Nurses treating patients in the emergency department? A patient survey
|
|
- Aleesha Hoover
- 6 years ago
- Views:
Transcription
1 Hong Kong Journal of Emergency Medicine Nurses treating patients in the emergency department? A patient survey YS Ong, YL Tsang, YH Ho, FKL Ho, WP Law, CA Graham, TH Rainer Background: Hong Kong residents are familiar with prolonged waiting times in emergency departments (ED), particularly with semi-urgent or non-urgent conditions. In the United Kingdom and Australasia, extended nurse practitioners are well established. The aim of this study was to identify whether Hong Kong patients would prefer treatment by ED nurses or traditional care by doctors under various waiting time conditions. Methods: This was a prospective questionnaire study of patients who had been triaged into category 4 (semi-urgent) or 5 (non-urgent) during office hours from 20 to 27 June Following verbal consent, three waiting time scenarios were considered by the patient using an interviewer-administered structured questionnaire. Statistical analysis used the chi square test. Results: Overall, 253 patients were approached and 249 patients [119 (47.8%) male; mean age 48 (SD 19.4) years] verbally agreed to participate (98.4%). Patients were classified into three age groups. When the waiting time for nurse treatment was four hours shorter than doctors, patients aged and years more often chose nurses (overall 59.3%) for treatment but those aged 65 years preferred doctors to nurses (58.1% in favour of doctors), despite the longer waiting time (p=0.013, chi square test). Men also preferred nursing treatment compared to women (p<0.001). When the waiting time for doctors was 4 hours shorter than nurses or the same, 99.2% and 95.5% chose doctors respectively. Conclusion: When the waiting times are long, Hong Kong patients <65 years would prefer to see suitably trained nurses in preference to doctors. Consideration should be given to providing training for senior nurses to have an extended role in Hong Kong EDs. (Hong Kong j.emerg.med. 2007;14:10-15) % % Correspondence to: Colin A Graham, MPH, FRCS, FCEM Prince of Wales Hospital, Accident and Emergency Medicine Academic Unit, The Chinese University of Hong Kong, Trauma and Emergency Centre, Shatin, N.T., Hong Kong cagraham@cuhk.edu.hk Ong Yin Sheng, MBBS, MRCSEd, FHKAM(Emergency Medicine) Tsang Yuk Ling, BN, MSc, RN Ho Yim Ha, MBChB Ho Kwok Leung, Franklin, MBChB Law Wai Ping, MBChB Timothy H Rainer, MD, FCEM, FHKAM(Emergency Medicine)
2 Ong et al./nurses treating patients? % 65 p= % p< % 95.5% 65 Keywords: Nurse clinicians, nurse practitioners, nurse's role, patient satisfaction, time factors Introduction Residents in Hong Kong are no strangers to overcrowding and prolonged waiting times in emergency departments (ED) across the territory. 1 This is in line with the experience throughout the world, with similar problems being reported in the United States, 2 United Kingdom (UK), 3 and Australasia. 4 Patients with semi-urgent (triage category 4) or nonurgent (triage category 5) conditions often have to wait for several hours to see an ED doctor. 'Long waiting times in EDs' occasionally appears in the headlines of local newspapers when patients have to wait more than six hours before being seen by ED doctors. The long waiting time can be a great source of frustration not only to patients, but also to health care personnel. Disgruntled patients and their accompanying relatives have been witnessed "storming" the nursing counter, demanding to see doctors earlier: this is a common sight in local EDs. ED staff are under pressure from clinical and non-clinical sources and they work under constant threat of verbal abuse and sporadic physical violence by agitated patients and relatives. A proportion of patient complaints have been attributed to long waiting times. 5 Despite the implementation of the ED service charge since November 2002, there has only been a modest drop in ED attendances. 6 In the UK and Australasia, the concept of extended nurse practitioners (ENP) or advanced practice nurses is well established This came as a result of the urge for nurses to exercise greater professional knowledge and to assume a more autonomous role in practice. They provide a protocol-based extended scope of nursing, including assessment, treatment and discharge for patients presenting with minor injuries and illnesses. They have to undergo significant training periods to be capable of performing this role, and start by working under supervision; with increasing experience they become more autonomous. In some parts of the UK, ENPs work independently in rural and difficult to staff areas to provide a minor injury and illness service to the local communities. The aim of this study was to identify whether ED patients in Hong Kong would be willing to have their diagnostic and treatment process performed by nurses in the ED under different waiting time conditions as opposed to doctor-provided care. If patients were willing to have such care provided, this might offer at least a partial solution to the ED waiting time issue in Hong Kong. Methods Study design The questionnaire study was carried out between 09:00 hour and 18:00 hour daily between 20 June and 27 June Following verbal consent, patients who had been triaged as semi-urgent (triage category 4) or non-urgent (triage category 5) conditions were asked to consider three different scenarios to ascertain their opinion on being seen and treated by senior nurses in the ED, taking into consideration the prevailing waiting time. The survey was conducted using an intervieweradministered structured questionnaire (Figure 1).
3 12 Hong Kong j. emerg. med. Vol. 14(1) Jan 2007 Figure 1. English and Chinese versions of the questionnaire. A brief introduction as outlined in the questionnaire form was given to the respondents. Interviewers were available to answer any queries from the patients. The questionnaire form and interview format were piloted prior to the start of the study and data collection. Inclusion and exclusion criteria Consecutive patients designated as semi-urgent (triage category 4) or non-urgent (triage category 5) at the triage station between the hours stated previously, whether ambulatory or non-ambulatory, were identified and approached. Patients aged below 15 years and patients with abnormal mentation were excluded. Data collection Three scenarios were posed and patients were asked questions by the interviewers about their preference for being assessed and treated by either a doctor or trained senior nurse, with the waiting time taken into account. The patient's age, sex and triage category were recorded on the questionnaire (Figure 1). Details of the three scenarios are given as in Figure 1. The patients were classified by sex and into three age groups (age 15 to 30 years; age 31 to 64 years; age 65 years or above) for analysis. Data was entered on to an Excel (Microsoft Corporation) worksheet and analysed using SPSS v13.0 (SPSS Inc; Chicago, Ill, USA). Categorical data were presented. Statistical analysis to compare the three age groups was performed by means of the chi square test. Results Overall, 253 patients were approached during the study period and invited to participate, and 249 verbally agreed to be interviewed (98.4%).
4 Ong et al./nurses treating patients? 13 There were 119 (47.8%) male and 130 (52.2%) female respondents. The respondents' age ranged from 15 years to 90 years, with a mean of 48 years (standard deviation 19.4 years). The patients were classified into three age groups: 55 (22.1%) patients were aged 15 to 30 years, 132 (53.0%) were between 31 and 64 years and 62 (24.9%) patients were aged 65 years. For Question 1, 249 valid responses were recorded as shown in Table 1. Patients aged 65 or above were more likely to prefer a doctor to a nurse, despite long waiting time. Younger patients (age 15-64) were more inclined to choose a senior nurse to manage their illness. Overall, there were significant differences between the age groups as to their choice of health care provider (p=0.013, chi square test). More men were willing to have treatment from a nurse (84/119, 70.6%) whereas most women preferred to wait for a doctor (77/130, 59.2%), p<0.001 by chi square test. For Question 2, 245 valid responses were recorded as shown in Table 2. Almost all respondents chose the doctor. There was no difference between the age groups (p=0.6, chi square test). There was also no difference between men and women (p=0.2, chi square test). For Question 3, 246 valid responses were recorded as shown in Table 3. Again most respondents chose the Table 1. Question 1 by age group: "If your illness/injury is semi-urgent or non-urgent, would you prefer to wait up to 6 hours to see a doctor for assessment and treatment or to wait 1-2 hours to see a nurse for assessment and treatment?" Count (% within age group) Total Doctor Nurse Age group (years) (30.9%) 38 (69.1%) 55 (100%) (44.7%) 73 (55.3%) 132 (100%) (58.1%) 26 (41.9%) 62 (100%) Total 112 (45.0%) 137 (55.0%) 249 (100%) Table 2. Question 2 by age group: "If your illness/injury is semi-urgent or non-urgent, would you prefer to wait up to 6 hours to see a nurse for assessment and treatment or to wait 1-2 hours to see a doctor for assessment and treatment?" Count (% within age group) Total Doctor Nurse Age group (years) (100%) 0 (0%) 55 (100%) (99.2%) 1 (0.8%) 129 (100%) (98.4%) 1 (1.6%) 61 (100%) Total 243 (99.2%) 2 (0.8%) 245 (100%) Table 3. Question 3 by age group: "If the waiting time to see a doctor or a nurse is the same, whom would you prefer?" Count (% within age group) Total Doctor Nurse Age group (years) (94.5%) 3 (5.5%) 55 (100%) (95.4%) 6 (4.6%) 130 (100%) (96.7%) 2 (3.3%) 61 (100%) Total 235 (95.5%) 11 (4.5%) 246 (100%)
5 14 Hong Kong j. emerg. med. Vol. 14(1) Jan 2007 doctor. There was no difference between the age groups (p=0.8, chi square test). Again, there was no difference between men and women (p=0.3, chi square test). Discussion In this questionnaire survey, 55% of the respondents preferred to be assessed and treated by a senior nurse rather than a doctor in face of a long waiting time. Men were more willing to have the opinion of a nurse compared to women. This might reflect the perceptions of the respondents who were triaged semi-urgent or non-urgent that their illness was not as serious as to warrant a doctor's attention and therefore they were happy to accept health care treatment from a senior ED nurse. This did not apply to the patients aged 65 years or above, as 58% within this age group chose the doctor despite up to a 6-hour waiting time. This may be explained by the fact that many of them are already retired and they do not mind spending many hours waiting to see a doctor in the ED. However, it may also reflect deeply held cultural beliefs that a doctor provides a higher standard of care compared to a nurse. Older people may also feel more 'entitled' to see a doctor by account of their seniority in society, and are unwilling to compromise on that. It remains unclear as to why men are more willing to have nursing assessment and treatment compared to women. On the other hand, if the time factor is taken out, almost all patients prefer a doctor to a senior nurse. This suggests that patients still have more faith and confidence in doctors' assessments and treatments, which is not surprising. However, reality is such that a long waiting time is a fact of life in many of Hong Kong's EDs, and the current system of offering every patient the chance to see a doctor may not be sustainable in the future. The high response rate may be attributable to the simplicity of the questionnaire. Minor injuries make up a sizeable proportion of the ED patient population. Aside from those who present to the ED independently, patients who have sustained minor cuts or small wounds are often referred to local EDs by general practitioners or government-run general outpatient clinics. They will have their wounds briefly assessed by a triage nurse, and usually be assigned to triage category 4, with a bandage applied if the wound is bleeding. They will then spend possibly some hours waiting before seeing a doctor. After the doctor's assessment, it would again be some time before their wounds get sutured (usually by a nurse in Hong Kong) or other definitive treatments completed. The management of patients with minor injuries (especially wounds and minor musculoskeletal injuries) is a promising area for extended nursing care. If patients with minor injuries were managed by trained, senior nurses working independently, it would serve to cut down the waiting time of this large group of patients and this could be achieved without compromise on the quality of care. Indeed, the reduction in waiting time could lead to an improvement in perceived quality of care. In conclusion, the response rate in this small study was very high, and hence the results would appear reliable. Since the study was carried out during the daytime and in Prince of Wales Hospital exclusively, applying these results to the whole ED patient population in Hong Kong may not be appropriate. Nevertheless, this study provides initial insights into the attitudes of ED patients with minor illnesses and injuries with respect to possibly being treated by senior ED nurses. Acknowledgement We would like to express our thanks to the nursing staff of the Emergency Department, Prince of Wales Hospital, for their efforts in supporting this study. References 1. Choi YF, Wong TW, Lau CC. Triage rapid initial assessment by doctor (TRIAD) improves waiting time and processing time of the emergency department. Emerg Med J 2006;23(4):262-5.
6 Ong et al./nurses treating patients? Kennedy J, Rhodes K, Walls CA, Asplin BR. Access to emergency care: restricted by long waiting times and cost and coverage concerns. Ann Emerg Med 2004;43 (5): Munro J, Mason S, Nicholl J. Effectiveness of measures to reduce emergency department waiting times: a natural experiment. Emerg Med J 2006;23(1): Mohsin M, Young L, Ieraci S, Bauman AE. Factors associated with walkout of patients from New South Wales hospital emergency departments, Australia. Emerg Med Australas 2005;17(5-6): Tam AYB, Lau FL. A three-year review of complaints in emergency department. Hong Kong J Emerg Med 2000;7(1): Cheng B, Wong TW, Choy YH. The impact of charging of emergency department visits on the pattern of utilization. Third Asian Conference of Emergency Medicine; 2004 Oct 7-10; Hong Kong, China. 7. Jones S, Davies K. The extended role of the nurse: the United Kingdom perspective. Int J Nurs Pract 1999;5 (4): Dolan B, Dale J, Morley V. Nurse practitioners: the role in A&E and primary care. Nurs Stand 1997;11(17): Cooper MA, Lindsay GM, Kinn S, Swann IJ. Evaluating Emergency Nurse Practitioner services: a randomized controlled trial. J Adv Nurs 2002;40(6): Considine J, Martin R, Smit D, Jenkins J, Winter C. Defining the scope of practice of the emergency nurse practitioner role in a metropolitan emergency department. Int J Nurs Pract 2006;12(4):
Improving patient satisfaction by adding a physician in triage
ORIGINAL ARTICLE Improving patient satisfaction by adding a physician in triage Jason Imperato 1, Darren S. Morris 2, Leon D. Sanchez 2, Gary Setnik 1 1. Department of Emergency Medicine, Mount Auburn
More informationComparison of a clinical pharmacist managed anticoagulation service with routine medical care: impact on clinical outcomes and health care costs
HEALTH SERVICES RESEARCH FUND HEALTH CARE AND PROMOTION FUND Comparison of a clinical pharmacist managed anticoagulation service with routine medical care: impact on clinical outcomes and health care costs
More informationUtilisation patterns of primary health care services in Hong Kong: does having a family doctor make any difference?
STUDIES IN HEALTH SERVICES CLK Lam 林露娟 GM Leung 梁卓偉 SW Mercer DYT Fong 方以德 A Lee 李大拔 TP Lam 林大邦 YYC Lo 盧宛聰 Utilisation patterns of primary health care services in Hong Kong: does having a family doctor
More informationA retrospective study of patients discharged within 24 hours after emergency admission in a public general hospital
Hong Kong Journal of Emergency Medicine A retrospective study of patients discharged within 24 hours after emergency admission in a public general hospital SST Cheng and CH Chung Objectives: To identify
More informationCommunity nurse specialists and prevention of readmissions in older patients with chronic lung disease and cardiac failure
HEALTH SERVICES RESEARCH FUND HEALTH CARE AND PROMOTION FUND Key Messages 1. A post-discharge follow-up by community nurses significantly reduced length of stay in acute hospital and accident and emergency
More informationT he National Health Service (NHS) introduced the first
265 ORIGINAL ARTICLE The impact of co-located NHS walk-in centres on emergency departments Chris Salisbury, Sandra Hollinghurst, Alan Montgomery, Matthew Cooke, James Munro, Deborah Sharp, Melanie Chalder...
More informationResearch & Reviews: Journal of Nursing & Health Sciences
Research & Reviews: Journal of Nursing & Health Sciences Survey on Patient s Satisfaction on the Service Quality in an Emergency Department in Malaysia Harvinderjit Kaur Basauhra Singh*, Subramanian Pathmawathi,
More informationPrevalence of Stress and Coping Mechanism Among Staff Nurses of Intensive Care Unit in a Selected Hospital
International Journal of Neurosurgery 2018; 2(1): 8-12 http://www.sciencepublishinggroup.com/j/ijn doi: 10.11648/j.ijn.20180201.12 Prevalence of Stress and Coping Mechanism Among Staff Nurses of Intensive
More informationTelephone consultations to manage requests for same-day appointments: a randomised controlled trial in two practices
Telephone consultations to manage requests for same-day appointments: a randomised controlled trial in two practices Brian McKinstry, Jeremy Walker, Clare Campbell, David Heaney and Sally Wyke SUMMARY
More informationCHAPTER 5 AN ANALYSIS OF SERVICE QUALITY IN HOSPITALS
CHAPTER 5 AN ANALYSIS OF SERVICE QUALITY IN HOSPITALS Fifth chapter forms the crux of the study. It presents analysis of data and findings by using SERVQUAL scale, statistical tests and graphs, for the
More informationUse of Hospital Appointment Registration Systems in China: A Survey Study
Global Journal of Health Science; Vol. 5, No. 5; 2013 ISSN 1916-9736 E-ISSN 1916-9744 Published by Canadian Center of Science and Education Use of Hospital Appointment Registration Systems in China: A
More informationKnowledge about anesthesia and the role of anesthesiologists among Jeddah citizens
International Journal of Research in Medical Sciences Bagabas AM et al. Int J Res Med Sci. 2017 Jun;5(6):2779-2783 www.msjonline.org pissn 2320-6071 eissn 2320-6012 Original Research Article DOI: http://dx.doi.org/10.18203/2320-6012.ijrms20172486
More informationThe costs and benefits of managing some low-priority 999 ambulance calls by NHS Direct nurse advisers
The costs and benefits of managing some low-priority 999 ambulance calls by NHS Direct nurse advisers Report for the National Co-ordinating Centre for NHS Service Delivery and Organisation R & D (NCCSDO)
More informationTelephone triage systems in UK general practice:
Research Tim A Holt, Emily Fletcher, Fiona Warren, Suzanne Richards, Chris Salisbury, Raff Calitri, Colin Green, Rod Taylor, David A Richards, Anna Varley and John Campbell Telephone triage systems in
More informationPrevalence of workplace violence against nurses in Hong Kong
Title Prevalence of workplace violence against nurses in Hong Kong Author(s) Kwok, RPW; Law, YK; Li, KE; Ng, YC; Cheung, MH; Fung, VKP; Kwok, KTT; Tong, JMK; Yen, PF; Leung, WC Citation Hong Kong Medical
More informationMeasuring self-efficacy for caregiving of caregivers of patients with palliative care need: Validation of the Caregiver Inventory
Measuring self-efficacy for caregiving of caregivers of patients with palliative care need: Validation of the Caregiver Inventory Doris YP LEUNG, PhD, Assistant Professor, The Nethersole School of Nursing,
More informationDo patients use minor injury units appropriately?
Journal of Public Health Medicine Vol. 18, No. 2, pp. 152-156 Printed in Great Britain Do patients use minor injury units appropriately? Jeremy Dale and Brian Dolan Abstract Background This study aimed
More informationRESEARCH METHODOLOGY
Research Methodology 86 RESEARCH METHODOLOGY This chapter contains the detail of methodology selected by the researcher in order to assess the impact of health care provider participation in management
More informationTabletop Exercise on Mass Casualty Incident Triage, Does it Work?
Research Article imedpub Journals www.imedpub.com Health Science Journal DOI: 10.21767/1791-809X.1000566 Tabletop Exercise on Mass Casualty Incident Triage, Does it Work? Keebat Khan * Hamad General Hospital
More informationInspecting Informing Improving. Patient survey report ambulance services
Inspecting Informing Improving Patient survey report 2004 - ambulance services The survey of ambulance service users was designed, developed and coordinated by the NHS survey advice centre at Picker Institute
More informationImogene King s Interacting Systems Theory: Application in Emergency and Rural Nursing. Leigh Ann Williams 1. Abstract
Imogene King s Interacting Systems Theory: Application in Emergency and Rural Nursing Leigh Ann Williams 1 1 Graduate Student, Capstone College of Nursing, University of Alabama, sugarbaker22@hotmail.com
More informationAssess, Treat and Refer Initiatives and Trends in EMS: A Review of Literature.
Assess, Treat and Refer Initiatives and Trends in EMS: A Review of Literature. Nicola Lefevre, EMT. Background. Increasing public use of the EMS system for non-emergency calls which often result in transport
More informationPatient views of over 75 years health assessments in general practice
Patient views of over 75 years health assessments in general practice AUTHORS Margaret Spillman B.Sc. (Hons) Geography Research worker, School of Medicine & Dentistry, James Cook University, Rural Health
More informationRequired Competencies for Nurse Managers in Geriatric Care: The Viewpoint of Staff Nurses
International Journal of Caring Sciences September December 2016 Volume 9 Issue 3 Page 985 Original Article Required Competencies for Nurse Managers in Geriatric Care: The Viewpoint of Staff Nurses Ben
More informationExamination of Professional Commitment and Stress Management among Nurses from Different Generations
International Journal of Caring Sciences January April 2017 Volume 10 Issue 1 Page 456 Original Article Examination of Professional Commitment and Stress Management among Nurses from Different Generations
More informationQueensland public sector nurse executives: job satisfaction and career opportunities
Queensland public sector nurse executives: job satisfaction and career opportunities Queensland public sector nurse executives: job satisfaction and career opportunities MARY COURTNEY, JANE YACOPETTI,
More informationRacial disparities in ED triage assessments and wait times
Racial disparities in ED triage assessments and wait times Jordan Bleth, James Beal PhD, Abe Sahmoun PhD June 2, 2017 Outline Background Purpose Methods Results Discussion Limitations Future areas of study
More informationDr. Leung Ho Yin Associate Consultant Community Outreach Services Team, NTEC
Dr. Leung Ho Yin Associate Consultant Community Outreach Services Team, NTEC Background Full implementation in NTEC since 1/2012 Discharge planning and post discharge support services for high risk patients
More informationKNOWLEDGE, ATTITUDE AND PRACTICE OF PSYCHOLOGICAL FIRST AID AMONG HEALTH PROFESSIONALS WORKING IN ACCIDENT & EMERGENCY DEPARTMENT IN BRUNEI DARUSSALAM
Original Research Article S99 KNOWLEDGE, ATTITUDE AND PRACTICE OF PSYCHOLOGICAL FIRST AID AMONG HEALTH PROFESSIONALS WORKING IN ACCIDENT & EMERGENCY DEPARTMENT IN BRUNEI DARUSSALAM Khairunnisa Zakaria,
More informationApproximately 180,000 patients die annually in the
PRACTICE IMPROVEMENT SITUATION, BACKGROUND, ASSESSMENT, AND RECOMMENDATION GUIDED HUDDLES IMPROVE COMMUNICATION AND TEAMWORK IN THE EMERGENCY DEPARTMENT Authors: Heather A. Martin, DNP, RN, PNP-BC, and
More informationCommunication in Healthcare: For Better Healing. Dr. Alexander Thomas President Consortium of Accredited Healthcare Organisations (CAHO)
1 Communication in Healthcare: For Better Healing Dr. Alexander Thomas President Consortium of Accredited Healthcare Organisations (CAHO) Executive Director, Association of Healthcare Providers, India
More informationRapid assessment and treatment (RAT) of triage category 2 patients in the emergency department
Trauma and Emergency Care Research Article Rapid assessment and treatment (RAT) of triage category 2 patients in the emergency department S. Hassan Rahmatullah 1, Ranim A Chamseddin 1, Aya N Farfour 1,
More informationAkpabio, I. I., Ph.D. Uyanah, D. A., Ph.D. 1. INTRODUCTION
International Journal of Humanities Social Sciences and Education (IJHSSE) Volume 2, Issue, January 205, PP 264-27 ISSN 2349-0373 (Print) & ISSN 2349-038 (Online) www.arcjournals.org Examination of Driving
More informationAdvanced practice in emergency care: the paediatric flow nurse
Advanced practice in emergency care: the paediatric flow nurse Development and implementation of a new liaison role in paediatric services in Australia has improved services for children and young people
More informationResearch Design: Other Examples. Lynda Burton, ScD Johns Hopkins University
This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike License. Your use of this material constitutes acceptance of that license and the conditions of use of materials on this
More informationA Study on AQ (Adversity Quotient), Job Satisfaction and Turnover Intention According to Work Units of Clinical Nursing Staffs in Korea
Indian Journal of Science and Technology, Vol 8(S8), 74-78, April 2015 ISSN (Print) : 0974-6846 ISSN (Online) : 0974-5645 DOI: 10.17485/ijst/2015/v8iS8/71503 A Study on AQ (Adversity Quotient), Job Satisfaction
More informationNUTRITION SCREENING SURVEYS IN HOSPITALS IN NORTHERN IRELAND,
NUTRITION SCREENING SURVEYS IN HOSPITALS IN NORTHERN IRELAND, 2007-2011 A report based on the amalgamated data from the four Nutrition Screening Week surveys undertaken by BAPEN in 2007, 2008, 2010 and
More informationUndiagnosed Hypertension in the ED Setting An Unrecognized Opportunity by Emergency Nurses
RESEARCH Undiagnosed Hypertension in the ED Setting An Unrecognized Opportunity by Emergency Nurses Authors: Paula Tanabe, RN, PhD, Rebecca Steinmann, RN, MS, Matt Kippenhan, MD, Christine Stehman, and
More informationA pre- experimental study on the effect of Assertiveness training program among nursing students of a selected college of Nursing, Ajitgarh,
2017; 3(5): 533-538 ISSN Print: 2394-7500 ISSN Online: 2394-5869 Impact Factor: 5.2 IJAR 2017; 3(5): 533-538 www.allresearchjournal.com Received: 25-03-2017 Accepted: 26-04-2017 Ritika Soni Rattan Group
More informationOccupational Therapy Pressure Sore Prevention Working Group CGAT NTEC Hospital Authority 2010
Prospective Case Cohort Study on the provision of alternating pressure air-filled mattress in relation to sore development in bed chair ridden private old aged home residents in TEAM Occupational Therapy
More informationManjula R., Anjani Kumar Srivastava*, Ashok S. Dorle. Department of Community Medicine, S. Nijalingappa Medical College, Bagalkot, Karnataka, India
International Journal of Community Medicine and Public Health Manjula R et al. Int J Community Med Public Health. 2018 Jun;5(6):2411-2415 http://www.ijcmph.com pissn 2394-6032 eissn 2394-6040 Original
More informationPerformance Measurement of a Pharmacist-Directed Anticoagulation Management Service
Hospital Pharmacy Volume 36, Number 11, pp 1164 1169 2001 Facts and Comparisons PEER-REVIEWED ARTICLE Performance Measurement of a Pharmacist-Directed Anticoagulation Management Service Jon C. Schommer,
More informationNursing Students Knowledge on Sports Brain Injury Prevention
Cloud Publications International Journal of Advanced Nursing Science and Practice 2015, Volume 2, Issue 1, pp. 36-40 Med-208 ISSN: 2320 0278 Case Study Open Access Nursing Students Knowledge on Sports
More informationThe effect of skill-mix on clinical decision-making in NHS Direct
The effect of skill-mix on clinical decision-making in NHS Direct A report for West Midlands NHS Executive June 2001 Alicia O Cathain Fiona Sampson Jon Nicholl James Munro Medical Care Research Unit, School
More informationOklahoma Health Care Authority. ECHO Adult Behavioral Health Survey For SoonerCare Choice
Oklahoma Health Care Authority ECHO Adult Behavioral Health Survey For SoonerCare Choice Executive Summary and Technical Specifications Report for Report Submitted June 2009 Submitted by: APS Healthcare
More informationA simple method for introducing care planning into specialist diabetes clinics. The WICKED project
A simple method for introducing care planning into specialist diabetes clinics. The WICKED project SMR Gillani 1 MRCP, MRCGP BM Singh 1 FRCP, MD 1 Wolverhampton Diabetes Centre, New Cross Hospital, Wolverhampton,
More informationOmobolanle Elizabeth Adekanye, RN 1 and Titilayo Dorothy Odetola, RN, BNSc, MSc 2
IOSR Journal of Nursing and Health Science (IOSR-JNHS) e-issn: 232 1959.p- ISSN: 232 194 Volume 3, Issue 5 Ver. III (Sep.-Oct. 214), PP 29-34 Awareness and Implementation of Integrated Management of Childhood
More informationGeneral Practice Extended Access: March 2018
General Practice Extended Access: March 2018 General Practice Extended Access March 2018 Version number: 1.0 First published: 3 May 2017 Prepared by: Hassan Ismail, Data Analysis and Insight Group, NHS
More informationExpanded Methodology for the 2001 Census of Publicly Funded Family Planning Clinics
Expanded Methodology for the 2001 Census of Publicly Funded Family Planning Clinics By Jennifer J. Frost, Lori Frohwirth and Alison Purcell Service data were collected for 2001 for all agencies and clinics
More informationIndividuals with mental illness are at
Assessing and managing wounds in mental health settings KEY WORDS Content analysis Mental health nursing Tissue viability workshops Wound care Recently, there has been increasing emphasis on improving
More informationPatient Satisfaction with Medical Student Participation in the Private OB/Gyn Ambulatory Setting
Patient Satisfaction with Medical Student Participation in the Private OB/Gyn Ambulatory Setting Katie G. Mellington, MD Faculty Mentor: Benjie B. Mills, MD Disclosure The authors have no meaningful conflicts
More informationNursing Students Information Literacy Skills Prior to and After Information Literacy Instruction
Nursing Students Information Literacy Skills Prior to and After Information Literacy Instruction Dr. Cheryl Perrin University of Southern Queensland Toowoomba, AUSTRALIA 4350 E-mail: perrin@usq.edu.au
More informationHealthcare Conflicts: Resolution Mode Choices of Doctors & Nurses in a Tertiary Care Teaching Institute
International Journal of scientific research and management (IJSRM) Volume Issue Pages 3-1 Website: www.ijsrm.in ISSN (e): 31-31 Healthcare Conflicts: Resolution Mode Choices of Doctors & Nurses in a Tertiary
More informationADDENDUM #1 STATE OF LOUISIANA DIVISION OF ADMINISTRATION OFFICE OF GROUP BENEFITS (OGB)
ADDENDUM #1 STATE OF LOUISIANA DIVISION OF ADMINISTRATION OFFICE OF GROUP BENEFITS (OGB) NOTICE OF INTENT TO CONTRACT (NIC) FOR ADMINISTRATIVE SERVICES ONLY (ASO) FOR HEALTH MAINTENANCE ORGANIZATION PLAN
More informationThe new chronic psychiatric population
Brit. J. prev. soc. Med. (1974), 28, 180.186 The new chronic psychiatric population ANTHEA M. HAILEY MRC Social Psychiatry Unit, Institute of Psychiatry, De Crespigny Park, London SE5 SUMMARY Data from
More informationGeneral practitioner workload with 2,000
The Ulster Medical Journal, Volume 55, No. 1, pp. 33-40, April 1986. General practitioner workload with 2,000 patients K A Mills, P M Reilly Accepted 11 February 1986. SUMMARY This study was designed to
More informationImpact of 4+1 Block Scheduling on Patient Care Continuity in Resident Clinic
INNOVATION AND IMPROVEMENT Impact of 4+1 Block Scheduling on Patient Care Continuity in Resident Clinic Kathleen Heist, MD 1, Mary Guese, MD 2, Michelle Nikels, MD 1, Rachel Swigris, DO 1, and Karen Chacko,
More informationÓ Journal of Krishna Institute of Medical Sciences University 74
ISSN 2231-4261 ORIGINAL ARTICLE Effects of Situation, Background, Assessment, and Recommendation (SBAR) Usage on Communication Skills among Nurses in a Private Hospital in Kuala Lumpur 1* 1 1 Ho Siew Eng,
More informationTechnology Overview. Issue 13 August A Clinical and Economic Review of Telephone Triage Services and Survey of Canadian Call Centre Programs
Technology Overview Issue 13 August 2004 A Clinical and Economic Review of Telephone Triage Services and Survey of Canadian Call Centre Programs Publications can be requested from: CCOHTA 600-865 Carling
More informationImproving Outcomes on End Stage Heart Failure Patients by Palliative Nurse Follow-up
Improving Outcomes on End Stage Heart Failure Patients by Palliative Nurse Follow-up Presenter : Ng Yee Man Alina The Hong Kong Polytechnic University 18 MAY 2015 Collaborators United Christian Hospital
More informationWhat do we know about why EUC demand has increased?
ScHARR, University of Sheffield What do we know about why EUC demand has increased? Colin O Keeffe March 2014 Research investigating factors behind the growth in demand for EUC systems has focused on demand
More informationIssue Brief. Non-urgent Emergency Department Use in Shelby County, Tennessee, May August 2012
Issue Brief May 2011 Non-urgent Emergency Department Use in Shelby County, Tennessee, 2009 Cyril F. Chang, Ph.D. Professor of Economics and Director of Methodist Le Bonheur Center for Healthcare Economics
More informationBarriers to Participation in Continuing Nursing Educational Programs among Registered Nurses in Maharashtra
Barriers to Participation in Continuing Nursing Educational Programs among Registered Nurses in Maharashtra Mahadeo Shinde 1, Nutan Potdar 2, Sunil Kulkarni 3 1 Professor, Krishna Institute of Nursing
More informationIssue Brief. Findings from HSC INSURED AMERICANS DRIVE SURGE IN EMERGENCY DEPARTMENT VISITS. Trends in Emergency Department Use
Issue Brief Findings from HSC INSURED AMERICANS DRIVE SURGE IN EMERGENCY DEPARTMENT VISITS by Peter Cunningham and Jessica May Visits to hospital emergency departments (EDs) have increased greatly in recent
More informationAn investigation into care of people detained under Section 136 of the Mental Health Act who are brought to Emergency Departments in England and
An investigation into care of people detained under Section 136 of the Mental Health Act who are brought to Emergency Departments in England and Wales. October 2014 1 Executive Summary The care of people
More informationNursing is a Team Sport
Nursing is a Team Sport Sideline Coaching to Achieve NCLEX-RN Success Tricia O Hara, PhD, RN Associate Professor Gwynedd Mercy University Gwynedd Valley, Pa, USA Purpose of the Study The primary purpose
More informationGEM UK: Northern Ireland Report 2011
GEM UK: Northern Ireland Report 2011 Mark Hart and Jonathan Levie The Global Entrepreneurship Monitor (GEM) is an international project involving 54 countries in 2011 which seeks to provide information
More informationRunning head: PICO 1. PICO Question: In regards to nurses working in acute care hospitals, how does working
Running head: PICO 1 PICO Question: In regards to nurses working in acute care hospitals, how does working twelve-hour shifts versus eight-hour shifts contribute to nurse fatigue? Katherine Ouellette University
More informationAmbulatory Emergency Care A Flexible Approach to Ambulatory Care at Pennine Acute Hospitals. The Pennine Acute Hospitals NHS Trust
Ambulatory Emergency Care A Flexible Approach to Ambulatory Care at Pennine Acute Hospitals The Pennine Acute Hospitals NHS Trust A Flexible Approach to Ambulatory Care at Pennine Acute Hospitals The Pennine
More informationRelationship between Organizational Climate and Nurses Job Satisfaction in Bangladesh
Relationship between Organizational Climate and Nurses Job Satisfaction in Bangladesh Abdul Latif 1, Pratyanan Thiangchanya 2, Tasanee Nasae 3 1. Master in Nursing Administration Program, Faculty of Nursing,
More informationWho calls 999 and why? A survey of the emergency workload of the London Ambulance
174 Department of Public Health Sciences, St George's Hospital Medical School C R Victor J L Peacock C Chazot London Ambulance Service S Walsh D Holmes Correspondence to: Dr Christina R Victor, Reader
More informationAssess the Knowledge and Practice On Road Safety Regulations among Primary School Children in Rural Community
Assess the Knowledge and Practice On Road Safety Regulations among Primary School Children in Rural Community Ms.Indhumathy, P.B.B.Sc(N) II Year 1 Mrs.Thenmozhi.P, M.Sc(N), RN.RM, Assistant Professor 2
More informationDevelopment of Emergency Medicine in the Far East. Prof V. Anantharaman Department of Emergency Medicine Singapore General Hospital
Development of Emergency Medicine in the Far East Prof V. Anantharaman Department of Emergency Medicine Singapore General Hospital Prof V. Anantharaman MBBS (S pore), FRCP (Edin), FRCS Ed (A&E), FAMS,
More informationCost-effectiveness of Dermabond versus sutures for lacerated wound closure: a randomised controlled trial
HEALTH AND HEALTH SERVICES RESEARCH FUND EML Wong 黃美玲 TH Rainer 譚偉恩 YC Ng 伍凝珠 MS Chan 陳民秀 V Lopez 羅考思 Key Messages 1. For management of simple lacerated wounds, tissue adhesive (Dermabond) achieved more
More informationEvaluation of the effect of nurse education on patient reported foot checks and foot care behaviour of people with diabetes receiving haemodialysis
Evaluation of the effect of nurse education on patient reported foot checks and foot care behaviour of people with diabetes receiving haemodialysis Evaluation of foot care education for haemodialysis nurses
More informationNurse practitioners in the accident and emergency department
Archives of Emergency Medicine, 1989, 6, 241-246 Nurse practitioners in the accident and emergency department M. R. JAMES & N. PYRGOS Department of Accident and Emergency Medicine, Lincoln County Hospital,
More informationINTERNATIONAL JOURNAL OF BUSINESS, MANAGEMENT AND ALLIED SCIENCES (IJBMAS) A Peer Reviewed International Research Journal
RESEARCH ARTICLE Vol.4.Issue.4.2017 Oct-Dec INTERNATIONAL JOURNAL OF BUSINESS, MANAGEMENT AND ALLIED SCIENCES (IJBMAS) A Peer Reviewed International Research Journal THE IMPACT OF HOSPITAL ACCREDITATION
More informationEmergency department visit volume variability
Clin Exp Emerg Med 215;2(3):15-154 http://dx.doi.org/1.15441/ceem.14.44 Emergency department visit volume variability Seung Woo Kang, Hyun Soo Park eissn: 2383-4625 Original Article Department of Emergency
More informationThe Patient-Physician Relationship, Primary Care Attributes, and Preventive Services
22 January 2004 Family Medicine The Patient-Physician Relationship, Primary Care Attributes, and Preventive Services Michael L. Parchman, MD, MPH; Sandra K. Burge, PhD Background: The importance of a sustained
More informationA Study on the Satisfaction of Residents in Wuhan with Community Health Service and Its Influence Factors Xiaosheng Lei
4th International Education, Economics, Social Science, Arts, Sports and Management Engineering Conference (IEESASM 2016) A Study on the Satisfaction of Residents in Wuhan with Community Health Service
More informationEdin), FRCP(Glasg), HA Convention, Hong Kong Convention and Exhibition Centre, June 7, 2011
Implementation of Managing Inter-departmental Consultation Requests by Clinical Inbox in a Medical Department Chan NY(1), Lo A(2), Leung SH(2), Lau A(3), Chan F(3), Wong S(3), Fung HO(3), Tong KL(1), Law
More informationIJPHCS Open Access: e-journal
NURSES PERCEIVED FAMILIARITY WITH DISASTER PREPAREDNESS Ng X.J. 1,2, Lim B.C. 3, Azlina Y. 1, & Soon L.K. 1* 1 School of Health Sciences, Universiti Sains Malaysia, Health Campus, 16150, Kubang Kerian,
More informationUptake of Medicare chronic disease items in Australia by general practice nurses and Aboriginal health workers
University of Wollongong Research Online Faculty of Science, Medicine and Health - Papers Faculty of Science, Medicine and Health 2010 Uptake of Medicare chronic disease items in Australia by general practice
More informationWill alternative immediate care services reduce demands for non-urgent treatment at accident and emergency?
482 Medical Care Research Unit, School of Health and Related Research, University of SheYeld, Regent Court, 30 Regent Street, SheYeld S1 4DA, UK Correspondence to: Ms Coleman (P.Coleman@SheYeld.ac.uk)
More informationA Study on Out Patient Satisfaction at a Super Specialty Hospital in India
A Study on Out Patient Satisfaction at a Super Specialty Hospital in India Dr. S. K. Jawahar MHA (AIIMS), DNB (Health Administration) Administrative Medical Officer, Sree Chitra Tirunal Institute for Medical
More informationA COMPREHENSIVE TRAINING PROGRAM FOR NURSE ENDOSCOPIST ON PERFORMING FLEXIBLE SIGMOIDOSCOPY IN HONG KONG
A COMPREHENSIVE TRAINING PROGRAM FOR NURSE ENDOSCOPIST ON PERFORMING FLEXIBLE SIGMOIDOSCOPY IN HONG KONG SHUM NGA FAN A.P.N. DEPARTMENT OF SUGERY QUEEN MARY HOSPITAL Introduction Hong Kong Cancer Registry
More informationFacing the Future: Standards for Paediatric Services. April 2011
Facing the Future: Standards for Paediatric Services April 2011 Facing the Future: Standards for Paediatric Services April 2011 (First Published December 2010 and amended by RCPCH Council March 2011) 2011
More informationSHORT FORM PATIENT EXPERIENCE SURVEY RESEARCH FINDINGS
SHORT FORM PATIENT EXPERIENCE SURVEY RESEARCH FINDINGS OCTOBER 2015 Final findings report covering the bicoastal short form patient experience survey pilot conducted jointly by Massachusetts Health Quality
More informationMeasured Implementation of an Accelerated Chest Pain Diagnostic Pathway in Rural Practice. Proof of concept
Measured Implementation of an Accelerated Chest Pain Diagnostic Pathway in Rural Practice Proof of concept Authors Tim Norman Pinnacle Midlands Health Network Dr Jo Scott Jones - Pinnacle Midlands Health
More informationDelayed discharges and unplanned admissions from the Day Care Unit at Mater Dei Hospital, Malta
Delayed discharges and unplanned admissions from the Day Care Unit at Mater Dei Hospital, Malta Abstract Introduction: Day care units are playing an increasingly important role in healthcare provision,
More informationA Delphi study to determine nursing research priorities in. the North Glasgow University Hospitals NHS Trust and the corresponding evidence base
A Delphi study to determine nursing research priorities in Blackwell Publishing Ltd. the North Glasgow University Hospitals NHS Trust and the corresponding evidence base Michelle Kirkwood*, Ann Wales and
More informationBMC Family Practice. Open Access. Abstract. BioMed Central
BMC Family Practice BioMed Central Research article Follow-up care by patient's own general practitioner after contact with out-of-hours care. A descriptive study Caro JT van Uden* 1,2, Paul J Zwietering
More informationavailable at journal homepage:
Australasian Emergency Nursing Journal (2009) 12, 16 20 available at www.sciencedirect.com journal homepage: www.elsevier.com/locate/aenj RESEARCH PAPER The SAPhTE Study: The comparison of the SAPhTE (Safe-T)
More informationPreventing In-Facility Falls
Preventing In-Facility Falls Presented by Paul Shekelle, M.D., Ph.D. RAND Corporation Evidence-based Practice Center Introduction: Making Health Care Safer II: An Updated Critical Analysis of the Evidence
More informationDrs Whittle, Scott, Bevz & Fairhead. Health & Social Care Act 2008
Drs Whittle, Scott, Bevz & Fairhead Cleveleys Group Practice Health & Social Care Act 2008 Version 1 - August 2013 Version 2 - December 2015 Date of Next Review: December 2016 Service Provider Details
More informationNurse Led Follow Up: Is It The Best Way Forward for Post- Operative Endometriosis Patients?
Research Article Nurse Led Follow Up: Is It The Best Way Forward for Post- Operative Endometriosis Patients? R Mallick *, Z Magama, C Neophytou, R Oliver, F Odejinmi Barts Health NHS Trust, Whipps Cross
More informationInterpretation and Translation Services Policy
Interpretation and Translation Services Policy This is a new procedural document. Did you print this document yourself? The Trust discourages the retention of hard copies of policies and can only guarantee
More informationRecently, the socio-economic development, from an industrial perspective
Original Article Factors Associated with Job Stress among Ambulance Nurses in Bangkok, Thailand. Jutamanee Sakkomonsri, RN 1 ;Plernpit Suwan-Ampai, PhD 2 ; Orawan Kaewboonchoo, PhD 2 Jutamanee Sakkomonsri,
More informationProfile of Registered Social Workers in Wales. A report from the Care Council for Wales Register of Social Care Workers June
Profile of Registered Social Workers in Wales A report from the Care Council for Wales Register of Social Care Workers June 2013 www.ccwales.org.uk Profile of Registered Social Workers in Wales Care Council
More informationGUIDANCE ON SUPPORTING INFORMATION FOR REVALIDATION FOR SURGERY
ON SUPPORTING INFORMATION FOR REVALIDATION FOR SURGERY Based on the Academy of Medical Royal Colleges and Faculties Core Guidance for all doctors GENERAL INTRODUCTION JUNE 2012 The purpose of revalidation
More information