Emergency department triage decision-making by registered nurses: An instrument development study.

Aim: To develop and psychometrically test the triage decision-making instrument, a tool to measure Emergency Department Registered Nurses decision-making.

Design: Five phases: (1) defining the concept, (2) item generation, (3) face validity, (4) content validity and (5) pilot testing.

Methods: Concept definition informed by a grounded theory study from which four domains emerged.

Mass casualty triage for the Emergency Department using the RATE protocol: Validation and results of a quasi-experiment.

Background: Triage practices in the Emergency Department (ED) need to be modified during a mass casualty incident (MCI) to accommodate the influx of patients. A triage protocol known as Rapid Assessment Triage for Emergency Department/Urgent Care (RATE) was developed specifically for use in EDs during MCIs.

Methods: Phase 1: validation of the RATE protocol by triage experts.

Thoracic Endotracheal Tube Insertion During Prehospital Thoracostomy: A Case Report.

This case highlights the novel use of endotracheal tubes to maintain patency of simple thoracostomies (STs) performed to relieve a tension pneumothorax after failed needle thoracostomy (NT). Treatment of a tension pneumothorax in the prehospital setting is typically performed using NT because of the minimal equipment required and rapid application. However, the variable efficacy of NT has led to a rise in the use of ST as an alternative procedure to treat a tension pneumothorax.

Clinical Characteristics of Patients Undergoing Needle Thoracostomy in a Canadian Helicopter Emergency Medical Service.

Needle thoracostomy (NT) can be a life-saving procedure when used to treat tension pneumothorax. However, there is some question regarding the efficacy of NT in the prehospital setting. Failure to treat tension pneumothorax in a helicopter emergency medical service (HEMS) setting may prove especially deleterious to the patient due to gas expansion with increasing altitude.

Triage emergency nurse decision-making: Incidental findings from a focus group study.

Introduction: Emergency Department (ED) triage decision-making is a complex process. Triage scales are used to determine patient acuity level, however, they do not provide information on how nurses make triage decisions. This focus group study was part of a larger project to develop a psychometrically sound instrument to measure triage decision-making by nurses; the Triage Decision-Making Instrument.

Transition in Care from EMS Providers to Emergency Department Nurses: A Systematic Review.

Transitions in care between emergency medical services (EMS) providers and emergency department (ED) nurses are critical to patient care and safety. However, interactions between EMS providers and ED nurses can be problematic with communication gaps and have not been extensively studied. The aim of this review was to examine (1) factors that influence transitions in care from EMS providers to ED nurses and (2) the effectiveness of interventional strategies to improve these transitions.

Creative adapting in a fluid environment: an explanatory model of paramedic decision making in the pre-hospital setting.

Background: Paramedics work in a highly complex and unpredictable environment which is characterized by ongoing decision-making. Decisions made by paramedics in the prehospital setting have implications for patient safety, transport, treatment, and health resource utilization. The objective of this study was; a) to understand how paramedics conduct decision-making in the field, and b) to develop a grounded theory of paramedic decision-making in the prehospital setting.

Transition in care from paramedics to emergency department nurses: a systematic review protocol.

Background: Effective and efficient transitions in care between emergency medical services (EMS) practitioners and emergency department (ED) nurses is vital as poor clinical transitions in care may place patients at increased risk for adverse events such as delay in treatment for time sensitive conditions (e.g., myocardial infarction) or worsening of status (e.

Staying theoretically sensitive when conducting grounded theory research.

Background Grounded theory (GT) is founded on the premise that underlying social patterns can be discovered and conceptualised into theories. The method and need for theoretical sensitivity are best understood in the historical context in which GT was developed. Theoretical sensitivity entails entering the field with no preconceptions, so as to remain open to the data and the emerging theory.

Momentary fitting in a fluid environment: A grounded theory of triage nurse decision making.

Background: Triage nurses control access to the Emergency Department (ED) and make decisions about patient acuity, patient priority, and placement of the patient in the ED. Understanding the processes and strategies that triage nurses use to make decisions is therefore vital for patient safety and the operation of the ED. The aim of the current study was to generate a substantive grounded theory (GT) of decision making by emergency triage Registered Nurses (RNs).

The application of theory to triage decision-making.

Theory in nursing is frequently thought of as being a mainly academic exercise with little relevance to the everyday practice of nursing. In nursing there is disagreement about what theory is and what it is not. Scientific theory is an abstract systematic explanation of how concepts are related to each other.