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Behavioral health issues present an ongoing challenge for ED managers in pediatric as well as adult facilities. To address these challenges, the ED leadership at Akron (OH) Children's Hospital has built a separate area within the department to treat patients with such issues.
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Initial data on the use of cell phone photos of injuries, taken by the patients themselves in the ED at The George Washington University Hospital in Washington, DC, offers the promise that they might have the potential to speed treatment without sacrificing diagnostic accuracy.
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Despite the adage, "If it wasn't documented, it wasn't done," not everything that ED nurses and physicians do is actually documented. The fact is, documentation omissions and errors do occur. The question is, what piece of information is likely to become crucially important from a legal perspective?
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When the University of Michigan Health System, Ann Arbor, instituted a "rolling forecast" approach to budgeting, its administrators established a target to improve labor productivity by 2% in fiscal 2010.
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Every summer The Joint Commission issues a list of those standards hospitals find most difficult to comply with. Among those challenging standards are three that experts say most directly impact the ED:
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There are any number of reasons why an ED and its hospital would have difficulty complying with The Joint Commission standard regarding egress, says Diana S. Contino, RN, MBA, FAEN, senior manager of health care with Deloitte Consulting in Los Angeles.
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As The Grateful Dead might say if asked to describe the various iterations of the National Patient Safety Goal (NPSG) for medication reconciliation, "what a long, strange trip it's been."
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What should ED managers be doing while they wait for The Joint Commission to publish a new standard for medication reconciliation? Take a team approach, recommends Diana S. Contino, RN, MBA, FAEN, senior manager of health care with Deloitte Consulting in Los Angeles.
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This web-based survey assessed 1976 critical care practitioners' perceptions of the risks for unplanned extubation. Members of the American Association for Respiratory Care, the American Association of Critical Care Nurses, and the Society of Critical Care Medicine reported a number of factors associated with unplanned extubation, including outward migration of the endotracheal tube (ETT; reported by 73% of respondents), the patient tugging on the ETT (87%), removing a nasogastric tube (71%), absence of physical restraints (72%), a nurse/patient ratio of 1:3 (60%), trips out of the ICU for tests (59%), and light sedation (42%).
