 ◽  
Author(s):  
Mahmoud M. Al-Qadi
Keyword(s):  
United States ◽  
Emergency Department ◽  
Workplace Violence ◽  
Physical Violence ◽  
Waiting Times ◽  
The United States ◽  
Research Approach ◽  
North East ◽  
Emergency Department Nurses ◽  
The Impact

Abstract Purpose This study described the experiences, thoughts, perceptions, and feelings of emergency department nurses regarding patient-related violence.Design and Methods A descriptive phenomenological research approach was adopted to collect data through unstructured interviews. Three participants were recruited via word of mouth through colleagues from two different states (North East) in the United States. Data were collected from October to November 2018. Colaizzi’s phenomenological methodology was adopted to analyze the interview content.Findings Seven themes emerged from the analysis of the data: physical violence, take care of patients regardless of their behavior, communication skills, lack of training and educational intervention, contributing factor: long waiting times, expletive forms of verbal abuse and threatening behaviors, and the impact of violent behavior on nurses led to feelings of negative emotions.Conclusions Provide training to ED nurses on how to handle violence situations and the employers has to implement policies to make the workplace safe for both nurses and patients. The findings of this study highlight the urgency of taking a realistic approach to preventing workplace violence to organizational leaders.

scholarly journals The Impact of the “Muslim Ban” Executive Order on Healthcare Utilization in Minneapolis-St. Paul, Minnesota

2020 ◽  
Author(s):  
Elizabeth A. Samuels ◽  
Lilla Orr ◽  
Elizabeth B. White ◽  
Altaf Saadi ◽  
Aasim I. Padela ◽  
...  
Keyword(s):  
United States ◽  
Primary Care ◽  
Emergency Department ◽  
Healthcare Utilization ◽  
The United States ◽  
Emergency Department Visits ◽  
Executive Order ◽  
Before And After ◽  
Muslim Majority ◽  
The Impact

AbstractObjectiveDetermine whether the 2017 “Muslim Ban” Executive Order impacted healthcare utilization by people born in Order-targeted nations living in the United States.MethodsWe conducted a retrospective cohort study of people living in Minneapolis-St. Paul, MN in 2016-2017 who were: 1) born in Order-targeted nations, 2) born in Muslim-majority nations not listed in the Order, and 3) born in the United States and non-Latinx. Primary outcomes were: 1) primary care visits, 2) missed primary care appointments, 3) primary care diagnoses for stress-responsive conditions, 4) emergency department visits, and 5) emergency department visits for stress-responsive diagnoses. We evaluated visit trends before and after Order issuance using linear regression and differences between study groups using a difference-in-difference analyses.ResultsIn early 2016, primary care visits and stress-responsive diagnoses increased among individuals from Muslim majority nations. Following the Order, there was an immediate increase in emergency department visits among individuals from Order-targeted nations.ConclusionsIncreases in healthcare utilization among people born in Muslim majority countries before and after the “Muslim Ban” likely reflect elevated cumulative stress including the impact of the Order.

Workplace violence in the emergency department in India and the United States

2017 ◽  
Vol 3 (2) ◽  
pp. 248 ◽  
Author(s):  
Nicolas Grundmann ◽  
Bonnie Arquilla ◽  
Yonatan Yohannes ◽  
Mark Silverberg ◽  
JayarajMymbilly Balakrishnan ◽  
...  
Keyword(s):  
United States ◽  
Emergency Department ◽  
Workplace Violence ◽  
The United States

scholarly journals 2004. Impact of Procalcitonin Roll-out Without Antimicrobial Stewardship Guidance in a Community Hospital Emergency Department

2019 ◽  
Vol 6 (Supplement_2) ◽  
pp. S672-S672
Author(s):  
Alfredo J Mena Lora ◽  
Samah Qasmieh ◽  
Eric Wenzler ◽  
Scott Borgetti ◽  
Naman Jhaveri ◽  
...  
Keyword(s):  
United States ◽  
Emergency Department ◽  
Length Of Stay ◽  
Antimicrobial Stewardship ◽  
Community Hospital ◽  
The United States ◽  
Healthcare Research ◽  
Antimicrobial Use ◽  
Tract Infections ◽  
The Impact

Abstract Background Lower respiratory tract infections (LRTIs) are one of the most common infectious disease-related emergency department (ED) visits in the United States. The ID Society of America and the Agency for Healthcare Research and Quality support the use of procalcitonin (PCT) for antimicrobial stewardship (ASP) in LRTI. Though not widely available, awareness and access to PCT is rising. At our facility, PCT became available in February 2018. The aim of our study is to assess the impact of PCT at an urban community hospital and identify possible targets for ASP interventions. Methods Retrospective review of cases from February to August 2018. Cases from the ED were selected for review. Appropriateness of testing was assessed, defined as guideline-based use for cessation of antibiotics in uncomplicated LRTIs without critical illness or immunosuppression. Demographic variables and clinical characteristics, such as, diagnosis, antimicrobial use and PCT levels were obtained. Results PCT was ordered 268 times hospital-wide, of which 160 (60%) were in the ED. Ages ranged from 0–90, with an average of 47. Most cases were male (51%). Appropriate testing for LRTI occurred in 33 (29%) cases. Antimicrobials were used in 75% of cases with low (< 0.5) PCT levels (Figure 1). Length of stay (LOS) was higher in groups that received antimicrobials (Figure 2). Testing was not appropriate in 127 cases (71%), with upper respiratory (21%), soft-tissue (17%), genitourinary (15%) and abdominal (13%) infections as the most common reasons for testing. Other diagnosis included alcohol withdrawal, seizures and altered mental status. Cumulative cost of PCT testing was $24000, of which $19050 was not consistent with guidelines. Conclusion Clinicians routinely ordered PCT in the ED. Antimicrobials were used for LRTIs despite low PCT levels. This may have contributed to higher LOS and excess antimicrobial use. Unwarranted PCT testing had a cost of $19050. As PCT becomes widely available in hospitals across the United States, education and decision support by ASP to clinicians may be needed to enhance guideline-appropriate evidence-based use of PCT. Targeted ASP interventions in the ED may have cost savings by reducing excess testing, length of stay and improving antimicrobial use. Disclosures All authors: No reported disclosures.

The Normalization of Violence in Commercial Kitchens Through Food Media

2021 ◽  
pp. 088626052110051
Author(s):  
Ellen T. Meiser ◽  
Penn Pantumsinchai
Keyword(s):  
United States ◽  
Workplace Violence ◽  
Physical Violence ◽  
The United States ◽  
Violence In The Workplace ◽  
Using Data ◽  
Behavioral Norm ◽  
Food Media ◽  
Bureau Of Labor Statistics ◽  
Normalization Of Violence

The Bureau of Labor Statistics estimates that there are 2.53 million cooks and chefs in the United States. Of those, one in four reports experiencing physical violence in the workplace—roughly 632,500 victims. While shocking, this figure fails to account for the psychological and sexual violence that also plagues commercial kitchens. Workplace harassment and bullying is not limited to the United States and has been documented in Scottish, English, Scandinavian, French, Malaysian, Korean, and Australian kitchens. Why is violence so prevalent in kitchens, and how has it become a behavioral norm? Using data from 50 in-depth interviews with kitchen workers and analysis of food media, this article shows that while kitchen workplace violence can be attributed to typical causes, such as occupational stress, there is an overlooked source: the normalization of violence through food media. By exploring television shows, like “Hell’s Kitchen,” and chef memoirs, like Bourdain’s Kitchen Confidential, readers will see how bullying and harassment are romanticized in these mediums, glorified as a product of kitchen subculture, and consequently normalized in the kitchen.

scholarly journals Effects of Workplace Violence on Nurses Working in the Emergency Department

2018 ◽  
Author(s):  
Alicia Blythe
Keyword(s):  
Emergency Department ◽  
Workplace Violence ◽  
Emotional Abuse ◽  
Physical Violence ◽  
Emergency Nurses ◽  
Staff Members ◽  
Emergency Department Nurses ◽  
Staff Assessment ◽  
Violence In The Workplace ◽  
Quantitative Descriptive

Workplace violence has been a trending topic of discussion across the country and is a concern for employees nationwide. The Emergency Department has been consistently documented as one area where workplace violence is most prevalent and presents a greater risk for occupational hazard. The escalating acts of violence toward emergency department nurses across the country have drastically increased and nurses have become targets of verbal and emotional abuse, subjected to threatening behavior, and have become victims of physical assaults. The purpose of this project was to identify the effects of workplace violence on nurses working in the Emergency Department. A quantitative descriptive study using modified Emergency Nurses Association (ENA) Workplace Violence staff assessment survey was used to identify emergency department nurses’ experiences with workplace violence. The mixed method design included a descriptive survey as well as series of open-ended questions to elicit personal accounts of violence in the workplace. A total of 36 nurses in the Emergency Department at Newport Hospital, a 129 bed community hospital in Newport, RI were surveyed. The results of the survey identified 95.45% (n=21) of nurses have experience some form of workplace violence. Physical violence such as being hit, punched, slapped, kicked, pinched, pushed, shoved, and scratched was experienced by at least half of nurses. Additionally, documented effects of workplace violence on staff members included burnout, low department morale, physical and emotional distress, and contributed to overall job dissatisfaction. The study identified workplace violence as an issue and recognizes the effects of violence on staff members is of significant concern that should be addressed with leadership support to recognize and decrease workplace violence in the ED.

scholarly journals 1651. The Impact of the 2017–2018 Influenza Season on Acute Care Hospitals in the United States: A Qualitative Evaluation of Immediate Responses and Future Preparedness

2019 ◽  
Vol 6 (Supplement_2) ◽  
pp. S603-S604
Author(s):  
Gavin H Harris ◽  
Kimberly J Rak ◽  
Jeremy M Kahn ◽  
Derek C Angus ◽  
Erin A Caplan ◽  
...  
Keyword(s):  
United States ◽  
Emergency Department ◽  
Acute Care ◽  
Hospital Admissions ◽  
Influenza Season ◽  
Acute Care Hospitals ◽  
The United States ◽  
Lessons Learned ◽  
Annual Reports ◽  
The Impact

Abstract Background The 2017–2018 influenza season was characterized by high illness severity, wide geographic spread, and prolonged duration compared with recent years in the United States – resulting in an increased number of emergency department evaluations and hospital admissions. The current study explored how US hospitals perceived the impact of influenza during this time period, including effects on patient volumes, ways in which hospitals responded, and how lessons learned were incorporated into future influenza preparedness. Methods We conducted semi-structured phone interviews with capacity management personnel in short-term acute care hospitals across the United States. A random hospital sample was created using Centers for Medicare and Medicaid Services annual reports. Hospitals self-identified key informants who were involved with throughput and capacity. The interview guide was developed and pilot tested by a team of clinicians and qualitative researchers, with interviews conducted between April 2018 and January 2019. We performed thematic content analysis to identify how hospitals experienced the 2017–2018 influenza season. Results We achieved thematic saturation after 53 interviews. Responses conformed to three thematic domains: impacts on staff and patient care, immediate staffing and capacity responses, and future preparedness (Table 1). Hospitals almost universally reported increased emergency department and inpatient volumes that frequently resulted in strain across the hospital. Strain was created by both increased patient volume and staff shortages due to influenza illness. As strategies to address strain, respondents reported the use of new protocols, new vaccination policies, additional staffing, suspected-influenza treatment areas, and more frequent hospital administration meetings. Many hospitals reported increased diversion time. Despite experiencing high levels of strain, some hospitals reported no changes to their future influenza preparation plans. Conclusion Acute care hospitals experienced significant strain as a result of the 2017–2018 influenza season. Hospitals implemented a range of immediate responses to seasonal influenza, but generally did not report future planning specific to influenza. Disclosures All authors: No reported disclosures.

Emergency Department Volume and Racial and Ethnic Differences in Waiting Times in the United States

Medical Care ◽  
2012 ◽  
Vol 50 (4) ◽  
pp. 335-341 ◽  
Author(s):  
Nancy Sonnenfeld ◽  
Stephen R. Pitts ◽  
Susan M. Schappert ◽  
Sandra L. Decker
Keyword(s):  
United States ◽  
Emergency Department ◽  
Ethnic Differences ◽  
Waiting Times ◽  
The United States ◽  
Racial And Ethnic Differences ◽  
Department Volume

scholarly journals P090: A scoping review on patient race, ethnicity, and care in the emergency department

CJEM ◽  
2019 ◽  
Vol 21 (S1) ◽  
pp. S96
Author(s):  
A. Owens ◽  
B. Holroyd ◽  
P. McLane
Keyword(s):  
United States ◽  
Emergency Department ◽  
Ethnic Groups ◽  
Scoping Review ◽  
Race And Ethnicity ◽  
Diagnostic Testing ◽  
The United States ◽  
Wait Times ◽  
Patient Race ◽  
The Impact

Introduction: Health disparities between racial and ethnic groups have been well documented in Canada, the United States, and Australia. Despite evidence that differences in emergency department (ED) care based on patient race and ethnicity exist, there is a lack of scientific reviews in this important area. The objective of this review is to provide an overview of the literature on the impact of patient race and ethnicity on ED care. Methods: A scoping review guided by the framework described by Arksey and O'Malley was undertaken. This approach was taken because it was best suited to the goal of providing an overview of all of the literature, given the broad nature of the topic. All studies with primary outcomes considering the impact of patient race and ethnicity on “throughput” factors in the ED as defined by Asplin et al., were considered. Outcomes considered included triage scores, wait times, analgesia, diagnostic testing, treatment, leaving without being seen, and patient experiences. Literature from Canada, the United States, Australia, and New Zealand was considered. A database search protocol was developed iteratively as familiarity with the literature developed. Inclusion and exclusion decisions were made using an established model. Results: The original search yielded 1157 citations, reduced to 453 after duplicate removal. 153 full texts were included for screening, of which 85 were included for final data extraction. Results indicate there is evidence that minority racial and ethnic groups experience disparities in triage scores, wait times, analgesia, treatment, diagnostic testing, leaving without being seen, and subjective experiences. Authors’ suggested explanations for these disparities can be placed in the following categories: (1) communication differences; (2) conscious or unconscious bias; (3) facility and resource factors in hospitals with higher minority presentation rates; and (4) differences in clinical presentations. Conclusion: This scoping review provides an overview of the literature on the impacts of race and ethnicity on ED care. As disparities have been shown to exist in numerous contexts, further research on the impact of race and ethnicity in ED care is warranted, especially in the Canadian literature. Such explorations could aid in the informing and creation of policy, and guide practice.

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