| 1. |
|
|
| 2. |
|
|
| 3. |
- Sturesson, L, et al.
(author)
-
Mandatory documentation of pain in the emergency department increases analgesic administration but does not improve patients' satisfaction of pain management
- 2016
-
In: Scandinavian journal of pain. - : Walter de Gruyter GmbH. - 1877-8879 .- 1877-8860. ; 13, s. 32-35
-
Journal article (peer-reviewed)abstract
- BackgroundPain is one of the most common symptoms treated in emergency department (ED). Pain may cause suffering and disability for the patient. Inadequate pain management may be associated with increased risk of complications such as sleep disturbance, delirium and depression. Previous studies conclude that pain management in ED is insufficient and inadequate. Yet, little is known about patients’ own experience regarding pain management in ED.ObjectiveThe aim of this study was to explore the satisfaction of pain management in patients having acute musculoskeletal injuries before and after implementation of mandatory documentation regarding pain assessment in the ED.MethodAn observational pre-post intervention study design was used. The study was conducted on patients having acute musculoskeletal injuries such as soft tissue injury, back pain or wrist/arm/leg/foot fractures in a 24-h adult (>15 years) ED at a public urban teaching hospital in Stockholm, Sweden. Data was collected by an interview based on a questionnaire.ResultsA total of 160 patients answered the questionnaire. In the pre- (n= 80) and post-intervention (n= 80) groups, 91/95% experienced pain in the ED. A significant difference (p< 0.003) was found during the post-intervention period, with more patients receiving analgesics compared to the pre-intervention group. A significant decline (p < 0.03) in patients’ own reported pain intensity at discharge was found between the groups. Patients’ reported satisfaction on pain management in the ED increased in the post-intervention group, but the difference was not statistically significantly.ConclusionPatients’ satisfaction with pain management increased, but not statistically significantly. However, both percentages of patients receiving analgesic drugs increased and pain intensity decrease at discharge were statistically significant after the intervention that made nurses obliged to register pain.ImplicationAccording to the findings of this study, mandatory pain documentation facilitates pain management in the ED, but there is still room for improvement. Additional actions are needed to improve patients’ satisfaction on pain management in the ED. Mandatory pain documentation in combination with person-centred care could be a way of improving patients’ satisfaction on pain management. Effective pain management is an important quality measure, and should be focused on in acute care in the ED. By routinely asking patients to report the pain intensity at discharge, the ED personnel can have direct feedback about the factual pain management. RNs may also be encouraged to use intravenous analgesics in higher extent when the patients have very severe pain.
|
|
| 4. |
- Hallikainen, J., et al.
(author)
-
The Wording of Telephone Guided CPRAffect on Senior Citizens Performance : A Simulation Study
- 2018
-
In: Journal of Clinical Medicine. - : SM Group. - 2077-0383. ; 4:1
-
Journal article (peer-reviewed)abstract
- Objectives: To assess how senior citizens followed Telephone CPR (T-CPR) instructions in a simulated cardiac arrest scenario. Methods: Twenty-two voluntary senior citizens were studied in a simulated cardiac arrest scenario following the instructions given to them by an Emergency Medical Dispatcher. The phone calls and the CPR performance were recorded and analyzed. Results: The rescuers reported that they had performed better than the analysis of video and phone call recordings showed. When asked after the scenario the rescuers felt that they had coped with the situation well 72% and quite well 28% of the cases. Every participant evaluated the given telephone CPR instructions as very easy to understand. 35% of the participants thought that performing CPR was physically quite easy. The unexpected result was the EMDs’ bad protocol compliance. Protocol was not strictly followed by the dispatchers. They gave more straight forward instructions without the full knowledge of the situation, than they should have. From the 12 analyzed instructions that the dispatchers should have given to the rescuer, only three instructions (give two deep rescue breaths, correct positioning of the rescuers arms and to compress 15 times) were totally as in the protocol. Conclusions: The quality of CPR given by the senior citizens was inadequate in this study. The EMDs had bad protocol compliance. Standardized and feasible T-CPR instructions by the dispatcher are not seen in this study, even if the rescuers stated that the instructions were clear and easy to understand.
|
|
| 5. |
|
|
| 6. |
- Makinen, M, et al.
(author)
-
Trainers' Attitudes towards Cardiopulmonary Resuscitation, Current Care Guidelines, and Training
- 2016
-
In: Emergency medicine international. - : Hindawi Limited. - 2090-2840 .- 2090-2859. ; 2016, s. 3701468-
-
Journal article (peer-reviewed)abstract
- Objectives. Studies have shown that healthcare personnel hesitate to perform defibrillation due to individual or organisational attitudes. We aimed to assess trainers’ attitudes towards cardiopulmonary resuscitation and defibrillation (CPR-D), Current Care Guidelines, and associated training.Methods. A questionnaire was distributed to CPR trainers attending seminars in Finland (N=185) focusing on the updated national Current Care Guidelines 2011. The questions were answered using Likert scale (1 = totally disagree, 7 = totally agree). Factor loading of the questionnaire was made using maximum likelihood analysis and varimax rotation. Seven scales were constructed (Hesitation,Nurse’s Role,Nontechnical Skill,Usefulness,Restrictions,Personal, andOrganisation). Cronbach’s alphas were 0.92–0.51. Statistics were Student’st-test, ANOVA, stepwise regression analysis, and Pearson Correlation.Results. The questionnaire was returned by 124/185, 67% CPR trainers, of whom two-thirds felt that their undergraduate training in CPR-D had not been adequate. Satisfaction with undergraduate defibrillation training correlated with theNontechnical Skillsscale (p<0.01). Participants scoring high onHesitationscale (p<0.01) were less confident about theirNurse’s Role(p<0.01) andNontechnical Skills(p<0.01).Conclusion. Quality of undergraduate education affects the work of CPR trainers and some feel uncertain of defibrillation. The train-the-trainers courses and undergraduate medical education should focus more on practical scenarios with defibrillators and nontechnical skills.
|
|
| 7. |
|
|
| 8. |
|
|
| 9. |
|
|
