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Do you always obtain an asthmatic childs medication history? Communication barriers such as noise, overcrowding, and other distractions often prevent this from happening in EDs, says Stephen C. Porter, MD, MPH, an ED physician at Childrens Hospital Boston.
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At triage, a patient reports fatigue and shortness of breath with a history of pulmonary and cardiovascular disease. Because you dont know the patients brain natriuretic peptide or troponin level, you begin treating the patient for pneumonia, chronic obstructive pulmonary disease (COPD), and heart failure, and you start the admission process.
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A 45-year-old man was brought by ambulance to the ED at Swedish Medical Center in Seattle. He presented with aphasia and left hemiparesis with symptom onset two hours before arrival.
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A nurse is about to give the incorrect dosage to a patient, but she catches the error beforehand and you notice its because two sound-alikes are stored next to each other.
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As an ED nurse, you are in a unique position to do two things: Assess tobacco use, and assess the patients interest in quitting.
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Free resources are available to help patients quit smoking on the Tobacco-Free Nurses web site (www.tobaccofreenurses.org), including links to the guidelines, patient education materials, state cessation quit-line numbers, and Internet-based programs.
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Several of your staff are in the first trimester of pregnancy. Youre thrilled for them, but you want to make sure they arent exposed to chemicals or radiation that might impair the fetus. One staff member brings in a note from her OB/GYN saying to follow guidelines for pregnant staff in the OR, but you cant find any state or federal guidelines.
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As surgery centers begin to analyze how a new reimbursement system, if passed, would affect their income and bottom line, they are finding that future changes will be a mixed bag.
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Same-day surgery managers and staff members will have more direction and some flexibility if they face a disaster that requires the use of health care volunteers or if they choose to stay open during a pandemic situation with new standards in the Joint Commission on Accreditation of Healthcare Organizations hospital, ambulatory care, and office-based surgery standards that are effective July 1, 2006.
