scholarly journals Nurses' Attitudes towards Drug-Seekers in the Emergency Room

2013 ◽  
Author(s):  
Megan Gernt

<p>Emergency department patients often present with a chief complaint of pain. There is a unique population of patients who present with this chief complaint in an effort to obtain narcotics for non-medical use. This population is often referred to as drug-seekers and there is little information available to define what exactly nurses mean when they use this term. This study utilized a descriptive survey design to gain a better understanding of nurses’ use of the term drug-seeker. Respondents agreed on a variety of behaviors that lead them to identify patients as drug-seeking and expressed a frustration with this population of patients. Many respondents identified a lack of clear policies and education around this population as a challenge. By understanding how nurses use the term drug-seeking, and developing an understanding what some of their concerns are regarding this population, the opportunity presents itself for the development of educational programs in order to train health care providers to best care for this challenging population. Additionally, the opportunity exists for policy development and implementation around this population in order to provide safe, comprehensive, and satisfactory care<strong>.</strong></p>

2017 ◽  
Vol 9 (1) ◽  
Author(s):  
Rene Borroto ◽  
Bill Williamson ◽  
Patrick Pitcher ◽  
Lance Ballester ◽  
Wendy Smith ◽  
...  

ObjectiveDescribe how the Georgia Department of Public Health (DPH) usessyndromic surveillance to initiate review by District Epidemiologists(DEs) to events that may warrant a public health response (1).IntroductionDPH uses its State Electronic Notifiable Disease SurveillanceSystem (SendSS) Syndromic Surveillance (SS) Module to collect,analyze and display results of emergency department patient chiefcomplaint data from hospitals throughout Georgia.MethodsDPH prepares a daily SS report, based upon the analysis ofdaily visits to 112 Emergency Department (EDs). The visits areclassified in 33 syndromes. Queries of chief complaint and dischargediagnosis are done using the internal query capability of SendSS-SSand programming in SAS/BASE. Charting of the absolute countsor percentage of ED visits by syndromes is done using the internalcharting capability of SendSS-SS. A daily SS report includes thefollowing sections:Statewide Emergency Department Visitsby Priority Syndromes(Bioterrorism, BloodyRespiratory,FeverRespiratory, FeverChest, FeverFluAdmit, FeverFluDeaths,VeryIll, andPoxRashFever, Botulism, Poison, BloodyDiarrhea,BloodyVomit, FeverGI, ILI, FeverFlu, RashFever, Diarrhea,Vomit).Statewide Flag Analysis: Is intended to detect statewideflags, by using theChartscapability in SendSS SS.Possible caseswith presumptive diagnosis of potentially notifiable diseases: Isintended to provide early-warning to the DEs of possible cases thatare reportable to public health immediately or within 7 days usingqueries in the Chief Complaint and Preliminary Diagnosis fields ofSendSS-SS.Possible clusters of illness: Since any cluster of illnessmust be reported immediately to DPH, this analysis is aimed atquerying and identifying possible clusters of patients with similarsymptoms (2).Possible travel-related illness: Is intended to identifypatients with symptoms and recent travel history.Other events ofinterest: Exposures to ill patients in institutional settings (e.g. chiefcomplaint indicates that other children in the daycare have similarsymptoms).Trend Analysis: Weekly analysis of seasonality andtrends of 14 syndromes. Finally, specific events are notified to andreviewed by the 18 DEs, who follow up by contacting the InfectionPreventionists of the hospitals to identify the patients using medicalrecords or other hospital-specific identification numbers and followup on the laboratory test results.ResultsSince 05/15/2016, 12 travel-related illnesses, 29 vaccine-preventable diseases, 14 clusters, and 3 chemical exposures havebeen notified to DEs. For instance, a cluster of chickenpox in childrenwas identified after the DE contacted the Infection Preventionist ofa hospital, who provided the DE with the laboratory results and thephysician notes about the symptoms of the patients. These actionshave resulted in earlier awareness of single cases or cluster of illness,prompt reporting of notifiable diseases, and successful interactionbetween DEs and health care providers. In addition, SS continues totrack the onset, peak, and decline of seasonal illnesses.ConclusionsThe implementation of SS in the State of Georgia is helping withthe timely detection and early responses to disease events and couldprove useful in reducing the disease burden caused by a bioterroristattack.


2004 ◽  
Vol 16 (1) ◽  
pp. 45-49 ◽  
Author(s):  
P.Y. Lee ◽  
E.M. Khoo

70 patients presented with acute asthma exacerbation requiring nebulised bronchodilator treatment at the emergency department of a teaching hospital in Kuala Lumpur, Malaysia, were interviewed over a two-week period in July 2001. The results showed that 45 (64%) patients had not been educated on the nature of asthma; 30 (43%) had not been advised on preventive measures or avoidance of triggers; 54 (77%) were not advised about the medications used and their side effects; 42 (60%) patients did not know the difference between reliever and preventive medications; 37 (53%) were unable to recognize features of worsening asthma and 68 (97%) were not told about the danger of non-prescribed self-medication or traditional medications. Only six (9%) patients were using peak flow meters and were taught self-management plans. The multiple regression results suggest that patients who were followed up at teaching hospital based clinics were better educated on asthma. In conclusion, asthmatic patients are still not educated well about their disease. Health care providers need to put more emphasis on asthma education so that the number of emergency room visits can be reduced. Asia Pac J Public Health 2004; 16(1): 45-49.


2021 ◽  
Vol 2 ◽  
Author(s):  
N. Haroon ◽  
S. S. Owais ◽  
A. S. Khan ◽  
J. Amin

Summary COVID-19 has challenged the mental health of healthcare workers confronting it world-wide. Our study identifies the prevalence and risk of anxiety among emergency healthcare workers confronting COVID-19 in Pakistan. We conducted a cross-sectional survey in an Emergency Department using the Generalized Anxiety Scale (GAD-7), and questions about sources of anxiety. Of 107 participants, 61.7% were frontline workers. The prevalence of anxiety was 50.5%. Nonparametric tests determined that nurses, younger and inexperienced staff, developed significant anxiety. Multivariate ordinal regression determined independent risk factors for developing anxiety were younger age (OR 2.11, 95% CI 0.89–4.99) and frontline placement (OR 1.34, 95% CI 0.33–1.66). Significant sources of stress were fear of infecting family (P = 0.003), lack of social support when the health care providers were themselves unwell (P = 0.02) and feelings of inadequate work performance (P = 0.05). Our study finds that HCWs’ anxiety is considerable. Appropriate measures for its alleviation and prevention are required.


2021 ◽  
Vol 8 ◽  
pp. 237437352110180
Author(s):  
Robin E. McAtee ◽  
Laura Spradley ◽  
Leah Tobey ◽  
Whitney Thomasson ◽  
Gohar Azhar ◽  
...  

Millions of Americans live with dementia. Caregivers of this population provide countless hours of multifaceted, complex care that frequently cause unrelenting stress which can result in immense burden. However, it is not fully understood what efforts can be made to reduce the stress among caregivers of persons with dementia (PWD). Therefore, the aim of this pretest–posttest designed study was to evaluate changes in caregiver burden after providing an educational intervention to those caring for PWD in Arkansas. Forty-one participants completed the Zarit Caregiver Burden Scale before and after attending a 4-hour dementia-focused caregiving workshop. The analysis of the means, standard deviations, and paired t tests showed that there was an increase in the confidence and competence in caring for PWD 30 to 45 days after attending the workshop. Health care providers need to understand both the vital role caregivers provide in managing a PWD and the importance of the caregiver receiving education about their role as a caregiver. Utilizing caregiver educational programs is a first step.


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Anh Ly ◽  
Roger Zemek ◽  
Bruce Wright ◽  
Jennifer Zwicker ◽  
Kathryn Schneider ◽  
...  

Abstract Background Multiple evidence-based clinical practice guidelines (CPGs) exist to guide the management of concussion in children, but few have been translated into clinical pathways (CP), which operationalize guidelines into accessible and actionable algorithms that can be more readily implemented by health care providers. This study aimed to identify the clinical behaviours, attitudinal factors, and environmental contexts that potentially influence the implementation of a clinical pathway for pediatric concussion. Methods Semi-structured interviews were conducted from October 2017 to January 2018 with 42 emergency department clinicians (17 physicians, 25 nurses) at five urban emergency departments in Alberta, Canada. A Theoretical Domains Framework (TDF)-informed interview guide contained open-ended questions intended to gather feedback on the proposed pathway developed for the study, as well as factors that could potentially influence its implementation. Results The original 14 domains of the TDF were collapsed into 6 clusters based on significant overlap between domains in the issues discussed by clinicians: 1) knowledge, skills, and practice; 2) professional roles and identity; 3) attitudes, beliefs, and motivations; 4) goals and priorities; 5) local context and resources; and 6) engagement and collaboration. The 6 clusters identified in the interviews each reflect 2–4 predominant topics that can be condensed into six overarching themes regarding clinicians’ views on the implementation of a concussion CP: 1) standardization in the midst of evolving research; 2) clarifying and communicating goals; 3) knowledge dissemination and alignment of information; 4) a team-oriented approach; 5) site engagement; and 6) streamlining clinical processes. Conclusion Application of a comprehensive, evidence-based, and theory-driven framework in conjunction with an inductive thematic analysis approach enabled six themes to emerge as to how to successfullly implement a concussion CP.


1995 ◽  
Vol 16 (6) ◽  
pp. 229-238
Author(s):  
Jill M. Baren ◽  
James S. Seidel

This section of Pediatrics in Review is designed to be clipped or duplicated and filed in a handy place in the office, clinic, or emergency department, providing a convenient and concise reference. All offices in which children are examined should have pediatric emergency equipment, supplies, drugs, policies, and procedures. The equipment, supplies, and drugs kept in the office will depend on the spectrum of ill or injured children seen in the practice. However, a source of oxygen, basic resuscitation drugs (suited to the patient population and experience of the health-care providers), and a dosage chart or weight-based dosing tape (Figure 1) should be available in all offices. The following list of drugs is fairly comprehensive and is organized according to sign or symptom needing treatment. Health-care providers should become familiar with the information regarding specific drugs that they use commonly, eg, choose a short-acting benzodiazepine such as diazepam or lorazepam for treating status epilepticus. The intraosseous (IO) route of drug administration can be used for the majority of emergency drugs listed in the chart that suggest administration by the intramuscular (IM) or intravenous (IV) routes. The IO route is appropriate for children age 6 years and younger and should be reserved for those circumstances where failure to achieve vascular access might result in loss of life or limb (ie, anaphylaxis, cardiopulmonary arrest).


2020 ◽  
Vol 25 (3) ◽  
pp. 140-147
Author(s):  
Kayla E. Boehm ◽  
Blaine C. Long ◽  
Mitchell T. Millar ◽  
Kevin C. Miller

Effectiveness of Kinesiology Tex Tape (KTT) is conflicting, with some clinicians supporting and others refuting its effects. There is limited information on the psychological effects of KTT or whether its increased use has been influenced by professional athletes. The purpose of this study was to assess the physiological, psychological, and use of KTT. A descriptive survey on the use of KTT was performed with athletic trainers and other health care providers. Many reported that KTT benefited patients physiologically and psychologically. Those who thought KTT provided a physiological benefit indicated that they use it. Many indicated KTT benefited patients psychologically, without impacting them physiologically. In addition, clinicians indicated KTT use has been influenced by professional athletes.


2019 ◽  
pp. 112067211989642
Author(s):  
Alicia Galindo-Ferreiro ◽  
Hortensia Sanchez-Tocino ◽  
Yago Varela-Conde ◽  
Cecilia Diez-Montero ◽  
Minal Belani-Raju ◽  
...  

Purpose: To determine the frequency of ocular conditions among patients presenting to an emergency department at a tertiary hospital in Spain. Methods: A retrospective, longitudinal analysis of all patients who presented to the ocular emergency department of Rio Hortega University Hospital, Valladolid, Spain, from 2013 to 2018 was performed. Data on demographics, ophthalmic examination, and diagnosis were collected. Diseases were classified according the International Classification of Diseases, Ninth Revision, Clinical Modification codes. Results: We had 20,822 patients, of which 10,878 (52.2%) were women. The main age categories were 45–65 years (7391 patients; 35.5%) and 15–45 years (5979 patients; 28.2%). Most of the patients (17,793; 85.5%) were discharged on the same day. Conjunctival pathology was the most common cause of presentation (4110; 19.7%), followed by corneal disorders (4025; 19.3%). Acute conjunctivitis was diagnosed in 2920 (14%) and ocular trauma in 2125 (10.2%) patients. Non-emergency ophthalmic conditions were diagnosed in 1581 (7.6%) patients. Retinal detachments and peripheral holes occurred more commonly in patients aged 45–65 years ( p <0.001). Corneal or conjunctival disorders and lid inflammation ( p <0.001) were more frequent in women, whereas men had higher incidences of trauma ( p <0.001). Conclusion: Most of our patients presented ocular surface diseases. Men were more vulnerable to trauma, mainly superficial foreign body. The majority of the patients presented with uncomplicated ocular conditions that would be managed more cost-effectively by primary health care providers. We advocate greater education of primary care physicians and patients in managing simple ocular emergencies to reduce the cases presenting to an emergency department of a tertiary hospital.


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