Subject(s)
General Practitioners , Humans , Patient Satisfaction , Surveys and Questionnaires , TrustABSTRACT
Aim To assess handover quality amongst Emergency Department (ED) physicians and improve quality by implementing a unique protocol entitled 'TAG, You're It!' (TAG protocol). Methods Patient charts assessed using set parameters prior to implementation of the 'TAG' protocol. 'TAG' protocol developed based on gaps in current practice and recommendations from literature. Identical parameters applied post-intervention, and results compared to those pre-intervention. Results 'TAG' protocol yielded positive impact on ED handover practices. A significant difference (p<0.05) between pre and post-TAG intervention values was seen across all parameters i.e. including the accepting physician's name in the computer system and ED chart, documenting a handover plan in the ED chart, and including a handover plan deemed sufficient by standards developed from relevant literature. Conclusion Shift-to-shift handover in the ED is a high risk time for patient safety. The 'TAG' protocol ensures that essential information is documented and communicated in a succinct and rapid way.
Subject(s)
Communication , Emergency Medicine , Patient Handoff/standards , Quality Improvement , Documentation , Emergency Service, Hospital , HumansABSTRACT
AIM: An audit was performed in an Irish Emergency department (ED) to evaluate adherence to established antimicrobial guidelines and to determine the most common presentations of sepsis. METHODS: Data on ED patients with clinically significant bacteraemia on blood cultures were recorded for three months . The antimicrobial given to the patient was compared to that which the hospital guidelines would recommend for the ED diagnosis. RESULTS: Eleven patients out of 53 had no antimicrobial guidelines for diagnosis. Of the 42/53 patients, non-adherence to antimicrobial guidelines by physicians was observed in 81% (n=34/42) patients and adherence was observed in 19% (n=8/42) patients. Escherichia coli 35.70% (n=18), was the most frequent organism isolated. CONCLUSIONS: Non-adherence to antimicrobial guidelines resulted in 68% (n=23/34) of organisms covered by the antibiotic. Adherence to antimicrobial guidelines resulted in 87% (n=7/8) of organisms covered by the antibiotic.
Subject(s)
Anti-Bacterial Agents/administration & dosage , Bacteremia/drug therapy , Clinical Audit , Emergency Service, Hospital/statistics & numerical data , Guideline Adherence/statistics & numerical data , Practice Guidelines as Topic , Adult , Aged , Aged, 80 and over , Bacteremia/diagnosis , Bacteremia/microbiology , Escherichia coli/isolation & purification , Female , Humans , Ireland , Male , Middle Aged , Retrospective Studies , Time Factors , Young AdultABSTRACT
AIM: To determine factors within the Emergency Department (ED) that have maximum influence on the '6-hour target'. METHODS: Regression Analysis methodology employed to analyse the influence of 9 ED variables on the '6-hour target' compliance. RESULTS: The number of patients waiting to be seen an ED physician at 8pm exerts maximum influence on the '6-hour target' (r = -0.581, p<0.05). CONCLUSION: The '6-hour target' compliance rises with lesser number of patients waiting to be seen by an ED physician at 8pm. Also, the '6-hour target' compliance rises by increasing the number of ED Registrar working hours and the number of ED SHO working hours per day.
Subject(s)
Emergency Service, Hospital/statistics & numerical data , Regression Analysis , Time-to-Treatment/statistics & numerical data , Humans , Retrospective Studies , Time FactorsABSTRACT
Sewing needles, albeit a rare case of penetrating cardiac injury, are potentially life-threatening. We report a case of successful intra-cardiac needle removal from a 32 year old who inserted multiple needles into the chest and abdomen.