ED Management – November 1, 2021
November 1, 2021
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The Steep Costs of Operating Under Crisis Standards of Care
New data shine a harsh light on what can happen when hospitals become so overcrowded that they have to resort to crisis standards of care, a level of care where practice standards are relaxed under the strain of scarce resources.
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Acknowledge Pandemic-Driven Moral Distress, Mitigate Harmful Effects
Clinicians experience a high level of moral distress when they know they are not providing optimal care to patients. However, investigators have found leaders can mitigate the effects of moral distress. Such information could not arrive at a better time as hospitals in many regions cope with surging COVID-19 case volumes amid a shortage of skilled nurses.
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Two Similar Studies, Two Different Conclusions: What Is the Best Way to Treat Sepsis?
The authors of two recent studies of the performance of the Epic Sepsis Model (ESM), a commonly used early warning tool for sepsis, reached different conclusions: One research group found ESM fails to predict many sepsis cases beyond what clinicians detect on their own, but another research group reported the tool enhances care.
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Certain Patients Might Meet Criteria, Still Do Not Receive Formal Sepsis Diagnosis
This study highlights two competing risks: The risk of undertreating sepsis and the risk overresuscitating a patient with another cause of their symptoms.
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SPADE Method Quantifies Potential Harm of Misdiagnosis
Methodology improves accuracy of diagnostics for sepsis and acute myocardial infarction, lowers malpractice risk.
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For Some Patients with Valid DNRs, Confusion Results in Unwanted CPR
Some DNR orders were not documented anywhere in the medical record. ED staff sometimes failed to recognize DNR orders that were documented. Other patients had advance directives, but no valid DNR order.
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Police Transport More Patients with Mental Health Needs to ED
Annual rates of adults transported to EDs by law enforcement increased by almost 50% from 2009 to 2016, according to the authors of a recent study. Of the 136,240 patients brought to EDs by law enforcement during the study period, 43.1% had a mental health diagnosis; 22% of all visits were for involuntary commitments.
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Notify Patient if Initial Radiology Read Is Incorrect
Failure to notify the patient about a new result can come back on the ED provider if it can be shown that earlier notification could have changed the patient’s outcome.