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How to break bad news. 如何打破坏消息
Q3 Nursing Pub Date : 2023-09-05 Epub Date: 2023-06-20 DOI: 10.7748/en.2023.e2174
Aby Mitchell

Rationale and key points: Breaking bad news is a fundamental yet challenging aspect of the role of healthcare professionals, including nurses. This article provides a step-by-step framework that nurses can use when delivering bad news and having challenging conversations with patients and/or families. • Preparation is important to ensure that challenging conversations are carried out in a suitable physical environment and with family members and/or friends present as appropriate. • Using a framework can aid nurses when undertaking challenging conversations, ensuring that all necessary aspects of the process are incorporated. • Nurses need to manage the expectations of patients and family members and respond appropriately to their emotional reactions. REFLECTIVE ACTIVITY: 'How to' articles can help to update your practice and ensure it remains evidence based. Apply this article to your practice. Reflect on and write a short account of: • How this article may help you to deliver bad news using a step-by-step framework in your practice. • How you can use the information in this article to communicate effectively and address emotional distress when breaking bad news.

理由和要点:发布坏消息是包括护士在内的医疗保健专业人员的一项基本职责,但也是一项具有挑战性的职责。本文提供了一个循序渐进的框架,供护士在传递坏消息以及与患者和/或家属进行具有挑战性的谈话时使用。- 准备工作非常重要,可确保在适当的物理环境中进行具有挑战性的谈话,并酌情让家人和/或朋友在场。- 在进行具有挑战性的谈话时,使用一个框架可以帮助护士,确保谈话过程中所有必要的方面都包含在内。- 护士需要管理患者和家属的期望,并对他们的情绪反应做出适当的反应。反思活动:"如何 "文章有助于更新您的实践,并确保其始终以证据为基础。将这篇文章应用到你的实践中。思考并写一篇简短的文章:- 这篇文章如何帮助你在实践中使用循序渐进的框架传递坏消息。- 在发布坏消息时,您如何使用本文中的信息进行有效沟通并解决情绪困扰。
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引用次数: 0
What nurses need to know to care for young adult patients in EDs 护士在急诊科照顾年轻成年病人需要知道什么
Q3 Nursing Pub Date : 2023-09-05 DOI: 10.7748/en.31.5.7.s5
Norman Miller
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引用次数: 0
Assessment and management of adult patients with neutropenic sepsis in the emergency department. 急诊科对嗜中性败血症成人患者的评估和管理。
Q3 Nursing Pub Date : 2023-09-05 Epub Date: 2023-02-16 DOI: 10.7748/en.2023.e2159
Daniella Elizabeth Leloch

As cancer diagnoses rise, and more treatment options become available, doctors, nurses and allied health professionals will increasingly encounter more patients with acute oncological emergencies in the emergency department (ED). Neutropenia (low levels of neutrophils in the blood) is a common side effect of systemic anti-cancer therapy, particularly chemotherapy, and has a negative effect on patients' immune system, leaving them vulnerable to infection. Patients who develop neutropenia are at increased risk of developing neutropenic sepsis, a potentially life-threatening condition that requires urgent assessment and treatment within an hour of presentation. This article describes the risk factors for and signs and symptoms of neutropenic sepsis and outlines assessment and management of patients who present to the ED with this condition.

随着癌症诊断率的上升和治疗方法的增多,医生、护士和专职医疗人员在急诊科(ED)会遇到越来越多的急性肿瘤急症患者。中性粒细胞减少症(血液中中性粒细胞水平低)是全身抗癌治疗(尤其是化疗)的常见副作用,会对患者的免疫系统产生负面影响,使他们容易受到感染。出现中性粒细胞减少症的患者罹患中性粒细胞败血症的风险会增加,这种疾病可能危及生命,需要在发病后一小时内进行紧急评估和治疗。本文介绍了中性粒细胞减少性败血症的风险因素、体征和症状,并概述了对急诊室就诊患者的评估和管理。
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引用次数: 0
How to manage radiology and pathology results 如何管理放射学和病理学结果
Q3 Nursing Pub Date : 2023-09-05 DOI: 10.7748/en.31.5.10.s7
Pavan Amara
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引用次数: 0
Meet the nurses working in some surprising places 认识一下在一些令人惊讶的地方工作的护士
Q3 Nursing Pub Date : 2023-09-05 DOI: 10.7748/en.31.5.12.s8
Yvonne Covell
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引用次数: 0
Inspectors raise concerns about staff burnout 检查员对员工倦怠表示担忧
Q3 Nursing Pub Date : 2023-09-05 DOI: 10.7748/en.31.5.6.s3
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引用次数: 0
Non-urgent presentations to the paediatric emergency department: a literature review. 儿科急诊的非急诊病例:文献综述。
Q3 Nursing Pub Date : 2023-09-05 Epub Date: 2023-02-02 DOI: 10.7748/en.2023.e2154
Alessandra Pol, Valentina Biagioli, Luca Adriani, Giulia Fadda, Orsola Gawronski, Luisa Cirulli, Rocco Stelitano, Tatiana Federici, Emanuela Tiozzo, Immacolata Dall'Oglio

It is estimated that between 58% and 82% of children and young people who present to paediatric emergency department (PEDs) have a non-urgent condition. This systematic review of the literature explores why parents of children with non-urgent conditions present to the PED rather than to community healthcare services. Five databases were searched for studies on children and young people's presentations to the PED for the treatment of a non-urgent condition, as identified by a low priority triage code. This article describes and discusses the findings of the 18 included studies.

据估计,在前往儿科急诊室(PED)就诊的儿童和青少年中,有 58% 至 82% 患有非急症。本系统性文献综述探讨了非急症患儿的家长为何会到儿科急诊室就诊,而不是到社区医疗服务机构就诊。我们在五个数据库中搜索了有关儿童和青少年到急诊室治疗非急症(由低优先级分诊代码确定)的研究。本文介绍并讨论了所纳入的 18 项研究的结果。
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引用次数: 0
Benefits of a collaborative approach to service evaluation in urgent care. 紧急护理服务评估合作方法的益处。
Q3 Nursing Pub Date : 2023-09-05 Epub Date: 2022-11-22 DOI: 10.7748/en.2022.e2160
Craig Brown, Deborah Armstrong, Alexandra Gibbins, Rhiannon Roynon, Alice Groves, Alastair Richards, Claire McCarthy, Richard Bowen, Helena White, Mike Brady

Collaboration and service evaluation are essential enablers for improving models of health and social care. Significant benefits can be achieved when they are combined to form a collaborative service evaluation, particularly when such collaboration involves different clinical professions. This article uses the NHS 111 Wales service to explore a simple example of collaborative service evaluation and to discuss the benefits and challenges identified. While the tabletop exercises described were expected to focus solely on compliance data and the reasons for non-compliance, broader learning was identified for all parties involved. It became clear that there was a lack of shared understanding of each service, and that there were opportunities for education and opportunities to develop new national pathways. It is hoped that readers may be able to compare, learn and possibly replicate the collaborative approach used in their practice settings to achieve similar outcomes.

合作与服务评估是改进医疗和社会护理模式的基本手段。当二者结合形成合作服务评估时,尤其是当这种合作涉及到不同的临床专业时,可以取得显著的效益。本文以威尔士国家医疗服务系统 111 服务为例,探讨了合作服务评估的一个简单例子,并讨论了所发现的益处和面临的挑战。虽然所述的桌面演练预计仅关注合规数据和不合规的原因,但对所有参与方而言,却发现了更广泛的学习内容。我们清楚地认识到,各方对每项服务都缺乏共同的理解,存在着教育机会和开发新的国家途径的机会。希望读者能够进行比较、学习,并在可能的情况下复制其实践环境中使用的合作方法,以取得类似的成果。
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引用次数: 0
Royal London wins city’s first autism inclusion award 皇家伦敦赢得了城市首个自闭症包容奖
Q3 Nursing Pub Date : 2023-09-05 DOI: 10.7748/en.31.5.6.s4
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引用次数: 0
Sepsis awareness month: a reminder of the need for swift action 脓毒症宣传月:提醒人们需要迅速采取行动
Q3 Nursing Pub Date : 2023-09-05 DOI: 10.7748/en.31.5.5.s1
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引用次数: 0
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Emergency Nurse
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