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acute care needs in an Indian emergency department： A retrospective analysis

World Journal of Emergency Medicine 2016年第3期7卷 191-195页

作者： Elizabeth G. Clark Jessica Watson Allison Leemann Alan H. Breaud Frank G. Feeley III James Wolff Tamorish Kole Gabrielle A. Jacquet Kerala Institute of Medical Sciences Trivandrum Kerala India Boston University School of Public Health Boston Massachusetts USA Department of Emergency Medicine Boston Medical Center Boston Massachusetts USA Boston University Center for Global Health and Development Boston Massachusetts USA Max Hospital New Delhi India Boston University School of Medicine Boston Massachusetts USA

BACKGROUND: Emergencies such as road traffic accidents(RTAs), acute myocardial infarction(AMI) and cerebrovascular accident(CVA) are the most common causes of death and disability in India. Robust emergency medicine(EM) services and proper education on acute care are necessary. In order to inform curriculum design for training programs, and to improve the quality of EM care in India, a better understanding of patient epidemiology and case burden presenting to the emergency department(ED) is ***: This study is a retrospective chart review of cases presenting to the ED at Kerala Institute of Medical Sciences(KIMS), a private hospital in Trivandrum, Kerala, India, from November 1, 2011 to April 21, 2012 and from July 1, 2013 to December 21, 2013. De-identified charts were systematically sampled and ***: A total of 1 196 ED patient charts were analyzed. Of these patients, 55.35%(n=662) were male and 44.7%(n=534) were female. The majority(67.14%, n=803) were adults, while only 3.85%(n=46) were infants. The most common chief complaints were fever(21.5%, n=257), renal colic(7.3%, n=87), and dyspnea(6.9%, n=82). The most common ED diagnoses were gastrointestinal(15.5%, n=185), pulmonary(12.3%, n=147), tropical(11.1%, n=133), infectious disease and sepsis(9.9%, n=118), and trauma(8.4%, n=101).CONCLUSION: The patient demographics, diagnoses, and distribution of resources identifi ed by this study can help guide and shape Indian EM training programs and faculty development to more accurately refl ect the burden of acute disease in India.

关键词： Emergency care systems Emergency department Education acute care Emergency department utilization

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Factors influencing individualized nursing care in acute medical and perioperative settings: A scoping review

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Journal of Integrative Nursing 2024年第4期6卷 231-240页

作者： Ana RAMOS Eunice SÁ Delmira POMBO Florinda SÁ Filipe RAMOS Fernanda BERNARDO Helena MIRA Hélder LOPES Paula SANTOS Regina MARCÃO Idalina GOMES Department of Medical-Surgical Nursing Nursing School of Lisbon(ESEL)LisbonPortugal Nursing Research Innovation and Development Centre of Lisbon(CIDNUR)LisbonPortugal Department of Medical Surgical Central Lisbon University Hospital CenterLisbonPortugal Department of Medical Hospital Garcia de OrtaAlmadaPortugal

Individualized nursing care addresses the needs,experiences,behaviors,feelings,and perceptions of patients and families,but its implementation in clinical practice contexts remains *** review aims to map the factors that interfere with the individualization of nursing care,in acute medical and perioperative *** review was conducted according to the Joanna Briggs Institute *** MEDLINE,CINAHL,Cochrane,SciELO,Scientific Repository of Open Access,and LILACS databases were searched for publications from January 2017 up to March *** the 124 articles selected,17 met the inclusion *** individualization of nursing care is complex and shaped by multiple variables in the care environment,nursing,and patient *** institutional organization,the nurses’expertise,and the patient’s attributes were identified as variables that interfere with the individualization of nursing *** nursing care is responsible for better quality of care and health *** identification of the variables that affect individualized care contributes to planning programs to improve individualization,during hospitalization and the discharge.

关键词： acute care nursing care patient individualization perioperative care

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Intravenous fluid selection rationales in acute clinical management

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World Journal of Emergency Medicine 2018年第1期9卷 13-19页

作者： Wing Yan Shirley Cheung Wai Kwan Cheung Chun Ho Lam Yeuk Wai Chan Hau Ching Chow Ka Lok Cheng Yau Hang Wong Chak Wah Kam Accident and Emergency Department Tuen Mun Hospital

BACKGROUND: Intravenous fluid(IVF) is commonly used in acute clinical management. This study aimed to review the choice and primary considerations in IVF prescriptions and to evaluate the adequacy of guidelines and trainings on it in the New Territories West Cluster(NTWC) of Hong ***: This is a descriptive study based on data collected from an online survey. Data were processed by SPSS for statistical analysis. This study focused on a general description and doctor-nurse between group comparison. Participants were asked the choice of IVF for nine acute clinical scenarios and provide reason. A 1–10 scale was used to assess the sufficiency of guideline, training and information, and time for revision on IVF ***: 0.9% sodium chloride was the most familiar IVF(36%), followed by 5% Dextrose solution(26%). In the nine scenarios, the most chosen IVF was 0.9% sodium chloride(37%–61%). There was significant difference in the choice of IVF between doctors and nurses in 7 cases. The second most chosen IVF for doctors was Plasma-Lyte A while that for nurses was Gelofusine. Departmental practice was the most chosen reason to account for the prescription. The adequacy of guideline, information and training, and time for revision was rated 5. Doctors had significantly more time at work than nurses to update knowledge in IVF prescription(5.41 versus 4.57).CONCLUSION: 0.9% sodium chloride was mostly chosen. The choice of IVF was mainly based on departmental practice. Adequacy of guideline, information and training, and time for revision on IVF prescription were average, indicating significant training deficit.

关键词： Intravenous fluid acute care Resuscitation

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Evaluating Health Planning Issues at the Community Level

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Case Reports in Clinical Medicine 2023年第11期12卷 433-438页

作者： Ronald Lagoe Mark Murphy Shelly Littau Hospital Executive Council Syracuse NY USA St. Joseph’s Hospital Health Center Syracuse NY USA

This study was a brief review of issues related to health planning in the metropolitan area of Syracuse, New York. It suggested that population demographics and health care utilization can have an impact on the use of services at the community level. The study suggested that the utilization of services can be associated with patient demographics. In this study, younger populations were associated with lower use of hospital inpatient care. The data have also suggested that larger numbers of younger populations are not necessarily related to opportunities for expanding local health care providers. Younger populations can be associated with lower per capita use of services. The data demonstrated that there were substantial reductions in hospital discharges for adult medicine. Total discharges declined by 3999 patients between the seven months in 2019 and 2023. The data also demonstrated that there were notable reductions in hospital discharges for adult surgery.

关键词： Hospitals acute care Ambulatory care Health Planning

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