Background There is an increase in the number of frail elderly patients presenting to the emergency department. Diagnosis and treatment for this patient group is challenging due to multimorbidity, a-typical presentation and polypharmacy and requires specialised knowledge and competencies from healthcare professionals. We aim to explore the needs and preferences regarding emergency care in frail older patients based on their experiences with received care during Emergency Department admission. Method A qualitative study design was used, and semi-structured interviews were conducted after discharge with twelve frail older patients admitted to emergency departments in the Netherlands. Data collection and analysis were performed iteratively, and data were thematically analysed. Results The analysis enfolded the following themes; feeling disrupted, expecting to be cared for, suppressing their needs and wanting to be seen. These themes indicated a need for situational awareness by healthcare professionals when taking care of the participants and were influenced by the participants' life experiences. Conclusion Frail older patients feel disrupted when admitted to the emergency department. Because of this, they expect to be cared for, lessen their own needs and want to be seen as human beings. The impact of the admission is influenced by the extent to which healthcare professionals show situational awareness.
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OBJECTIVE: To determine the value of training for the Emergency Management of Severe Burns (EMSB) for medical and nursing staff working in emergency care as measured by their performance in a simulated burn incident online program.METHODS: An Internet-based questionnaire, which included a simulated burn incident, was developed. All of the medical and nursing staff in hospital emergency departments and ambulance services in the Netherlands were invited to complete this questionnaire. The effect of EMSB training on the individual's knowledge of and performance in the emergency management of a burn victim was evaluated because some of the respondents had participated in EMSB training, whereas others had not.RESULTS: Of the 280 responses received, 198 questionnaires were included in the analysis. The analyzed questionnaires were submitted by nurses (43%), ambulance workers (33%), and physicians (23%). Only 14% of the people in the study had participated in EMSB training, whereas 78% had received other or additional life support training and 22% of respondents had no additional life support training. Medical and nursing staff who had participated in EMSB training performed better in the following subjects: mentioning hypothermia as a focus of attention (70% versus 53%, p=0.085), correct use of hand size (70% versus 36%, p=0.001) and use of the correct hand percentage in the estimation of total body surface area (TBSA, 82% versus 57%, p=0.015), suspicion of no airway obstruction in an outdoor trauma (93% versus 63%, p = 0.002) and referral of functional area burns to a burn center (22% versus 8%, p = 0.04). However, both groups overestimated the TBSA (34% of the total group overestimated ≥ 20%) and did not know the correct formula for fluid resuscitation (87% of the total group).CONCLUSION: There is some evidence that medical staff members who have participated in EMSB training have a better knowledge of emergency management and are more effective in the management of a simulated burn case. However, both individuals who had participated in EMSB as well as those who had not participated in EMSB needed additional training in EMSB.
Background: Emergency department utilization has increased tremendously over the past years, which is accompanied by an increased necessity for emergency medicine research to support clinical practice. Important sources of evidence are systematic reviews (SRs) and meta-analyses (MAs), but these can only be informative provided their quality is sufficiently high, which can only be assessed if reporting is adequate. The purpose of this study was to assess the quality of reporting of SRs and MAs in emergency medicine using the PRISMA statement. Methods: The top five emergency medicine related journals were selected using the 5-year impact factor of the ISI Web of Knowledge of 2015. All SRs and MAs published in these journals between 2015 and 2016 were extracted and assessed independently by two reviewers on compliance with each item of the PRISMA statement. Results: The included reviews (n = 112) reported a mean of 18 ± 4 items of the PRISMA statement adequately. Reviews mentioning PRISMA adherence did not show better reporting than review without mention of adherence (mean 18.6 (SE 0.4) vs. mean 17.8 (SE 0.5); p = 0.214). Reviews published in journals recommending or requiring adherence to a reporting guideline showed better quality of reporting than journals without such instructions (mean 19.2 (SE 0.4) vs. mean 17.2 (SE 0.5); p = 0.001). Conclusion: There is room for improvement of the quality of reporting of SRs and MAs within the emergency medicine literature. Therefore, authors should use a reporting guideline such as the PRISMA statement. Active journal implementation, by requiring PRISMA endorsement, enhances quality of reporting.
Personal factors, team factors, and organizational factors have a strong influence on the adoption of technology used by, for instance, nurses in homecare. This part of the research portfolio in Point of Care Diagnostics regards the adoption of diagnostic technology in the health care domain.
