Emergency
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Joint Commission Revises National Patient Safety Goal Regarding Suicide Risk
The move follows a re-evaluation of the National Patient Safety Goal covering this issue that began in 2016, and included research, public field review, and analysis with experts in suicide prevention as well as representatives from healthcare organizations and other key stakeholders.
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Sarasota Memorial Hospital Implements Sweeping Initiative, Raising HCAHPS Scores
Discovering that there was a decline in patient experience scores among patients aged 80 years and older, Sarasota Memorial Hospital in Florida initiated a multidisciplinary effort, dubbed PEACE (patient experience for acute care elders), to address the gap. With continual input from senior advisors from the community, the effort focused on engaging frontline caregivers and improving communications with patients and caregivers at multiple levels.
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State Hospital Association Tackles Workplace Violence With De-Escalation Training, Evolving Toolkit for Member Institutions
The Washington State Hospital Association intends to make meaningful modifications to an existing toolkit to ensure resources and recommendations remain relevant and applicable to new issues and emerging trends facing hospital leaders and workers.
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ACEP, AMA Announce Steps Aimed at Curbing Gun Violence
The American College of Emergency Physicians pledged to review current research and legislation to decide next steps, while the American Medical Association unveiled a new continuing medical education online module to help physicians with the knowledge and preparation to effectively counsel patients on firearm safety.
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Hospitals Work to Improve Procedures Designed to Protect Staff and Patients From Harm
Hospitals are looking for new and better ways to protect staff and patients, both from intruders who mean harm, and patients or family members who become aggressive and agitated. However, defending against active assailants presents the greatest challenge, as hospitals and EDs strive to remain open and welcoming to the communities they serve.
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Suicide Assessment and Disposition
During the past 20 years, suicide has become recognized as a major public health concern. Focused medical assessment and suicide risk assessment in the emergency department can help determine whether a mental health consultation is required and whether patients need hospitalization.
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Early Rehospitalization Among ICU Survivors: How Can We Do Better?
Based on inductive analysis of a large sample of patients and caregivers, this study provides an organizational framework on which to focus efforts to develop complex healthcare interventions aimed at reducing readmission after critical illness.
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Diagnosis Sepsis: Is Newer Better?
Sepsis-3 criteria may be the favored method for prognostication, whereas SIRS-based criteria may be the preferred method to screen patients for consideration of ICU admission. Future studies are necessary to continue to explore the benefits of qSOFA and potentially reveal a more precise and reliable screening tool. Most importantly, it is paramount to remember that neither set of criteria is diagnostic. Using clinical judgment along with these guides remains the ideal approach.
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A Combination of Commonly Measured Clinical Variables May Predict Prolonged Mechanical Ventilation
The results of this study validate a clinical tool using common ICU variables for predicting prolonged mechanical ventilation. However, one must consider both the implications and strength of any predictive model for clinical decision-making.
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Antipsychotics Do Not Shorten the Duration of ICU Delirium
These results support minimizing the use of haloperidol and ziprasidone in delirious patients who are not agitated. Current best practice is to adhere to the ABCDE bundle, remove causative agents when possible, and continue antipsychotics (only if they appear effective and for the minimum time necessary). The jury is still out regarding how to manage agitated delirium.