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If it is not practical to create a psychiatric ED at your facility, you can create a separate area within your department for psychiatric patients, says Steve Sterner, MD, chief clinical officer and an emergency physician at Hennepin County Medical Center in Minneapolis and chair of a joint American College of Emergency Physicians (ACEP)/Minnesota Medical Association task force evaluating psychiatric bed availability and the boarding of psychiatric patients.
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When patients present in an ED with chest pain, blood can be drawn, and the patient's enzyme levels will indicate whether there has been cardiac tissue damage. At present, however, no similar test is available to detect kidney damage.
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A woman who initially had come into the ED at Northwestern Memorial Hospital in Chicago with a miscarriage returned three days later. She was extremely upset because she had continued to bleed.
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In light of a recent study in the Annals of Emergency Medicine, some experts recommend that EDs use "read-backs" by asking the patient to repeat back what they have been told to verify whether patients have understood their instructions. However, support is not universal among ED managers.
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While a recent study in the Annals of Emergency Medicine showed that English-speaking adults often have difficulty understanding physicians' instructions, patients who don't understand English present an additional challenge for ED managers.
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The floods that ravaged Cedar Rapids, IA, in July caused several hospitals to evacuate their patients, including Mercy Medical Center, a 370-bed regional medical facility.
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The ED at Mercy Medical Center in Cedar Rapids, IA, had to be moved to another floor on July 13, as flood waters filled the hospital's lower levels. Despite having to uproot patients and equipment, the ED remained in constant contact with internal and external resources due to the presence of redundant communications options.
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As the effective response of the ED at Mercy Medical Center in Cedar Rapids, IA, to the recent floods demonstrates, the extra dollars required to invest in top-notch communications systems are well worth it, according to Rich Head, director of information services.
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Overcrowding, higher-acuity patients being held in hallways, and The Joint Commission's new National Patient Safety Goals (NPSGs) for 2009: It's the "perfect storm" to put hospital-acquired infections on the top of any ED nurse's priority list.
