Pub Date : 2025-06-30DOI: 10.1016/j.auec.2025.06.005
Jeffery Faccenda , Natasha Jennings , Kathleen Tori
Quality of patient care in emergency departments is a key indicator of healthcare performance. While the role of Nurse Practitioners (NPs) in adult emergency care is well established, limited research exists on Paediatric Emergency Nurse Practitioners, particularly in the Australian context. This study retrospectively evaluated patient demographics and emergency department service indicators—including waiting time and overall length of stay—for patients in the Paediatric Emergency Department of a tertiary hospital in South Australia. A descriptive exploratory design included all patients managed by Paediatric Nurse Practitioners for a complete episode of care between December 1, 2022, and December 1, 2023. 4849 patients were included, with more males (58.7 %, n = 2845) than females (41.3 %, n = 2004), and a median age of 9 years (IQR 5–13). Median waiting time was 36 min (IQR 18–68), and median length of stay was 129 min (IQR 92–178). Most patients (94.1 %, n = 4561) were discharged home. Common presentations included head wounds (16.1 %, n = 781), distal radius fractures (7.9 %, n = 386), and hand injuries (7.3 %, n = 355). This first evaluation offers insight into patient characteristics and service benchmarks, demonstrating need for further research to support comparisons with other Paediatric Emergency Department services.
急诊病人护理质量是医疗保健绩效的关键指标。虽然护士从业人员（NPs）在成人急诊护理中的作用已经确立，但对儿科急诊护士从业人员的研究有限，特别是在澳大利亚的背景下。本研究回顾性评估了南澳大利亚一家三级医院儿科急诊科患者的人口统计数据和急诊科服务指标，包括等待时间和住院总时间。描述性探索性设计纳入了2022年12月1日至2023年12月1日期间由儿科执业护士管理的所有患者。纳入4849例患者，男性（58.7 %,n = 2845）多于女性（41.3 %,n = 2004），中位年龄为9岁（IQR 5-13）。中位等待时间为36 min (IQR 18-68)，中位停留时间为129 min （IQR 92-178）。大多数患者出院回家（94.1 %,n = 4561）。常见症状包括头部受伤(16.1 % n = 781),半径远端骨折(7.9 % n = 386),和手受伤(7.3 % n = 355)。第一次评估提供了对患者特征和服务基准的深入了解，表明需要进一步研究以支持与其他儿科急诊科服务的比较。
{"title":"Evaluating a paediatric emergency nurse practitioner service in South Australia: A retrospective analysis of 12 months of patient presentations","authors":"Jeffery Faccenda , Natasha Jennings , Kathleen Tori","doi":"10.1016/j.auec.2025.06.005","DOIUrl":"10.1016/j.auec.2025.06.005","url":null,"abstract":"<div><div>Quality of patient care in emergency departments is a key indicator of healthcare performance. While the role of Nurse Practitioners (NPs) in adult emergency care is well established, limited research exists on Paediatric Emergency Nurse Practitioners, particularly in the Australian context. This study retrospectively evaluated patient demographics and emergency department service indicators—including waiting time and overall length of stay—for patients in the Paediatric Emergency Department of a tertiary hospital in South Australia. A descriptive exploratory design included all patients managed by Paediatric Nurse Practitioners for a complete episode of care between December 1, 2022, and December 1, 2023. 4849 patients were included, with more males (58.7 %, n = 2845) than females (41.3 %, n = 2004), and a median age of 9 years (IQR 5–13). Median waiting time was 36 min (IQR 18–68), and median length of stay was 129 min (IQR 92–178). Most patients (94.1 %, n = 4561) were discharged home. Common presentations included head wounds (16.1 %, n = 781), distal radius fractures (7.9 %, n = 386), and hand injuries (7.3 %, n = 355). This first evaluation offers insight into patient characteristics and service benchmarks, demonstrating need for further research to support comparisons with other Paediatric Emergency Department services.</div></div>","PeriodicalId":55979,"journal":{"name":"Australasian Emergency Care","volume":"28 4","pages":"Pages 300-306"},"PeriodicalIF":2.1,"publicationDate":"2025-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144546292","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-06-26DOI: 10.1016/j.auec.2025.06.004
Eillish Satchell , Merryn Gott , Madeleine Juhrmann , Bridget Dicker , Natalie Elizabeth Anderson
Background
Ambulance personnel play an important role in supporting families during death, dying, and bereavement. Evidence-based clinical practice guidelines are crucial for ensuring high-quality ambulance care. However, it is unknown what guidance currently informs care of bereaved families. This document analysis examines ambulance guidelines pertaining to family care in out-of-hospital death in Australia and Aotearoa New Zealand.
Methods
Clinical practice guidelines were sourced from all Australian and Aotearoa New Zealand ambulance services. Using qualitative document analysis, guidance addressing family care during death, dying, and bereavement was examined. Analysis was conducted using a customised coding framework informed by the Australian National Consensus Statement: Essential Elements for safe and high-quality end-of-life care.
Results
While most guidelines included essential elements of end-of-life care, there was significant heterogeneity in the scope, detail and nature of guidance. Care instructions varied between services, populations and clinical scenarios. Guidance pertaining to culturally safe care was limited.
Conclusions
Ambulance clinical guidance remains focused on technical skills during resuscitation, death, and dying. More guidance is needed to inform important elements of family care such as communication, family partnership, and cultural safety. Incorporating evidenced-based principles of end-of-life care presents an opportunity to improve ambulance support for bereaved families.
{"title":"Emergency ambulance care of families during death, dying, and bereavement: A document analysis of Australian and Aotearoa New Zealand clinical practice guidelines","authors":"Eillish Satchell , Merryn Gott , Madeleine Juhrmann , Bridget Dicker , Natalie Elizabeth Anderson","doi":"10.1016/j.auec.2025.06.004","DOIUrl":"10.1016/j.auec.2025.06.004","url":null,"abstract":"<div><h3>Background</h3><div>Ambulance personnel play an important role in supporting families during death, dying, and bereavement. Evidence-based clinical practice guidelines are crucial for ensuring high-quality ambulance care. However, it is unknown what guidance currently informs care of bereaved families. This document analysis examines ambulance guidelines pertaining to family care in out-of-hospital death in Australia and Aotearoa New Zealand.</div></div><div><h3>Methods</h3><div>Clinical practice guidelines were sourced from all Australian and Aotearoa New Zealand ambulance services. Using qualitative document analysis, guidance addressing family care during death, dying, and bereavement was examined. Analysis was conducted using a customised coding framework informed by the Australian National Consensus Statement: Essential Elements for safe and high-quality end-of-life care.</div></div><div><h3>Results</h3><div>While most guidelines included essential elements of end-of-life care, there was significant heterogeneity in the scope, detail and nature of guidance. Care instructions varied between services, populations and clinical scenarios. Guidance pertaining to culturally safe care was limited.</div></div><div><h3>Conclusions</h3><div>Ambulance clinical guidance remains focused on technical skills during resuscitation, death, and dying. More guidance is needed to inform important elements of family care such as communication, family partnership, and cultural safety. Incorporating evidenced-based principles of end-of-life care presents an opportunity to improve ambulance support for bereaved families.</div></div>","PeriodicalId":55979,"journal":{"name":"Australasian Emergency Care","volume":"28 4","pages":"Pages 294-299"},"PeriodicalIF":2.1,"publicationDate":"2025-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144512743","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-06-25DOI: 10.1016/j.auec.2025.06.002
Mohd Idzwan Zakaria
This letter highlights the lack of standardised frailty assessment in Malaysia’s prehospital emergency care and contrasts it with emerging practices in Australia. It advocates for system-wide improvements including training, integration, and policy reform to support frailty screening, aiming to enhance outcomes for older adults in resource-limited settings
{"title":"Frailty assessment in prehospital care: Bridging the gap in Malaysia’s emergency services","authors":"Mohd Idzwan Zakaria","doi":"10.1016/j.auec.2025.06.002","DOIUrl":"10.1016/j.auec.2025.06.002","url":null,"abstract":"<div><div>This letter highlights the lack of standardised frailty assessment in Malaysia’s prehospital emergency care and contrasts it with emerging practices in Australia. It advocates for system-wide improvements including training, integration, and policy reform to support frailty screening, aiming to enhance outcomes for older adults in resource-limited settings</div></div>","PeriodicalId":55979,"journal":{"name":"Australasian Emergency Care","volume":"28 4","pages":"Page 249"},"PeriodicalIF":2.1,"publicationDate":"2025-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144499482","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-06-25DOI: 10.1016/j.auec.2025.06.006
Angela Park , Richard Armour , Kate Cantwell
Background
Tension pneumothorax (TPTX) is a life-threatening condition requiring rapid diagnosis and management. However, accurate diagnosis is challenging in the prehospital environment. We sought to investigate the clinical presentation of TPTX in the prehospital environment. Secondary objectives were to investigate if any vital signs are independently associated with TPTX, and if any differences in vital signs of TPTX exist between patients based on ventilatory status.
Methods
We conducted a retrospective cohort study of adult patients > 18 years of age, not in cardiac arrest, who received thoracostomy from paramedics in Ambulance Victoria between January 2020 and July 2023. Descriptive characteristics, vital signs and management data were collected. Patients were defined as having had a TPTX if they met a published definition criterion of TPTX. A secondary sub-group sample was created by dividing patients in the TPTX group based on their ventilatory status at the time of thoracostomy (positive pressure ventilated [PPV] or spontaneously ventilating [SV]). Descriptive statistics, univariate analysis and multivariate analysis via logistic regression were performed.
Results
A total of 361 patients were included, with 179 (49.6 %) of these patients meeting the definition criteria of TPTX. Out of these, 67 were receiving PPV and 112 were SV. The median age of patients with TPTX was 44 years, most (79 %) were male, most occurred secondary to trauma (91.6 %). Out of patients with TPTX, 98 (87.5 %) had an altered conscious state, 128 (71.5 %) were tachycardic, 75 (41.9 %) were hypotensive, 33 (18.4 %) had an unrecordable blood pressure, 97 (54.2 %) had hypoxemia, and 82 (73.2 %) were tachypneic. Hypotension (aOR 2.04; 95 % CI 1.09–3.79; p = 0.025) and hypoxemia (aOR 2.12; 95 % CI 1.18–3.81; p = 0.011) were independently associated with the presence of TPTX in multivariate analysis. When comparing vital signs between SV and PPV patients with TPTX, no vital signs reached a statistically significant difference in multivariate analysis.
Conclusion
The presence of hypoxemia and hypotension were independently associated with the presence of TPTX. Vital signs associated with the presence of TPTX did not differ by ventilatory status of the patient. Future research should report on conscious state assessment and respiratory rate when investigating the clinical presentation of TPTX.
{"title":"Clinical presentation of tension pneumothorax among patients undergoing prehospital thoracostomy: A retrospective cohort study","authors":"Angela Park , Richard Armour , Kate Cantwell","doi":"10.1016/j.auec.2025.06.006","DOIUrl":"10.1016/j.auec.2025.06.006","url":null,"abstract":"<div><h3>Background</h3><div>Tension pneumothorax (TPTX) is a life-threatening condition requiring rapid diagnosis and management. However, accurate diagnosis is challenging in the prehospital environment. We sought to investigate the clinical presentation of TPTX in the prehospital environment. Secondary objectives were to investigate if any vital signs are independently associated with TPTX, and if any differences in vital signs of TPTX exist between patients based on ventilatory status.</div></div><div><h3>Methods</h3><div>We conducted a retrospective cohort study of adult patients > 18 years of age, not in cardiac arrest, who received thoracostomy from paramedics in Ambulance Victoria between January 2020 and July 2023. Descriptive characteristics, vital signs and management data were collected. Patients were defined as having had a TPTX if they met a published definition criterion of TPTX. A secondary sub-group sample was created by dividing patients in the TPTX group based on their ventilatory status at the time of thoracostomy (positive pressure ventilated [PPV] or spontaneously ventilating [SV]). Descriptive statistics, univariate analysis and multivariate analysis via logistic regression were performed.</div></div><div><h3>Results</h3><div>A total of 361 patients were included, with 179 (49.6 %) of these patients meeting the definition criteria of TPTX. Out of these, 67 were receiving PPV and 112 were SV. The median age of patients with TPTX was 44 years, most (79 %) were male, most occurred secondary to trauma (91.6 %). Out of patients with TPTX, 98 (87.5 %) had an altered conscious state, 128 (71.5 %) were tachycardic, 75 (41.9 %) were hypotensive, 33 (18.4 %) had an unrecordable blood pressure, 97 (54.2 %) had hypoxemia, and 82 (73.2 %) were tachypneic. Hypotension (aOR 2.04; 95 % CI 1.09–3.79; p = 0.025) and hypoxemia (aOR 2.12; 95 % CI 1.18–3.81; p = 0.011) were independently associated with the presence of TPTX in multivariate analysis. When comparing vital signs between SV and PPV patients with TPTX, no vital signs reached a statistically significant difference in multivariate analysis.</div></div><div><h3>Conclusion</h3><div>The presence of hypoxemia and hypotension were independently associated with the presence of TPTX. Vital signs associated with the presence of TPTX did not differ by ventilatory status of the patient. Future research should report on conscious state assessment and respiratory rate when investigating the clinical presentation of TPTX.</div></div>","PeriodicalId":55979,"journal":{"name":"Australasian Emergency Care","volume":"28 4","pages":"Pages 307-313"},"PeriodicalIF":2.1,"publicationDate":"2025-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144509579","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-06-19DOI: 10.1016/j.auec.2025.06.001
Shanley Chong , Helen M. Achat , Joanne M. Stubbs , Mark McLean
Background
Patients with mental health (MH) problems are at higher-than-average risk of leaving emergency departments (EDs) against medical advice and of re-presentations. For patients with a MH diagnosis in ED, we aimed to identify factors associated with patients who leave at own risk (LAOR) and the association between LAOR and 7- and 28-day re-presentations.
Methods
A retrospective analysis of all MH presentations to public hospital EDs in a Local Health District in Sydney, Australia between 2022 and 2023. GLIMMIX logistic regression models explored associations between patient and healthcare characteristics and risk of LAOR, and between LAOR and re-presentations.
Results
Patients more likely to LAOR were younger than 60, born in Australia, arrived at the ED between 4 pm and 8 am by private transport, were not triaged as resuscitation/emergency, had treatment initiated outside the triage benchmark time, and had an “Unspecified mental disorder” diagnosis. LAOR was inversely associated with time spent in the ED. LAOR was independently positively associated with a multi-fold risk of 7- and 28-day re-presentation.
Conclusion
Aspects of individual circumstances, healthcare, and patient’s MH contribute to LAOR incidence. Future research should examine the potential long-term consequences of LAOR for MH patients and disentangle factors affecting the ED’s care of MH presentations. (195 words)
{"title":"Who has incomplete emergency department care among mental health patients in Australia? Does it impact short and longer-term representations?","authors":"Shanley Chong , Helen M. Achat , Joanne M. Stubbs , Mark McLean","doi":"10.1016/j.auec.2025.06.001","DOIUrl":"10.1016/j.auec.2025.06.001","url":null,"abstract":"<div><h3>Background</h3><div>Patients with mental health (MH) problems are at higher-than-average risk of leaving emergency departments (EDs) against medical advice and of re-presentations. For patients with a MH diagnosis in ED, we aimed to identify factors associated with patients who leave at own risk (LAOR) and the association between LAOR and 7- and 28-day re-presentations.</div></div><div><h3>Methods</h3><div>A retrospective analysis of all MH presentations to public hospital EDs in a Local Health District in Sydney, Australia between 2022 and 2023. GLIMMIX logistic regression models explored associations between patient and healthcare characteristics and risk of LAOR, and between LAOR and re-presentations.</div></div><div><h3>Results</h3><div>Patients more likely to LAOR were younger than 60, born in Australia, arrived at the ED between 4 pm and 8 am by private transport, were not triaged as resuscitation/emergency, had treatment initiated outside the triage benchmark time, and had an “Unspecified mental disorder” diagnosis. LAOR was inversely associated with time spent in the ED. LAOR was independently positively associated with a multi-fold risk of 7- and 28-day re-presentation.</div></div><div><h3>Conclusion</h3><div>Aspects of individual circumstances, healthcare, and patient’s MH contribute to LAOR incidence. Future research should examine the potential long-term consequences of LAOR for MH patients and disentangle factors affecting the ED’s care of MH presentations. (195 words)</div></div>","PeriodicalId":55979,"journal":{"name":"Australasian Emergency Care","volume":"28 4","pages":"Pages 287-293"},"PeriodicalIF":2.1,"publicationDate":"2025-06-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144337218","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-05-27DOI: 10.1016/j.auec.2025.05.006
Luise Kazda , Kristen Pickles , Philomena Colagiuri , Katy Bell , Brian O’Connell , Erin Mathieu , on behalf of the NSW Health Net Zero Clinical Leads Program
Background
Pathology testing in emergency departments (EDs) is often unnecessary, leading to avoidable financial and environmental costs without improving clinical care. This overview summarises interventions to reduce pathology testing in EDs, their effectiveness, and any resulting financial, environmental, patient, or staff impacts.
Methods
We searched multiple databases up to February 2025 and conducted citation searches. Eligible studies included intervention and aetiological observational studies of pathology tests in EDs. Secondary studies and conference abstracts were excluded.
Results
Of 1,755 records, 34 studies met inclusion criteria: 32 quality improvement studies, one cohort study, and one randomised controlled trial. Interventions included ordering system changes, education, audit & feedback, guideline development, penalties, and alternative care models. Significant reductions ranging from 1.5% to 99% (median: 29%) in targeted pathology tests were reported in 33 of 34 studies. All 25 studies reporting financial impacts found cost reductions, with potential savings up to AUS$1 million in one Australian ED over 18 months (median:US$247,000 per year for nine studies reporting annual savings in US$). No adverse patient or staff impacts were found. No studies reported on environmental impacts.
Conclusion
Nearly all interventions reduced test frequency with beneficial or no impacts on patient care and staff efficiency, along with notable cost savings. Future studies should include environmental impacts and assess clinical care co-benefits of reducing unnecessary pathology testing.
{"title":"Reducing pathology testing in emergency departments: A scoping review","authors":"Luise Kazda , Kristen Pickles , Philomena Colagiuri , Katy Bell , Brian O’Connell , Erin Mathieu , on behalf of the NSW Health Net Zero Clinical Leads Program","doi":"10.1016/j.auec.2025.05.006","DOIUrl":"10.1016/j.auec.2025.05.006","url":null,"abstract":"<div><h3>Background</h3><div>Pathology testing in emergency departments (EDs) is often unnecessary, leading to avoidable financial and environmental costs without improving clinical care. This overview summarises interventions to reduce pathology testing in EDs, their effectiveness, and any resulting financial, environmental, patient, or staff impacts.</div></div><div><h3>Methods</h3><div>We searched multiple databases up to February 2025 and conducted citation searches. Eligible studies included intervention and aetiological observational studies of pathology tests in EDs. Secondary studies and conference abstracts were excluded.</div></div><div><h3>Results</h3><div>Of 1,755 records, 34 studies met inclusion criteria: 32 quality improvement studies, one cohort study, and one randomised controlled trial. Interventions included ordering system changes, education, audit & feedback, guideline development, penalties, and alternative care models. Significant reductions ranging from 1.5% to 99% (median: 29%) in targeted pathology tests were reported in 33 of 34 studies. All 25 studies reporting financial impacts found cost reductions, with potential savings up to AUS$1 million in one Australian ED over 18 months (median:US$247,000 per year for nine studies reporting annual savings in US$). No adverse patient or staff impacts were found. No studies reported on environmental impacts.</div></div><div><h3>Conclusion</h3><div>Nearly all interventions reduced test frequency with beneficial or no impacts on patient care and staff efficiency, along with notable cost savings. Future studies should include environmental impacts and assess clinical care co-benefits of reducing unnecessary pathology testing.</div></div>","PeriodicalId":55979,"journal":{"name":"Australasian Emergency Care","volume":"28 4","pages":"Pages 250-263"},"PeriodicalIF":2.1,"publicationDate":"2025-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144163777","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-05-26DOI: 10.1016/j.auec.2025.05.002
Sophie Dilworth , Jean Ball , Michelle Giles , Lynette Lackay , Candice Dahlstrom , Michael Fahy , Peter Massey , Gena Lieschke
In Australia emergency department (ED) workflows have traditionally been reliant on a medical workforce. Ongoing and critical medical workforce shortages in rural areas have resulted in sub-optimal access to emergency department services. Nurse Practitioners (NP) have been proposed as one solution to the crisis. This study aimed to examine patient experiences and satisfaction with a newly implemented rural emergency department nurse practitioner model of care (RED-NP MoC). Between November 2023 to June 2024, patients seen by NPs in one of five participating emergency departments were invited to complete an anonymous online or telephone survey. A total 382 participants responded to the survey (22 % response rate). Over 90 % of patients agreed or strongly agreed that the NP listened to them, had time to talk to them, explained in a way that could be understood, was thorough, provided high quality care, was trustworthy and gave good advice. Similarly, over 90 % of patients were satisfied with the care they received from the NP and would be happy to see the NP in the ED again. Most additional comments about the RED-NP MoC supported the quantitative findings, expressing positive experiences. The RED-NP-MoC was highly acceptable to surveyed patients attending five rural hospital EDs.
{"title":"Patient acceptability and satisfaction with the rural emergency department nurse practitioner model of care (RED-NP MoC)","authors":"Sophie Dilworth , Jean Ball , Michelle Giles , Lynette Lackay , Candice Dahlstrom , Michael Fahy , Peter Massey , Gena Lieschke","doi":"10.1016/j.auec.2025.05.002","DOIUrl":"10.1016/j.auec.2025.05.002","url":null,"abstract":"<div><div>In Australia emergency department (ED) workflows have traditionally been reliant on a medical workforce. Ongoing and critical medical workforce shortages in rural areas have resulted in sub-optimal access to emergency department services. Nurse Practitioners (NP) have been proposed as one solution to the crisis. This study aimed to examine patient experiences and satisfaction with a newly implemented rural emergency department nurse practitioner model of care (RED-NP MoC). Between November 2023 to June 2024, patients seen by NPs in one of five participating emergency departments were invited to complete an anonymous online or telephone survey. A total 382 participants responded to the survey (22 % response rate). Over 90 % of patients agreed or strongly agreed that the NP listened to them, had time to talk to them, explained in a way that could be understood, was thorough, provided high quality care, was trustworthy and gave good advice. Similarly, over 90 % of patients were satisfied with the care they received from the NP and would be happy to see the NP in the ED again. Most additional comments about the RED-NP MoC supported the quantitative findings, expressing positive experiences. The RED-NP-MoC was highly acceptable to surveyed patients attending five rural hospital EDs.</div></div>","PeriodicalId":55979,"journal":{"name":"Australasian Emergency Care","volume":"28 4","pages":"Pages 268-273"},"PeriodicalIF":2.1,"publicationDate":"2025-05-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144163775","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-05-24DOI: 10.1016/j.auec.2025.05.005
Syed Aaraiz Ul Hassan, Noor Ul Huda, Maryam Maheen
{"title":"Mild and moderate traumatic brain injury: Screening, documentation and referral to concussion services","authors":"Syed Aaraiz Ul Hassan, Noor Ul Huda, Maryam Maheen","doi":"10.1016/j.auec.2025.05.005","DOIUrl":"10.1016/j.auec.2025.05.005","url":null,"abstract":"","PeriodicalId":55979,"journal":{"name":"Australasian Emergency Care","volume":"28 4","pages":"Pages 247-248"},"PeriodicalIF":2.1,"publicationDate":"2025-05-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144144541","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-05-15DOI: 10.1016/j.auec.2025.05.004
Carrie Janerka , Gavin D. Leslie , Fenella J. Gill , PCC ED Triage Group
Background
A person-centred care approach is widely considered a standard for quality healthcare and has been adopted in various acute care settings. However, emergency department (ED) triage presents unique challenges to operationalising person-centred care and provision in this setting is unclear. This study aimed to explore nurses’ perspectives of person-centred care at ED triage and waiting room.
Methods
A cross-sectional study of triage nurses across Australia was conducted to understand nurses’ knowledge, attitudes and provision of person-centred care. Quantitative data were analysed using descriptive statistics. Responses to open-ended questions were analysed inductively and deductively using the Picker principles of person-centred care.
Results
176 survey responses from nurses across a range of EDs were received. Nurses reported they understood concepts and benefits of person-centred care, yet provision of it varied. Time constraints, high volumes of patients, inadequate staffing and environmental constraints were common barriers. Nurses reported using communication and interpersonal skills, patient involvement and nurse-initiated interventions as strategies for person-centred care.
Conclusions
System and organisational-level factors challenge the provision of person-centred care, despite individual efforts by triage nurses. To facilitate person-centred care at ED triage and in the waiting room, consideration of the ED triage context, processes and outcomes is necessary.
{"title":"A cross-sectional survey reporting nurses’ perspectives of person-centred care at emergency department triage and waiting room in Australia","authors":"Carrie Janerka , Gavin D. Leslie , Fenella J. Gill , PCC ED Triage Group","doi":"10.1016/j.auec.2025.05.004","DOIUrl":"10.1016/j.auec.2025.05.004","url":null,"abstract":"<div><h3>Background</h3><div>A person-centred care approach is widely considered a standard for quality healthcare and has been adopted in various acute care settings. However, emergency department (ED) triage presents unique challenges to operationalising person-centred care and provision in this setting is unclear. This study aimed to explore nurses’ perspectives of person-centred care at ED triage and waiting room.</div></div><div><h3>Methods</h3><div>A cross-sectional study of triage nurses across Australia was conducted to understand nurses’ knowledge, attitudes and provision of person-centred care. Quantitative data were analysed using descriptive statistics. Responses to open-ended questions were analysed inductively and deductively using the Picker principles of person-centred care.</div></div><div><h3>Results</h3><div>176 survey responses from nurses across a range of EDs were received. Nurses reported they understood concepts and benefits of person-centred care, yet provision of it varied. Time constraints, high volumes of patients, inadequate staffing and environmental constraints were common barriers. Nurses reported using communication and interpersonal skills, patient involvement and nurse-initiated interventions as strategies for person-centred care.</div></div><div><h3>Conclusions</h3><div>System and organisational-level factors challenge the provision of person-centred care, despite individual efforts by triage nurses. To facilitate person-centred care at ED triage and in the waiting room, consideration of the ED triage context, processes and outcomes is necessary.</div></div>","PeriodicalId":55979,"journal":{"name":"Australasian Emergency Care","volume":"28 4","pages":"Pages 280-286"},"PeriodicalIF":2.1,"publicationDate":"2025-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144086932","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-05-09DOI: 10.1016/j.auec.2025.05.003
Ba Tuan Nguyen , C. Leigh Blizzard , Andrew Palmer , Huu Tu Nguyen , Quyet Thang Cong , Viet Tran , Toi Lam Phung , Marcus Skinner , Haydn Perndt , Mark R. Nelson
Background
Road trauma is a major public health problem in Vietnam. The Vietnamese medical education system is deficient in providing education to address this. The Primary Trauma Care (PTC) course has been used but not yet been evaluated for its impact on patient outcomes'. We conducted this study to assess the impact of the PTC course on patient outcomes in 2 local hospitals in Vietnam.
Methods
The research was a prospective before and after intervention study. The intervention (PTC course) was run over 2 days in 2021. The outcomes reported here are mortality at 24 hours, 30 days, and length of hospital stay. Univariate analyses were conducted using χ2 to investigate the effectiveness of the course. Multivariate analysis was also taken to control for confounding factors. Fisher’s exact test was used to discern statistical significance.
Result
The PTC course halved 24-hour and 30-day mortality from 2.9 % and 4.6 % in the pre-course to 1.0 % and 2.4 % in the post-course period respectively (p < 0.01). However, it failed to shorten the length of hospital stay from 9.0 ± 7.8–8.2 ± 7.1 days (p = 0.458).
Conclusion
The PTC course was effective in two Vietnamese hospitals in improving road trauma survival without reducing the length of hospital stay.
{"title":"PISTACHIO (Primary Trauma Care Course Impact & Outcome): A prospective before and after intervention study of the Primary Trauma Care course effect on road trauma morbidity and mortality in two Vietnamese hospitals","authors":"Ba Tuan Nguyen , C. Leigh Blizzard , Andrew Palmer , Huu Tu Nguyen , Quyet Thang Cong , Viet Tran , Toi Lam Phung , Marcus Skinner , Haydn Perndt , Mark R. Nelson","doi":"10.1016/j.auec.2025.05.003","DOIUrl":"10.1016/j.auec.2025.05.003","url":null,"abstract":"<div><h3>Background</h3><div>Road trauma<span><span> is a major public health problem in Vietnam. The Vietnamese </span>medical education system is deficient in providing education to address this. The Primary Trauma Care (PTC) course has been used but not yet been evaluated for its impact on patient outcomes'. We conducted this study to assess the impact of the PTC course on patient outcomes in 2 local hospitals in Vietnam.</span></div></div><div><h3>Methods</h3><div><span>The research was a prospective before and after intervention study. The intervention (PTC course) was run over 2 days in 2021. The outcomes reported here are mortality at 24 hours, 30 days, and length of hospital stay. Univariate analyses were conducted using χ</span><sup>2</sup><span> to investigate the effectiveness of the course. Multivariate analysis<span> was also taken to control for confounding factors. Fisher’s exact test was used to discern statistical significance.</span></span></div></div><div><h3>Result</h3><div>The PTC course halved 24-hour and 30-day mortality from 2.9 % and 4.6 % in the pre-course to 1.0 % and 2.4 % in the post-course period respectively (p < 0.01). However, it failed to shorten the length of hospital stay from 9.0 ± 7.8–8.2 ± 7.1 days (p = 0.458).</div></div><div><h3>Conclusion</h3><div>The PTC course was effective in two Vietnamese hospitals in improving road trauma survival without reducing the length of hospital stay.</div></div>","PeriodicalId":55979,"journal":{"name":"Australasian Emergency Care","volume":"28 4","pages":"Pages 274-279"},"PeriodicalIF":2.1,"publicationDate":"2025-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144040913","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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