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Change in culture: Addition of a clinical pharmacist to the emergency department antimicrobial culture review process
(2016-12-13)
Objective: To evaluate the effectiveness of a unit based pharmacist in assisting with antimicrobial selection of female patients discharged from the emergency department with a diagnosis of an uncomplicated urinary tract infection.
Setting: Academic-affiliated emergency department in Pittsburgh, Pennsylvania.
Methods: A retrospective chart review was conducted among 870 female patients who were discharged from the emergency department with a positive urine culture requiring antimicrobial therapy revision. The primary investigator abstracted specific medical record information to determine if a pharmacist-driven culture review resulted in a higher percentage of appropriate antimicrobial selection when compared to the standard nurse/physician driven-culture review. The revised antimicrobial therapy treatment plan was deemed appropriate or not based on the “International Clinical Practice Guidelines for the Treatment of Acute Uncomplicated Cystitis and Pyelonephritis in Women: A 2010 Update by the Infectious Disease Society of American and the European Society for Microbiology and Infectious Disease”.
Results: A Chi-Square Test of Independence was conducted to evaluate the relationship between two categorical variables: (1) type of provider (physician/pharmacists) and (2) adherence to clinical practice guidelines (yes/no). The test emerged significant, C2 = 17.4, df= 2, p < 0.01. Thus, a significant relationship between type of provider and appropriate treatment was found. Specifically, 52.2% of physicians used the appropriate treatment whereas 84.4% of pharmacists used the appropriate treatment....
A screening tool for early recognition and treatment of sepsis
(2014-05-14)
Purpose: This study investigates the use of a sepsis screening tool to decrease the length of time from triage to treatment.
Design: In this exploratory study, a convenience sample was drawn from all patients triaged in ...
The role of fast tracks on length of stay in emergency departments
(5/18/2017)
Overcrowding in emergency departments (EDs) is a national crisis affecting hospitals. It has led to an association with poor patient outcomes and is a threat to public safety. Fast tracks (FTs) in the ED are one strategy ...
Initiation of a HIV screening protocol and pathway in the emergency department: A quality improvement initiative
(11/9/2017)
There is currently a nationwide campaign to address human immunodeficiency virus (HIV) prevention and treatment. The emergency department (ED) is a significant venue in the HIV prevention and treatment campaign. The quality ...
Trust me...I'm a trauma nurse
(2017-12-04)
Purpose: There is a large number of staff in the Emergency Department, high turnover rates, many different areas of focus which lead to inconsistencies in the care and documentation of care for trauma patients. The ...
Trauma nurse fellowship: Developing the novice trauma nurse
(2017-12-04)
Purpose: Residency and fellowship programs have successfully been implemented in combination with workshops to develop nurses and increase nursing knowledge over the past several years. These programs can improve both ...
STAND Method: Changing nursing culture from the bedside up
(2017-12-05)
Purpose: According to the literature, it is highly recognized that when people are in an environment that fosters growth, encourages diversity and encourages learning, employees become more engaged and have a higher level ...
Sustainability of change: Evaluating febrile neutropenia process in pediatric setting
(2017-12-04)
Purpose: Febrile neutropenia is considered an oncologic emergency. It has been shown that decreasing the door-to-antibiotic time for this population positively effects patient outcomes. A pathway was created to improve ...
Lifelong learning through mobile reflection at the stretcherside
(2017-12-05)
Purpose: The purpose of this project is to impact the lifelong learning process of ED nurses to effective leadership development at the stretcherside. Millennials need leadership opportunities before the routine 18 moths ...
Optimizing the management of emergency department patients with atrial fibrillation
(2017-12-05)
Purpose: Atrial Fibrillation is the most common cardiac dysrhythmia in adults, with an annual cost of care estimated at $6.65 billion (3/4 of cost due to hospitalization), and greater than 70% of patients admitted with AF ...