Enough is enough: Alcohol-related occupational violence and aggression in emergency departments in Australia and New Zealand.

Objective: To determine the extent of alcohol-related violence in EDs throughout Australia and New Zealand and the impact this has had on ED staff.

Methods: A mixed methods, cross-sectional, online survey of ED staff working in Australia and New Zealand conducted between 1 August and 11 September 2022 measuring the frequency of physical or verbal alcohol-related aggression from patients and their relatives/carers; changes to the frequency of alcohol-related occupational violence over the preceding 5 years; the impact of COVID-19 on these presentations; and the perceived impact on ED function and staff well-being.

Results: A total of 1284 ED staff responded, with almost all (97.

Using emergency department data to reduce late-night alcohol-related presentations in an Australian central business district.

Introduction: The Cardiff Model for Violence Prevention is a data sharing approach aiming to reduce violence-related presentations to emergency departments (EDs). This model has not previously been tested with patients attending EDs in a major Australian urban setting, nor has the use of media reporting of results and letters to venues without a local violence prevention board been tested.

Objective: To determine this approach's effect on alcohol-associated presentation rates during high-alcohol hours (HAHs) in a major ED servicing the nightlife district in central Melbourne.

Impact of the Southeast Melbourne Virtual Emergency Department on reducing transfers from residential aged care facilities.

Objective: To evaluate the impact of the Southeast Melbourne Virtual Emergency Department (SEMVED) on transfers from residential aged care facilities (RACFs) to traditional EDs.

Methods: A cohort study of residents requesting transfer to the ED via ambulance within participating health networks' catchments from April to June 2022.

Results: Two hundred thirty-eight VED consultations occurred with 79% (188/238) avoiding transfer.

Making the most of what we have: What does the future hold for Emergency Department data?

Over 10 million ED visits occur each year across Australia and Aotearoa New Zealand. Outside basic administrative data focused on time-based targets, there is minimal information about clinical performance, quality of care, patient outcomes, or equity in emergency care. The lack of a timely, accurate or clinically useful data collection represents a missed opportunity to improve the care we deliver each day.

Australia's first cardiac emergency department: Patient profile, activity and performance in the initial 6 months.

Objective: To profile the initial 6-month experience at the Victorian Heart Hospital (VHH) cardiac emergency (CE). The primary objective was to describe VHH CE patient characteristics, including presenting complaint, final diagnosis and disposition. Secondary objectives were to report on patient numbers, patient source and quality indicator performance including ambulance off-load by 40 min, waiting time and length of stay (LOS).

Summer alcohol-related emergency department workload and occupancy in Australasia 2019-2022.

Objective: Alcohol is a major public health issue and the ACEM funds regular 'snapshot' surveys of the prevalence of alcohol-related presentations in EDs. The present study uses these data to investigate ED occupancy and alcohol- and methamphetamine-related presentations at the time of the COVID-19 pandemic.

Methods: Survey-based point prevalence study of EDs in Australia and New Zealand conducted at 02:00 hours local time on the Saturday of the weekend before Christmas in 2019-2022.

Harm from the drinking of people you know: A range of effects from different relationships.

Aims: To describe the range of effects experienced due to the drinking of people respondents know and analyze risk and protective factors for harm from the drinking of partners and household members, other relatives and friends and co-workers.

Design, Setting And Participants: Surveys of 2574 participants' experiences were obtained from two samples: 1000 people responded to random digitally dialled Australian mobile calls and 1574 participants responded from the Life in Australia panel survey.

Measurements: Respondents were asked whether they had been negatively affected in the previous 12 months by the drinking of persons they knew who were 'a heavy drinker or drank a lot sometimes' and the nature of these harms.

Regular Medications in the Emergency Department Short Stay Unit (ReMedIES): Can Prescribing be Improved Without Increasing Resources?

Hospital medication errors are frequent and may result in adverse events. Data on non-prescription of regular medications to emergency department short stay unit patients is lacking. In response to local reports of regular medication omissions, a multi-disciplinary team was tasked to introduce corrective emergency department (ED) process changes, but with no additional financing or resources.

Hypertension in the emergency department: A missed opportunity to screen for primary aldosteronism?

Objectives: Primary aldosteronism (PA) is a common but underdiagnosed secondary cause of hypertension. Emergency departments (EDs) often assess patients with severe hypertension or its sequelae, some of whom have underlying PA. We aimed to determine the proportion of patients presenting to the ED with hypertension who meet the Endocrine Society criteria for PA testing and the proportion who were screened.

Modelled economic evaluation of a virtual emergency department in Victoria.

Objective: Virtual ED (VED) can potentially alleviate ED overcrowding which has been a public health challenge. The aim of the present study was to conduct a return-on-investment analysis of a VED programme developed in response to changing healthcare needs in Australia.

Methods: An economic model was developed based on initial patient outcome data to assess the healthcare costs, potential costs saved and return on investment (ROI) from the VED.

Using the Cardiff model to reduce late-night alcohol-related presentations in regional Australia.

Introduction: The Cardiff model is a data sharing approach that aims to reduce the volume of intoxicated patients in emergency departments (EDs). This approach has not been tested in a rural setting.

Objective: This study assessed whether this approach would reduce the number of alcohol-associated presentations during high-alcohol hours (HAH) in a regional ED.

Alcohol's harm to others in 2021: Who bears the burden?

Background And Aims: Alcohol's harm to others (AHTO) has become a key driver of national and international alcohol policy. This study aimed to produce a contemporary, comprehensive estimate of the correlates and harms from others' drinking in 2021 in Australia.

Design, Setting, Participants And Measurements: Across Australia, 2574 adults (1380 women; 1172 men) were sampled via two cross-sectional survey modes: a random-digit dial mobile phone sample of 1000 people and 1574 people from the Life in Australia™ panel survey.

Most common principal diagnoses assigned to Australian emergency department presentations involving alcohol use: a multi-centre study.

Objectives: Alcohol is the most widely consumed psychoactive substance in Australia and the consequences of alcohol consumption have enormous personal and social impacts. This study aimed to describe the principal diagnoses of emergency department (ED) presentations involving alcohol use in the previous 12 hours at eight hospitals in Victoria and the Australian Capital Territory, Australia.

Methods: Twelve months' data (1 July 2018 - 30 June 2019) were collected from eight EDs, including demographics, ICD-10 codes, hospital location and self-reported drinking in the preceding 12 hours.

From little things, big things grow: An exploratory analysis of the national cost of peripheral intravenous catheter insertion in Australian adult emergency care.

Objective: To estimate the total economic impact of peripheral intravenous catheter (PIVC) or cannula insertion and use in adult Australian EDs, including those cannulas that remain unused for therapeutic purposes.

Methods: Searches on Australian government websites were conducted to find rates of insertion, complications and cost of cannula; following this, gaps in national data sets were filled with MEDLINE and PubMed searches to estimate the total cost of cannula use in Australian EDs. Once the data were collected, totals were combined to establish an estimated cost for the listed categories.

Is a nudge all we need to promote deliberate clinical inertia and thoughtful clinical decision making?

Deliberate clinical inertia is the art of doing nothing as a positive response. Individual clinicians can promote deliberate clinical inertia through teaching, re-framing the act of 'doing nothing' as 'doing something' and engaging in shared decision making. Behaviour change on a larger scale requires a systematic approach.

Imaging triage of acute stroke patients for endovascular clot retrieval: Effect of increased therapeutic window on the utilization of CT perfusion.

Introduction: Recent randomized trials showing improved outcomes for later-presenting acute ischaemic stroke (AIS) patients with large vessel occlusion (LVO) treated with endovascular clot retrieval (ECR) may result in substantial increases in CTP utilization. This 3-hospital, single-institution cohort study aimed to compare 2017 and 2018 patient cohorts for the following: CTP use in AIS. Prevalence of LVO in all patients having CTP.

Evaluating the sustained effectiveness of a multimodal intervention aimed at influencing PIVC insertion practices in the emergency department.

Introduction: Multimodal interventions (MMI) are frequently used in various healthcare settings to encourage change in healthcare personnel practices and improve patient safety. In 2013, an MMI conducted in an Australian metropolitan ED used clinician champions, guidelines, education sessions and promotional materials to encourage a reduction in unused and inappropriate peripheral intravenous cannulas (PIVC). A 60-day postintervention demonstrated a successful reduction in the number of unused PIVCs without changes in appropriate insertions.

Conservative versus Interventional Treatment for Spontaneous Pneumothorax.

Background: Whether conservative management is an acceptable alternative to interventional management for uncomplicated, moderate-to-large primary spontaneous pneumothorax is unknown.

Methods: In this open-label, multicenter, noninferiority trial, we recruited patients 14 to 50 years of age with a first-known, unilateral, moderate-to-large primary spontaneous pneumothorax. Patients were randomly assigned to immediate interventional management of the pneumothorax (intervention group) or a conservative observational approach (conservative-management group) and were followed for 12 months.

Expectations and experiences of women presenting to emergency departments with early pregnancy bleeding.

Objective: To explore women's expectations and experiences when presenting to the ED with early pregnancy bleeding.

Methods: We conducted a qualitative study where women presenting to the ED with early pregnancy bleeding participated in two semi-structured interviews. An initial interview explored expectations of care and was conducted prior to ED treatment.