ED Management – August 1, 2023

Virtual Nurses Alleviate Burdens on Frontline Staff, Critical Workforce Shortages

Across the United States, health systems are experimenting with programs that enable nurses, working remotely, to handle tasks that usually are handled by in-person, bedside nurses. These virtual nurses are managing everything from purposeful rounding to handling administrative tasks that often keep bedside nurses from spending more time on patient care.

Whole-Hospital Approach Accelerates Patient Flow in ED, Slashes Wait Times and Walk-Outs

To prevent people from leaving an ED without seeing a provider, researchers identified bottlenecks, secured support from leadership, and engaged with all units that conduct business with the department to address throughput problems. Coordination and accountability helped solve flow issues at the source.

Legal Exposure if Patient Is Not Reassessed in ED Waiting Room

An attorney offers some recommendations for emergency physicians concerned about liability when patients are not reassessed in waiting rooms.

Sophisticated Technology Gives Clinicians Head Start on Diagnosing, Treating Sepsis

At Tampa General Hospital, staff have shortened the average length of stay for patients with sepsis and lowered mortality rates. When early recognition and treatment is the goal, the ED plays a critical role in ensuring patients with sepsis are set up for success.

New Diagnostic Tools Expected to Revamp Sepsis Care

An expert panel agreed a test is needed to indicate the severity of dysregulated host immune response. Although there was some uncertainty over which patients would benefit most from such a test, the panel agreed the sepsis test should be conducted at triage and produce results in less than 30 minutes.

Fewer Delays in Sepsis Treatment via Provider in Triage Model

However, more research is needed to identify which key elements of this process can be reliably replicated using cost-effective resources to balance liabilities and risks.

Legal Considerations if ED Embraces Provider in Triage Approach

Implementing standing orders at triage and taking a team approach to care, with triage nurses, nurse practitioners, physician assistants, and emergency physicians all working together, are better approaches to improve the triage process.

EDs Face OSHA Citations for Failing to Prevent Violence

OSHA cited a Texas hospital for failing to adequately protect employees from violence, after a patient assaulted a security officer who lost consciousness and was subsequently hospitalized. The agency noted the hospital had not created policies and procedures to protect employees from assault by patients who had exhibited violent behavior.

How Emergency Medicine Leaders Can Implement an Intervention to Assess Suicide Risk

EDs will need to build a multidisciplinary implementation team to review their current care delivery, build improved protocols, deploy those protocols, adjust them iteratively over time to work out the kinks, and install methods for sustaining the effort long-term.