3.0 Critical Appraisal. This Chapter Will Explore The Main

A visit to the emergency department (ED) is usually associated with negative thoughts by most people. It creates preconceived images of overcrowded waiting rooms and routine long waits for treatment (Jarousse, 2011). From 1996 to 2006, ED visits increased annually from 90.3 million to 119.2 million (32% increase). During this same time period, the number of EDs has declined by 186 facilities creating the age old lower supply and greater demand concept (Crane & Noon, 2011). There are many contributing factors that have led to an increase in ED visits. A few of these key drivers include lack of primary care access, rising of the uninsured population, dwindling mental health services, and the growing elderly

The purpose of this report is to conduct a critical appraisal of a published article.

Once an area of evidence-based practice has been chosen for investigation, the reviewer must locate current evidence sources and, using a structured approach, assess each for applicability to the issue being investigated. The aim of this paper is to use a Rapid Critical Appraisal Checklist (Melnyk and Fineout-Overholt, 2011) to support these sources of evidence into a review that discusses the importance of daily, high-level, multidisciplinary communication and patient safety. The summaries of these evaluations will be provided as an appraisal of each study.

14 million Canadians visit Emergency Departments (ED) every year, and also reported to having the highest use of EDs (Ontario Hospital Association, 2006). ED overcrowding in Canada has become an epidemic. ED overcrowding has been defined as “a situation in which the demand for emergency services exceeds the ability of an (emergency) department to provide quality care within acceptable time frames” (Ontario Ministry of Health and Long Term Care, 2014). This has been an ongoing problem across Canada. Ontario has developed an initiative to reduce ED wait times by implementing a variety of strategies and collaborating with other institutions. This paper describes the Emergency Room National Ambulatory Intuitive (ERNI), an

The purpose of the research review was to attempt to answer the question, does monitoring naturietic peptide twice a month for a month post discharge and altering treatment plan vs. monitoring naturietic as standard practice and altering treatment plan decrease readmission rates in Heart Failure patients after discharge from the hospital? The dependent variable was readmission of Chronic Heart Failure patients (CHF). In order to answer this question, the Cochrane Database was searched using the keywords natriuretic peptide, CHF and readmissions with no limits. The search provided 8 results. According to research naturietric peptide aids in showing the probability for readmission and can therefore

An important aspect involved in critical appraisal of a study involves identifying and evaluating the study framework. This allows the reader to determine whether it is appropriate to apply the study findings to nursing practice. The author of this study identified the specific perspective from which the study was developed. More specifically, the author sought to provide insight into the phenomenon of lay presence during adult CPR specifically from the perspective of ambulance staff and

I would like to give you some insight as to the daily operation of a major Emergency Department in this city. Not unlike many other “ER’s” the nursing staff is tasked with the triage or assessment of patients in order to sort by priority. The nurse is then tasked with maintaining flow of the department and ensuring the timely care and physician evaluation of patients. This requires clinical nursing judgement and expertise which is tested constantly. To explain this plainly, nurses are faced with a meat grinder which cannot stop. There may be twenty patients in the lobby with ambulances lining up. The room nurses are trying to

In this article, the authors investigated the vulnerabilities in emergency department to internal medicine patient transfers through self-administered surveys of all emergency medicine house staff. More specifically, the survey investigated adverse events due to faulty communications during handoffs. According to this survey, 29% of the emergency staff reported either an adverse or near-miss event due to errors during handoffs. Furthermore, the survey respondents identified inaccurate or incomplete information, cultural and professional conflict, crowding, and many other factors as the contributors to handoff errors. By identifying specific contributors to handoff errors, this article serves as guidance for handoff intervention.

The author will discuss within the essay, the introduction of the Emergency Care Standard and the effects on patient flow within the NHS. Also, the many changes which have implications for the author professional practice and how if possible they maybe overcome.

Assess the current Models of Care in their Emergency Departments using the given criteria It is recognised that not all of the Models of Emergency Care are applicable for all NSW Emergency Departments. Decisions to implement them will be made based on the staff, patient presentations and space available in the ED to operate each model. Assess the potential to introduce models to their hospitals that may improve patient care and flow, the patient experience and clinical outcomes

Doctors are busy giving family members updates on their loved ones. Traumas are coming in with families in complete fear. Admitting staff trying to get information from the families to get patients registered while trying explain to patients why they must stay, and why some procedures aren’t covered by insurance. The thousands of questions the admitting staff get from patients about their stay all the while being invisible to majority of the staff. That is the Emergency room, that is what an ordinary person walking in does not see. The clicks and the social norms and the hierchy involved in hospital care. The disconnect of clinical staff from non-clinical staff. This same disconnect that contributes to low emergency room patient satisfaction scores, the reason why people leave the ER unhappy. People who work in the ER come in all shapes and sizes. Most of the nurses are females with just a few male nurses, all of which are between 20 to 60 years of age. Admitting staff is made up of males and females from different social backgrounds. The ER is a melting pot, which sometimes can be difficult to

In this course, we had group critical appraisal paper. Initially, the appraisal explored the use of palliative care among minority groups, but only qualitative research appeared for this topic. Due to limit research articles, so we had group meeting and met with librarian to discuss searching strategy. A decision was made to change the intervention to acupuncture treatment with the comparator being standard opioid medication in the outcome of reducing pain in palliative care patients. This proved to be a more successful topic when searching for relevant research. Based on the highest level of available evidence, three articles were selected from PubMed.

Visit your local Emergency Room on any given day and you are likely to witness a sort of controlled chaos: nurses, doctors, transporters, patient care technicians, and other ancillary staff members all darting about, attempting to meet the needs of increasingly sick patients in oft-overwhelmed and overpopulated hospitals. All around, various alarms sound. IV pumps signal fluid bags about to run dry. Vital sign monitors ping at differing volumes and intensities, in an electronic demand for staff to mind the out-of-normal-range

The boss’s evaluation is not good and fair for Sandy. And it is not helpful for Sandy to improve.

I am in agreement with your process of critical appraisals; identifying the steps in the research process, determining the strengths and weaknesses in the studies and evaluating the validity and credibility of the studies seem to be the root elements of critical appraisals. I appreciated the scholarly article you chose linking depression and mortality among diabetes mellitus patients, particularly because of the straightforwardness of the article. it seemed the conclusion and points of the article were straight forward and the article was easy to understand. If I could suggest any addition, it would be a way to verify the credibility of the study. maybe in this study in particular there is not much incentive for lack of credibility, but in