scholarly journals P006: Patient passports in the emergency department: a scoping review

CJEM ◽  
2018 ◽  
Vol 20 (S1) ◽  
pp. S58-S59
Author(s):  
C. B. Bennett ◽  
J. Curran
Keyword(s):  
Emergency Department ◽  
Emergency Medicine ◽  
Health Care Providers ◽  
Scoping Review ◽  
Research Question ◽  
Reference List ◽  
Care Providers ◽  
Communication Tool ◽  
Inclusion Criteria ◽  
Emergency Department Setting

Introduction: Discharge communication in the emergency department occurs frequently and has been identified as an important, underestimated problem. Tools, such as patient or caregiver-held passports have been used in other departments to improve communication and facilitate provider and patient decision making. The objective of this review was to identify what modalities, methods and designs have been used and evaluated when implementing a communication tool or passport type document in the emergency department setting. Methods: This review was conducted following Joanna Briggs Institute methodology. Iterative steps included identifying the research question, identifying relevant studies, data extraction and synthesis. Keywords and indexed terms were used to search PubMed, Cinahl, Embase and Web of Science. The reference list of all identified reports and articles from that search were reviewed for additional studies and a hand search of the last 5 years of Annals of Emergency Medicine and the Canadian Journal of Emergency Medicine was completed. Inclusion criteria were set to select studies investigating either patients, caregivers or health care providers use of passports, communication documents or journals with the goal of improving any aspect of communication in the emergency department setting. Results: Of the 81 potential publications screened, only 4 met inclusion criteria for extraction. 1 reviewed a passport that aimed at pediatric pain management in settings that include the emergency department, 2 of the publications reported on the same project which developed a passport for asthma patients and 1 discussed a passport for patients with learning disabilities. All the included publications were published in and discuss passports that were developed for use in the UK. Descriptions of implementation, evaluation and perception of the passports in these publications was limited. Conclusion: This scoping review has revealed a major gap in the current literature on communication tools in the emergency department, a department where communication, especially about discharge is of utmost importance. The included studies focused on very different patient populations and aim to improve different outcomes and therefore dont allow us to make for passports aimed at helping the general emergency department population.

scholarly journals MP34: Elder abuse in the emergency department: a systematic scoping review

CJEM ◽  
2019 ◽  
Vol 21 (S1) ◽  
pp. S54-S55
Author(s):  
E. Mercier ◽  
A. Nadeau ◽  
A. Brousseau ◽  
M. Emond ◽  
J. Lowthian ◽  
...  
Keyword(s):  
Older Adults ◽  
Health Care ◽  
Emergency Department ◽  
Physical Abuse ◽  
Health Care Providers ◽  
Scoping Review ◽  
Elder Abuse ◽  
Community Dwelling ◽  
Screening Tools ◽  
Care Providers

Introduction: This systematic scoping review aims to synthetize the available evidence on the epidemiology, risk factors, clinical characteristics, screening tools, prevention strategies, interventions and knowledge of health care providers regarding elder abuse in the emergency department (ED). Methods: A systematic literature search was performed using three databases (Medline, Embase and Cochrane Library). Grey literature was scrutinized. Studies were considered eligible when they were observational studies or randomized control trials reporting on elder abuse in the prehospital and/or ED setting. Data extraction was performed independently by two researchers and a qualitative approach was used to synthetize the findings. Results: A total of 443 citations were retrieved from which 58 studies published between 1988 and 2018 were finally included. Prevalence of elder abuse following an ED visit varied between 0.01% and 0.03%. Reporting of elder abuse to proper law authorities by ED physicians varied between 2% to 50% of suspected cases. The most common reported type of elder abuse detected was neglect followed by physical abuse. Female gender was the most consistent factor associated with elder abuse. Cognitive impairment, behavioral problems and psychiatric disorder of the patient or the caregiver were also associated with physical abuse and neglect as well as more frequent ED consultations. Several screening tools have been proposed, but ED-based validation is lacking. Literature on prehospital- or ED-initiated prevention and interventions was scarce without any controlled trial. Health care providers were poorly trained to detect and care for older adults who are suspected of being a victim of elder abuse. Conclusion: Elder abuse in the ED is an understudied topic. It remains underrecognized and underreported with ED prevalence rates lower than those in community-dwelling older adults. Health care providers reported lacking appropriate training and knowledge with regards to elder abuse. Dedicated ED studies are required.

scholarly journals Urgency of Violence Screening in Pregnant Women: A Scoping Review

2020 ◽  
Author(s):  
Eviana Maya Saputri ◽  
◽  
Keyword(s):  
Health Care ◽  
Pregnant Women ◽  
Health Care Providers ◽  
Scoping Review ◽  
Partner Violence ◽  
Critical Appraisal ◽  
Care Providers ◽  
Inclusion Criteria ◽  
Community Based ◽  
Screening Practice

ABSTRACT Background: Partner violence during pregnancy might contribute to the clinical conditions of pregnant women. Early assessment and supportive response are required to improve clinical diagnosis and subsequent care. This scoping review aimed to identify the partner violence screening practices of community-based health care providers in pregnant women. Subjects and Method: A scoping review method was conducted in eight stages including (1) Identification of study problems; (2) Determining priority problem and study question; (3) Determining framework; (4) Literature searching; (5) Article selec­tion; (6) Critical appraisal; (7) Data extraction; and (8) Mapping. The search included PubMed, Science Direct, EBSCO, Wiley Online Library, and ProQuest databases. The inclusion criteria were English-language and full-text articles published between 2010 and 2020. A total of 580 articles were obtained by the searched database. After the review process, eight articles were eligible for this review. The critical appraisal for searched articles were measured by Mix Methods Appraisal Tools (MMAT). The data were reported by the PRISMA flow chart. Results: Two articles from developing countries (Zimbabwe and Kenya) and six articles from developed countries (Australia, Norway, Italy, and Sweden) met the inclusion criteria with a mixed-method, qualitative, and quantitative (cross-sectional) studies. The existing studies revealed that violence screening in pregnant women was effective to increase awareness of violence by their partners. Screening practice had an empowering effect on women to disclose the violence experienced. Barriers to the health care providers performing partner violence screening included: lack of knowledge, experience and training, confidence in undertaking the screening, taboo cultural practices, and absence of domestic violence screening policies. Conclusion: Partner violence screening practice should be strongly considered at antenatal care visits. Further insights of community-based health care providers are required to perform effective screening. Keywords: partner violence screening, pregnant women, health care providers Correspondence: Eviana Maya Saputri. Universitas ‘Aisyiyah Yogyakarta. Jl. Siliwangi No. 63, Nogotirto, Gamping, Sleman, Yogyakarta, 55292. Email: [email protected]. Mobile: +6281367470323. DOI: https://doi.org/10.26911/the7thicph.03.61

scholarly journals Barriers to Accessing Health Care in Rural Regions by Transgender, Non-Binary, and Gender Diverse People: A Case-Based Scoping Review

2021 ◽  
Vol 12 ◽  
Author(s):  
Janis Renner ◽  
Wiebke Blaszcyk ◽  
Lars Täuber ◽  
Arne Dekker ◽  
Peer Briken ◽  
...  
Keyword(s):  
Health Care ◽  
Health Care Providers ◽  
Scoping Review ◽  
Health Care Professionals ◽  
Well Being ◽  
Reference List ◽  
Care Providers ◽  
Trans People ◽  
Case Vignettes ◽  
The Impact

Research shows an overrepresentation of trans people in vulnerable socioeconomic situations, primarily due to experiences of discrimination. At the same time, rural or suburban living areas often lack specialized trans-related health care, which a majority of trans people rely on to some extent. Taken together, the lack of both socioeconomic resources and access to trans-related health care can exacerbate health-related distress and impairment for trans people. We illustrate this problem using case vignettes of trans people from rural and suburban areas in (Northern) Germany. They are currently participating in an e-health intervention and randomized controlled trial (RCT) called i2TransHealth, whose case vignettes provided the impetus for the scoping review. The scoping review analyzes the impact of place of residence and its intersection with barriers to accessing trans-related health care. PubMed and Web of Science Data bases were searched for relevant studies using a search strategy related to trans people and remote, rural, or suburban residences. 33 studies were selected after full-text screening and supplemented via reference list checks and study team expertise by 12 articles addressing the living conditions of remotely living trans people and describing requirements for trans-related health care. The literature on trans people living remotely reveals intersections of trans mental health with age, race, gender expression, geographic location, community size, socioeconomic status, discrimination experiences, and attitudes towards health care providers. Several structural health care barriers are identified. The role of health care professionals (HCPs) for remotely living trans people is discussed. There is no need assuming that rural life for trans people is inevitably worse for health and well-being than urban life. Nevertheless, some clear barriers and health disparities exist for trans people in remote settings. Empowering trans groups and diversity-sensitive education of remote communities in private and institutional settings are needed for respectful inclusion of trans people. Facilitating access to trans-related health care, such as through video-based e-health programs with HCPs, can improve both the health and socioeconomic situation of trans people.

How Well were Asthmatic Patients Educated about Their Asthma? A Study at the Emergency Department

2004 ◽  
Vol 16 (1) ◽  
pp. 45-49 ◽  
Author(s):  
P.Y. Lee ◽  
E.M. Khoo
Keyword(s):  
Emergency Department ◽  
Health Care Providers ◽  
Teaching Hospital ◽  
Care Providers ◽  
Self Medication ◽  
Asthmatic Patients ◽  
Management Plans ◽  
Acute Asthma Exacerbation ◽  
The Difference ◽  
Bronchodilator Treatment

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.

scholarly journals Prevalence, risk factors and sources of anxiety among Emergency Department healthcare workers in Pakistan during COVID-19 pandemic: A single center survey

2021 ◽  
Vol 2 ◽  
Author(s):  
N. Haroon ◽  
S. S. Owais ◽  
A. S. Khan ◽  
J. Amin
Keyword(s):  
Risk Factors ◽  
Emergency Department ◽  
Health Care Providers ◽  
Healthcare Workers ◽  
Work Performance ◽  
Nonparametric Tests ◽  
Care Providers ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Frontline Workers

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.

A Scoping Review and Content Analysis of Common Depressive Symptoms of Young People

2021 ◽  
pp. 105984052110126
Author(s):  
Jia-Wen Guo ◽  
Brooks R. Keeshin ◽  
Mike Conway ◽  
Wendy W. Chapman ◽  
Katherine A. Sward
Keyword(s):  
Content Analysis ◽  
Depressive Symptoms ◽  
Young People ◽  
Health Care Providers ◽  
Scoping Review ◽  
School Nurses ◽  
Future Research ◽  
Depression Symptom ◽  
Care Providers ◽  
Five Dimensions

School nurses are the most accessible health care providers for many young people including adolescents and young adults. Early identification of depression results in improved outcomes, but little information is available comprehensively describing depressive symptoms specific to this population. The aim of this study was to develop a taxonomy of depressive symptoms that were manifested and described by young people based on a scoping review and content analysis. Twenty-five journal articles that included narrative descriptions of depressive symptoms in young people were included. A total of 60 depressive symptoms were identified and categorized into five dimensions: behavioral ( n = 8), cognitive ( n = 14), emotional ( n = 15), interpersonal ( n = 13), and somatic ( n = 10). This comprehensive depression symptom taxonomy can help school nurses to identify young people who may experience depression and will support future research to better screen for depression.

scholarly journals “What is the actual goal of the pathway?”: examining emergency department physician and nurse perspectives on the implementation of a pediatric concussion pathway using the theoretical domains framework

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Anh Ly ◽  
Roger Zemek ◽  
Bruce Wright ◽  
Jennifer Zwicker ◽  
Kathryn Schneider ◽  
...  
Keyword(s):  
Emergency Department ◽  
Health Care Providers ◽  
Clinical Pathways ◽  
Theoretical Domains Framework ◽  
Local Context ◽  
Emergency Department Physician ◽  
Evidence Based ◽  
Care Providers ◽  
Structured Interviews ◽  
Pediatric Concussion

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.

scholarly journals Quality improvement primer part 2: executing a quality improvement project in the emergency department

CJEM ◽  
2017 ◽  
Vol 20 (4) ◽  
pp. 532-538 ◽  
Author(s):  
Lucas B. Chartier ◽  
Antonia S. Stang ◽  
Samuel Vaillancourt ◽  
Amy H. Y. Cheng
Keyword(s):  
Health Care ◽  
Emergency Department ◽  
Emergency Medicine ◽  
Quality Improvement ◽  
Improvement Project ◽  
Emergency Department Setting ◽  
Pdsa Cycle ◽  
Time To Antibiotics ◽  
Final Article

ABSTRACTThe topics of quality improvement (QI) and patient safety have become important themes in health care in recent years, particularly in the emergency department setting, which is a frequent point of contact with the health care system for patients. In the first of three articles in this series meant as a QI primer for emergency medicine clinicians, we introduced the strategic planning required to develop an effective QI project using a fictional case study as an example. In this second article we continue with our example of improving time to antibiotics for patients with sepsis, and introduce the Model for Improvement. We will review what makes a good aim statement, the various categories of measures that can be tracked during a QI project, and the relative merits and challenges of potential change concepts and ideas. We will also present the Model for Improvement’s rapid-cycle change methodology, the Plan-Do-Study-Act (PDSA) cycle. The final article in this series will focus on the evaluation and sustainability of QI projects.

PERIPHERAL BRAIN

1995 ◽  
Vol 16 (6) ◽  
pp. 229-238
Author(s):  
Jill M. Baren ◽  
James S. Seidel
Keyword(s):  
Health Care ◽  
Emergency Department ◽  
Health Care Providers ◽  
Cardiopulmonary Arrest ◽  
Pediatric Emergency ◽  
Care Providers ◽  
Loss Of Life ◽  
Policies And Procedures ◽  
Emergency Drugs ◽  
Emergency Equipment

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).

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