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[After Ut√łya...Swedish disaster planning needs to be improve].

https://arctichealth.org/en/permalink/ahliterature121389
Source
Lakartidningen. 2012 Jul 18-Aug 8;109(29-31):1339
Publication Type
Article
Author
Louis Riddez
Per Ortenwall
Author Affiliation
Gastrocentrum kirurgi, Karolinska universitetssjukhuset, Solna. louis.riddez@karolinska.se
Source
Lakartidningen. 2012 Jul 18-Aug 8;109(29-31):1339
Language
Swedish
Publication Type
Article
Keywords
Bombs
Centralized Hospital Services - organization & administration - standards
Disaster Planning - organization & administration - standards
Disasters
Firearms
Humans
Norway
Sweden
Terrorism
Triage - organization & administration - standards
PubMed ID
22913113 View in PubMed
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An experience with an online learning environment to support a change in practice in an emergency department.

https://arctichealth.org/en/permalink/ahliterature177618
Source
Comput Inform Nurs. 2004 Mar-Apr;22(2):107-10
Publication Type
Article
Author
Janet Curran-Smith
Shauna Best
Author Affiliation
IWK Health Centre, Halifax, Nova Scotia, Canada. janet.curransmith@iwk.nshealth.ca
Source
Comput Inform Nurs. 2004 Mar-Apr;22(2):107-10
Language
English
Publication Type
Article
Keywords
Computer-Assisted Instruction - methods - standards
Education, Nursing, Continuing - organization & administration
Emergency Nursing - education - organization & administration
Emergency Service, Hospital - organization & administration
Humans
Internet - organization & administration
Nova Scotia
Nurse's Role
Nursing Assessment - organization & administration
Nursing Education Research
Online Systems - organization & administration
Organizational Culture
Organizational Innovation
Practice Guidelines as Topic
Program Evaluation
Social Support
Triage - organization & administration
Abstract
Providing continuing education to support a change in practice for a busy Emergency Department poses a challenge. Factors such as shift work, high patient acuity, and unpredictable patient flow create barriers to traditional methods of delivery of a comprehensive educational experience. This article describes an experience with introducing a change in practice using an innovative Web-based delivery plan. Specific strategies were employed to address presentation of content, application of knowledge, establishment of a shared understanding, and enhancement of communication opportunities. The Web-based learning environment proved to be a successful means of providing nurses with a collaborative learning experience around a new practice issue. This experience also highlighted the need for a new skill set for learners and educators using online learning technologies.
PubMed ID
15520575 View in PubMed
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Application of Lean principles to improve early cardiac care in the emergency department.

https://arctichealth.org/en/permalink/ahliterature130918
Source
CJEM. 2011 Sep;13(5):325-32
Publication Type
Article
Date
Sep-2011
Author
Zoë Piggott
Erin Weldon
Trevor Strome
Alecs Chochinov
Author Affiliation
Royal College Emergency Medicine Residency Program, University of Manitoba, Winnipeg, MB, Canada. zoepiggott@gmail.com
Source
CJEM. 2011 Sep;13(5):325-32
Date
Sep-2011
Language
English
Publication Type
Article
Keywords
Acute Coronary Syndrome - diagnosis - therapy
Efficiency, Organizational - standards
Electrocardiography - statistics & numerical data
Emergency Service, Hospital - organization & administration
Health Services Research
Humans
Manitoba
Organizational Culture
Outcome and Process Assessment (Health Care) - organization & administration
Quality Improvement - organization & administration - standards
Triage - organization & administration
Abstract
To achieve our goal of excellent emergency cardiac care, our institution embarked on a Lean process improvement initiative. We sought to examine and quantify the outcome of this project on the care of suspected acute coronary syndrome (ACS) patients in our emergency department (ED).
Front-line ED staff participated in several rapid improvement events, using Lean principles and techniques such as waste elimination, supply chain streamlining, and standard work to increase the value of the early care provided to patients with suspected ACS. A chart review was also conducted. To evaluate our success, proportions of care milestones (first electrocardiogram [ECG], ECG interpretation, physician assessment, and acetylsalicylic acid [ASA] administration) meeting target times were chosen as outcome metrics in this before-and-after study.
The proportion of cases with 12-lead ECGs completed within 10 minutes of patient triage increased by 37.4% (p
PubMed ID
21955414 View in PubMed
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Applying the Lean principles of the Toyota Production System to reduce wait times in the emergency department.

https://arctichealth.org/en/permalink/ahliterature146037
Source
CJEM. 2010 Jan;12(1):50-7
Publication Type
Article
Date
Jan-2010
Author
David Ng
Gord Vail
Sophia Thomas
Nicki Schmidt
Author Affiliation
Emergency Department, Hôtel-Dieu Grace Hospital, Windsor, Ontario. dng@hdgh.org
Source
CJEM. 2010 Jan;12(1):50-7
Date
Jan-2010
Language
English
Publication Type
Article
Keywords
Efficiency, Organizational - standards
Emergency Service, Hospital - organization & administration
Humans
Length of Stay - statistics & numerical data
Ontario
Patient Admission - statistics & numerical data
Patient satisfaction
Process Assessment (Health Care)
Retrospective Studies
Time Factors
Triage - organization & administration
Waiting Lists
Abstract
In recognition of patient wait times, and deteriorating patient and staff satisfaction, we set out to improve these measures in our emergency department (ED) without adding any new funding or beds.
In 2005 all staff in the ED at Hôtel-Dieu Grace Hospital began a transformation, employing Toyota Lean manufacturing principles to improve ED wait times and quality of care. Lean techniques such as value-stream mapping, just-in-time delivery techniques, workplace organization, reduction of systemic wastes, use of the worker as the source of quality improvement and ongoing refinement of our process steps formed the basis of our project.
Our ED has achieved major improvements in departmental flow without adding any additional ED or inpatient beds. The mean registration to physician time has decreased from 111 minutes to 78 minutes. The number of patients who left without being seen has decreased from 7.1% to 4.3%. The length of stay (LOS) for discharged patients has decreased from a mean of 3.6 to 2.8 hours, with the largest decrease seen in our patients triaged at levels 4 or 5 using the Canadian Emergency Department Triage and Acuity Scale. We noted an improvement in ED patient satisfaction scores following the implementation of Lean principles.
Lean manufacturing principles can improve the flow of patients through the ED, resulting in greater patient satisfaction along with reduced time spent by the patient in the ED.
PubMed ID
20078919 View in PubMed
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The availability and use of out-of-hospital physiologic information to identify high-risk injured children in a multisite, population-based cohort.

https://arctichealth.org/en/permalink/ahliterature148721
Source
Prehosp Emerg Care. 2009 Oct-Dec;13(4):420-31
Publication Type
Article
Author
Craig D Newgard
Kyle Rudser
Dianne L Atkins
Robert Berg
Martin H Osmond
Eileen M Bulger
Daniel P Davis
Martin A Schreiber
Craig Warden
Thomas D Rea
Scott Emerson
Author Affiliation
Center for Policy and Research in Emergency Medicine, Department of Emergency Medicine, Oregon Health & Science University, Portland, Oregon 97239-3098, USA. newgardc@ohsu.edu
Source
Prehosp Emerg Care. 2009 Oct-Dec;13(4):420-31
Language
English
Publication Type
Article
Keywords
Adolescent
Canada
Child
Child, Preschool
Emergency medical services
Humans
Infant
Infant, Newborn
Prospective Studies
Risk assessment
Trauma Centers
Triage - organization & administration
United States
Wounds and Injuries - physiopathology
Abstract
The validity of using adult physiologic criteria to triage injured children in the out-of-hospital setting remains unproven. Among children meeting adult field physiologic criteria, we assessed the availability of physiologic information, the incidence of death or prolonged hospitalization, and whether age-specific criteria would improve the specificity of the physiologic triage step.
We analyzed a prospective, out-of-hospital cohort of injured children aged 29 breaths/min, Glasgow Coma Scale (GCS) score 2 days. The decision tree was derived and validated using binary recursive partitioning.
Nine hundred fifty-five children were included in the analysis, of whom 62 (6.5%) died and 117 (12.3%) were hospitalized > 2 days. Missing values were common, ranging from 6% (respiratory rate) to 53% (pulse oximetry), and were associated with younger age and high-risk outcome. The final decision rule included four variables (assisted ventilation, GCS score 96 mmHg), which demonstrated improved specificity (71.7% [95% confidence interval (CI) 66.7-76.6%]) at the expense of missing high-risk children (sensitivity 76.5% [95% CI 66.4-86.6%]).
The incidence of high-risk injured children meeting adult physiologic criteria is relatively low and the findings from this sample do not support using age-specific values to better identify such children. However, the amount and pattern of missing data may compromise the value and practical use of field physiologic information in pediatric triage.
Notes
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PubMed ID
19731152 View in PubMed
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Computer-supported telephone nurse triage: an evaluation of medical quality and costs.

https://arctichealth.org/en/permalink/ahliterature78506
Source
J Nurs Manag. 2007 Mar;15(2):180-7
Publication Type
Article
Date
Mar-2007
Author
Marklund B.
Ström M.
Månsson J.
Borgquist L.
Baigi A.
Fridlund B.
Author Affiliation
Research and Development Unit, Primary Health Care, Halland, Sweden. bertil.marklund@lthalland.se
Source
J Nurs Manag. 2007 Mar;15(2):180-7
Date
Mar-2007
Language
English
Publication Type
Article
Keywords
Adolescent
Adult
Aged
Cost Savings
Decision Support Techniques
Emergency Nursing - organization & administration
Female
Guideline Adherence
Hotlines - organization & administration
Humans
Male
Middle Aged
Models, Nursing
Nursing Assessment - organization & administration
Nursing Audit
Nursing Evaluation Research
Nursing Records
Practice Guidelines
Primary Health Care - organization & administration
Quality of Health Care - organization & administration
Referral and Consultation - organization & administration
Sweden
Triage - organization & administration
Abstract
AIM: To evaluate a telephone nurse triage model in terms of appropriateness of referrals to the appropriate level of care, patient's compliance with given advice and costs. BACKGROUND: A key concern in each telephonic consultation is to evaluate if appropriate. METHOD: An evaluative design in primary health care with consecutive patients (N = 362) calling telephone nurse triage between November 2002 and February 2003. RESULTS: The advice was considered adequate in 325 (97.6%) cases. The patients' compliance with self-care was 81.3%, to primary health care 91.1% and to Accident and Emergency department 100%. The nurses referred self-care cases (64.7%) and Accident and Emergency cases (29.6%) from a less adequate to an appropriate level of care. The cost saving per call leading to a recommendation of self-care was euro 70.3, to primary health care euro 24.3 and to Accident and Emergency department euro 22.2. CONCLUSIONS: The telephone nurse triage model showed adequate guidance for the patients concerning level of care and released resources for the benefit of both patients and the health care system.
PubMed ID
17352701 View in PubMed
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A concept for major incident triage: full-scaled simulation feasibility study.

https://arctichealth.org/en/permalink/ahliterature141615
Source
BMC Emerg Med. 2010;10:17
Publication Type
Article
Date
2010
Author
Marius Rehn
Jan E Andersen
Trond Vigerust
Andreas J Krüger
Hans M Lossius
Author Affiliation
Norwegian Air Ambulance Foundation, Drøbak, Norway. marius.rehn@snla.no
Source
BMC Emerg Med. 2010;10:17
Date
2010
Language
English
Publication Type
Article
Keywords
Accidents, Traffic
Cooperative Behavior
Emergency Medical Service Communication Systems - organization & administration
Emergency Medical Services - organization & administration
Feasibility Studies
Female
Humans
Male
Manikins
Mass Casualty Incidents
Norway
Patient Simulation
Professional Competence
Triage - organization & administration
Abstract
Efficient management of major incidents involves triage, treatment and transport. In the absence of a standardised interdisciplinary major incident management approach, the Norwegian Air Ambulance Foundation developed Interdisciplinary Emergency Service Cooperation Course (TAS). The TAS-program was established in 1998 and by 2009, approximately 15 500 emergency service professionals have participated in one of more than 500 no-cost courses. The TAS-triage concept is based on the established triage Sieve and Paediatric Triage Tape models but modified with slap-wrap reflective triage tags and paediatric triage stretchers. We evaluated the feasibility and accuracy of the TAS-triage concept in full-scale simulated major incidents.
The learners participated in two standardised bus crash simulations: without and with competence of TAS-triage and access to TAS-triage equipment. The instructors calculated triage accuracy and measured time consumption while the learners participated in a self-reported before-after study. Each question was scored on a 7-point Likert scale with points labelled "Did not work" (1) through "Worked excellent" (7).
Among the 93 (85%) participating emergency service professionals, 48% confirmed the existence of a major incident triage system in their service, whereas 27% had access to triage tags. The simulations without TAS-triage resulted in a mean over- and undertriage of 12%. When TAS-Triage was used, no mistriage was found. The average time from "scene secured to all patients triaged" was 22 minutes (range 15-32) without TAS-triage vs. 10 minutes (range 5-21) with TAS-triage. The participants replied to "How did interdisciplinary cooperation of triage work?" with mean 4,9 (95% CI 4,7-5,2) before the course vs. mean 5,8 (95% CI 5,6-6,0) after the course, p
Notes
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PubMed ID
20701802 View in PubMed
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The criteria nurses use in assessing acute trauma in military emergency care.

https://arctichealth.org/en/permalink/ahliterature162621
Source
Accid Emerg Nurs. 2007 Jul;15(3):148-56
Publication Type
Article
Date
Jul-2007
Author
Sten-Ove Andersson
Lars Owe Dahlgren
Lars Lundberg
Björn Sjöström
Author Affiliation
Swedish Armed Forces, Centre for Defence Medicine, Box 5155, S-426 05 V Frölunda, Göteborg, Sweden. sten-ove.andersson@mil.se
Source
Accid Emerg Nurs. 2007 Jul;15(3):148-56
Date
Jul-2007
Language
English
Publication Type
Article
Keywords
Acute Disease
Adult
Attitude of Health Personnel
Bosnia-Herzegovina
Emergencies - nursing
Emergency Nursing - organization & administration
Emergency Treatment - nursing
Female
Humans
Injury Severity Score
Male
Middle Aged
Military Nursing - organization & administration
Nurse's Role - psychology
Nursing Assessment - organization & administration
Nursing Methodology Research
Nursing Process
Nursing Staff, Hospital - organization & administration - psychology
Qualitative Research
Questionnaires
Sweden
Thinking
Triage - organization & administration
Wounds and Injuries - diagnosis - nursing
Abstract
Emergency medical care for seriously injured patients in war or warlike situations is highly important when it comes to soldiers' survival and morale. The Swedish Armed Forces sends nurses, who have limited experience of caring for injured personnel in the field, on a variety of international missions. The aim of this investigation was to identify the kind of criteria nurses rely on when assessing acute trauma and what factors are affecting the emergency care of injured soldiers. A phenomenographic research approach based on interviews was used. The database for the study consists of twelve nurses who served in Bosnia in 1994-1996. The criteria nurses rely on, when assessing acute trauma in emergency care, could be described in terms of domain-specific criteria such as a physiological, an anatomical, a causal and a holistic approach as well as contextual criteria such as being able to communicate, having a sense of belonging, the military environment, the conscript medical orderly and familiarity with health-caring activity. The present study shows that the specific contextual factors affecting emergency care in the field must also be practised before the nurse faces military emergency care situations. This calls for realistic exercises and training programs, where experience from civilian emergency care is interwoven with the knowledge specific to military medical care.
PubMed ID
17614287 View in PubMed
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[Disaster triage--needs for a Norwegian standard].

https://arctichealth.org/en/permalink/ahliterature139534
Source
Tidsskr Nor Laegeforen. 2010 Nov 4;130(21):2112-3
Publication Type
Article
Date
Nov-4-2010
Author
Marius Rehn
Hans Morten Lossius
Author Affiliation
Stiftelsen Norsk Luftambulanse, Postboks 94, 1441 Drøbak, Norway. marius.rehn@snla.no
Source
Tidsskr Nor Laegeforen. 2010 Nov 4;130(21):2112-3
Date
Nov-4-2010
Language
Norwegian
Publication Type
Article
Keywords
Disaster Planning - methods
Emergency Medical Services - organization & administration
Humans
Mass Casualty Incidents
Norway
Triage - organization & administration - standards
PubMed ID
21052110 View in PubMed
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Doing the drill. Hospital staffs get inventive during bioterror drills.

https://arctichealth.org/en/permalink/ahliterature185005
Source
Mod Healthc. 2003 May 19;33(20):22
Publication Type
Article
Date
May-19-2003

76 records – page 1 of 8.