According to Lynch,1 "Forensic nurses care for individuals whose illness, injury or death stems from acts of violence, maltreatment, abuse, neglect, or exploitation."
Pediatric Readiness in the Emergency Department Remick, Katherine; Gausche-Hill, Marianne; Joseph, Madeline M. ...
Journal of emergency nursing,
January 2019, 2019-Jan, 2019-01-00, 20190101, Volume:
45, Issue:
1
Journal Article
Peer reviewed
Note: This is a revision of the previous joint policy statement titled “Guidelines for Care of Children in the Emergency Department.” Children have unique physical and psychosocial needs that are ...heightened in the setting of serious or life-threatening emergencies. The majority of ill and injured children are brought to community hospital emergency departments (EDs) by virtue of proximity. It is, therefore, imperative that all EDs have the appropriate resources (medications, equipment, policies, and education) and capable staff to provide effective emergency care for children. This policy statement outlines resources necessary for EDs to stand ready to care for children of all ages. These recommendations are consistent with the recommendations of the Institute of Medicine (now called the National Academy of Medicine) in its report “The Future of Emergency Care in the United States Health System.” Although resources within emergency and trauma care systems vary locally, regionally, and nationally, it is essential that ED staff, administrators, and medical directors seek to meetor exceedthese recommendations to ensure high-quality emergency care is available for all children. These updated recommendations are intended to serve as a resource for clinical and administrative leadership of EDs as they strive to improve their readiness for children of all ages.
The emergency department is a stressful and high-risk area of the hospital at any time but particularly when ED staff are caring for an acutely ill child. ED nurses are dedicated, hard working, and ...highly skilled, but errors continue to occur despite the availability of specialized courses such as Pediatric Advanced Life Support and the ENA Emergency Nurse Pediatric Course. Here, Foresman-Capuzzi specifically discusses the effective delivering of resuscitation medications to pediatric patients.
Foresman-Capuzzi and Eckenrode discuss the appropriate pediatric equipment, medications, and competency of care in accordance with the joint policy statement on guidelines for care of children in the ...emergency department issued by the American Academy of Pediatrics. This landmark publication recommends that all emergency departments need to be prepared to care for children and describe and elaborate on seven major sections to arrive at that standard with one section that describe the guidelines for policies, procedures, and protocols to address all-hazard preparedness plans for children. Although many emergency departments plan and perform drills regularly for adults, there is often not a focus on the special needs of the pediatric population.
More Big Help from Little Tools Foresman-Capuzzi, Joyce
Journal of emergency nursing,
05/2009, Volume:
35, Issue:
3
Journal Article
Peer reviewed
Foresman-Capuzzi presents tips and tricks for respiratory assessment and treatment, successful intravenous access, and medication administration. ED nurses are aware of the importance of the ...respiratory assessment, especially in the child. Knowing that the child's condition can quickly deteriorate if respiratory conditions are not recognized, the ED nurse must act quickly to intervene to meet the needs of the child and at the same time gain the parents' confidence. Here are some tips for administering supplemental oxygen. Because a younger child likely will not know what oxygen is, one can use the term "fresh air," which is a concept they may understand.
Big Help From Little Tools Foresman-Capuzzi, Joyce
Journal of emergency nursing,
10/2008, Volume:
34, Issue:
5
Journal Article
Peer reviewed
Open access
When it comes to caring for children, emergency nurses needs some tools in the toolbox to provide the confidence needed to face the challenge. Firts, it must be remembered that "play is the work of ...the child." The emergency nurse who keeps this adage in mind will go a long way in developing a relationship with the child and his or her family. Although this may add some minutes to tasks and require some extra creativity, it will allow the child to receive optimal care and will make the work of the nurse much easier. Here, Foresman-Capuzzi offers some "down and dirty" tips for caring for children.
This is a revision of the previous joint Policy Statement titled "Guidelines for Care of Children in the Emergency Department." Children have unique physical and psychosocial needs that are ...heightened in the setting of serious or life-threatening emergencies. The majority of children who are ill and injured are brought to community hospital emergency departments (EDs) by virtue of proximity. It is therefore imperative that all EDs have the appropriate resources (medications, equipment, policies, and education) and capable staff to provide effective emergency care for children. In this Policy Statement, we outline the resources necessary for EDs to stand ready to care for children of all ages. These recommendations are consistent with the recommendations of the Institute of Medicine (now called the National Academy of Medicine) in its report "The Future of Emergency Care in the US Health System." Although resources within emergency and trauma care systems vary locally, regionally, and nationally, it is essential that ED staff, administrators, and medical directors seek to meet or exceed these recommendations to ensure that high-quality emergency care is available for all children. These updated recommendations are intended to serve as a resource for clinical and administrative leadership in EDs as they strive to improve their readiness for children of all ages.
Foresman-Capuzzi advises that advanced preparation by the Emergency department staff is vital to appropriately caring for the patient, the grieving family, and the staff. Emergency department nurses ...must view this subject as an opportunity to promote best practice guidelines and develop core competencies for the death of a child. It is beneficial for the ED nurse to incorporate considerations such as family presence during resuscitation, forensic evidence collection, cultural diversity, organ procurement, critical incident debriefing, and consent for autopsy when holistically caring for the patient and family in this situation.
Abstract only Introduction: Anecdotal stories exist about pausing to honor resuscitation teams and the patient after in-hospital deaths. It is unknown whether conducting a moment of silence (MOS) at ...the time of death impacts caregivers. Objectives: We sought to assess whether implementing a scripted and brief, secular MOS ritual after a patient dies reduces healthcare team burnout or improves resiliency. Methods: We conducted an unblinded, prospective cohort study of multidisciplinary intensive care unit (ICU) staff from two hospitals, implementing the MOS in one ICU with the other a control. The Maslach Burnout Inventory (MBI) was administered pre- and post-implementation and focus groups obtained qualitative feedback. Changes in median composite scores were assessed for comparisons using the Wilcoxon Signed-Rank Test. Results: We obtained 25 pre-post paired responses. The implementation ICU’s respondents included more physicians (36.4% vs 0%, p=0.032) with no difference in other measured characteristics. MBI scores pre-implementation were similar. After implementation, intervention staff had a significant decrease in median Depersonalization subscore on the MBI (median: 8 vs 6; p=0.045). MBI Emotional Exhaustion subscore trended toward improvement (median: 26 vs 24; p=0.075) and the Personal Accomplishment subscore was unchanged (median: 37 vs 34; p=0.18). No significant changes over time in MBI scores were noted in the staff from the control ICU. Qualitative feedback was universally positive, resulting in dissemination of the MOS system-wide. Conclusion: Implementation of a brief, secular MOS ritual in a community hospital’s ICU was associated with decreased burnout, specifically in the Depersonalization domain. This may be due to the creation of a formalized, group time for clinicians, nurses and multidisciplinary staff to attend to their own emotions after a patient death. Rollout of the scripted MOS intervention across the 5-hospital system, including distinctive phraseology for the pediatric, peri-operative, and maternity settings, shows widespread buy-in including within health system leadership. Larger studies and those conducted in other healthcare settings would increase confidence in the generalizability of results.
The case study of a 65-year-old woman presenting to the emergency department with bilateral jaw pain is presented. The charge nurse was surprised to find a diagnosis of mumps on discharge. The ...implications of overlooking infectious diseases that have been nearly eliminated are discussed.
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