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The Canadian Journal of Emergency Nursing

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This is the official podcast of the Canadian Journal of Emergency Nursing www.CJEN.ca, a free open-access peer-review journal. We share content related to emergency care, interviews with published CJEN authors and members of our emergency care community. We are the journal of the National Emergency Nurses Association (NENA) www.NENA.ca
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Article:https://www.cjen.ca/index.php/cjen/article/view/41DOI: https://doi.org/10.29173/cjen41The treatment and support patients receive in their transition from the Emergency Department (ED) to the patient care unit (PCU), and eventually, the community, have clinical consequences, psycho-social outcomes, and financial ramifications. This quality improvement report provides recommendations intended to improve patient experiences and outcomes, in the context of ED crowding. The recommendations provided are informed by the findings of a master's project that examined the transfer of patients from admission in a crowded ED, to a select PCU, and then to the community using process mapping and patient surveys. The purpose of this project was to examine the sequence of care beyond the walls of the ED and include the PCU (McHugh et al., 2011) using a systems approach (Villa, Prenestini, & Giusepi. 2014). We believe that by understanding process successes and failures, between EDs and PCUs, we can make improvements to ensure efficient, effective, and streamlined transitions to promote continuity of care.Keywords: transitions, quality improvement, health systems, continuity of care, handovers, patient perspective
Article: https://www.cjen.ca/index.php/cjen/article/view/44DOI: https://doi.org/10.29173/cjen44This article is about nurse practitioners' effectiveness working in the Strathcona emergency department (ED), as well as the efficacy of two nurse practitioner-led clinics that run parallel to the ED. Prior to opening Strathcona Community Hospital in 2014, site leadership were tasked with developing an innovative care model with the aim of improved patient safety and quality of care delivered, incorporating a nurse practitioner (NP) model. There are NPs in three areas at Strathcona Community Hospital. NPs work directly in the ED, assessing and treating patients autonomously and with emergency physician collaboration. They also complete diagnostic and microbiology reviews and perform triage liaison nurse practitioner duties. There is also an NP led Emergency Department Transition Clinic for urgent or emergent follow up patients from the ED. Lastly, the NP-led Intravenous Therapy Clinic was developed to see patients previously attended through the ED for IV antibiotic and other IV non-antibiotic treatments, while supporting increased community access to IV treatments. Evaluation of the three areas was completed using qualitative and quantitative methods over the period of 2015–2018. Statistical analysis was completed bythe Alberta Health Services workforce team. Outcomes included reduced patient return visits, decreased wait times and patients leaving without treatment, and high patient satisfaction. Other results included improved staff satisfaction, facilitation of continuity of care and avoiding unnecessary ED visits.Keywords: NP, nurse practitioner, quality improvement, operations
Article: https://www.cjen.ca/index.php/cjen/ar...DOI: https://doi.org/10.29173/cjen34This article provides the reader with a thoughtful example of an emergency nurse-led intervention to improve emergency department patient screening for domestic violence. Background information is provided along with the development of educational tools. Example ID badge cards and posters are also provided. Finally, helpful takeaways fare provided to aid in the implementation of similar projects in other emergency departments. Keywords: IPV, interpersonal violence, domestic violence
Article:https://www.cjen.ca/index.php/cjen/ar...DOI: https://doi.org/10.29173/cjen15Opioid use disorder (OUD) is a public health crisis that continues to affect individuals across Canada and requires a multifaceted approach to minimize its impact. Through the chronic consumption of opioids, many individuals can become dependent on opioids and develop OUD. Buprenorphine/naloxone is the recommended first-line treatment, whenever possible, for patients living with OUD. The Emergency Strategic Clinical NetworkTM within Alberta Health Services is targetingthe crisis in emergency departments by implementing a provincially standardized program. The Buprenorphine/ Naloxone Initiations in Emergency Departments program includes identifying OUD, initiating treatment with the medication buprenorphine/naloxone, and providing rapid and reliable referrals to community clinics for titration and continued patient care. This paper provides an overview of opioids, OUD, opioid agonist treatments such as buprenorphine/naloxone, and details the program and protocol available in Alberta.Keywords: opioids, opioid use disorder (OUD), opioid agonist treatment (OAT), buprenorphine/naloxone, emergency department (ED)
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