RESUMO
Review of recent evidence with translation to practice for the advanced practice nurse (APN) role is presented using a case study module for "Persistent Pain Among Older Adults Discharged Home From the Emergency Department After Motor Vehicle Crash: A Prospective Cohort Study." This longitudinal inquiry enrolled 161 patients 65 years or older seeking care in an emergency department (ED) following a motor vehicle crash. Interviews were conducted at the initial ED visit and at 6 weeks, 6 months, and 1 year. Variables of interest were persistent pain, depressive symptoms, and interference with activities of daily living, with an end goal of impact on functionality. Study subjects with persistent pain at 6 months reported an overall decrease in their health status, and 23% needed additional assistance with their activities of daily living, resulting in a change in living arrangements compared with 8% of the subjects without persistent pain. Repeat ED visits in the 6 months following the crash were more likely to occur in those with persistent pain (30% vs. 15%). This study highlights the important role of the APN in providing quality care, communication about pain management, and related follow-up care.
Assuntos
Acidentes de Trânsito , Dor Crônica/enfermagem , Dor Crônica/fisiopatologia , Papel do Profissional de Enfermagem , Manejo da Dor/enfermagem , Atividades Cotidianas , Idoso , Dor Crônica/etiologia , Depressão/etiologia , Depressão/enfermagem , Serviço Hospitalar de Emergência , Feminino , Indicadores Básicos de Saúde , Humanos , Entrevistas como Assunto , Estudos Longitudinais , Masculino , Medição da Dor , Estudos ProspectivosRESUMO
Review of recent evidence with translation to practice for the advanced practice nurse (APN) role is presented using a case study module for "Return Visits to the Emergency Department: The Patient Perspective." This qualitative inquiry performed 60 semistructured interviews of patients who returned to the emergency department within 9 days of their primary visit for the same complaint. Patients most often returned because of concerns that their initial visit did not adequately address their complaint, and they needed assurance from providers that their clinical condition was not a serious health concern. Patients also expressed a lack of contact with a provider between the 2 visits either to answer questions or to address ongoing concerns. This study highlights the important role of the APN in providing quality care, reassurance, and communication related to follow-up care.
