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Biomedical subjects

Paul O'Donovan

Publications and source records attributed to Paul O'Donovan.

3 recordsLinked to original sources

The forensic nurse practitioner role (emergency nursing)--potential response to changing health needs in New Zealand.

There is little existing policy related to Forensic Evidence collection in the Emergency Department environment within New Zealand (NZ). A case study based on the Christchurch Hospital Emergency Department (ChCh ED) environment is presented, which outlines the need to develop a specialised nursing role, that of Forensic Nurse Practitioner (emergency care). The role of nursing input in the field of Forensic Medicine in NZ is essentially limited to the psychiatric focus. While roles such as those of the Forensic Psychiatric Nurse are relatively well established, there is an apparent absence of other 'forensic' functions, in particular those related to victims or perpetrators of crime. It is an accepted feature of emergency care that serious injuries and deaths do occur despite intervention. In addition, there are significant numbers of patients who present as a result of assault or in suspicious circumstances. Awareness of the importance of forensic evidence collection, appropriate storage and disposal of material is growing. Legal implications have significance for nurses, in particular with the movement towards Advanced Nursing Practice with its focus on increasing autonomy, accountability and independent practice. In order to achieve holistic healthcare and to provide appropriate and effective interventions, forensic emergency nursing skills need to be developed.

Emergency Nursing↗

A telephone advice line does not decrease the number of presentations to Christchurch Emergency Department, but does decrease the number of phone callers seeking advice.

AIM: To describe the effect of a pilot national telephone advice service (Healthline) on a public hospital emergency department. METHODS: We prospectively gathered information from the Christchurch Hospital Emergency Department (ED) computer- and non-computer-based information systems, for a six-month period during the operation of Healthline. We compared the data with five earlier periods when Healthline was not running. In addition, Healthline collected and analysed data from call log information. RESULTS: There was a small increase (1.1%) in ED attendance during the study period. Patients referred by Healthline had a similar triage distribution to the general ED population, but a lower admission rate (29% vs 47%). Telephone calls to the ED dropped dramatically during the study period. CONCLUSIONS: Healthline had little effect on overall ED census and appeared to refer patients with similar acuity to the general ED census. It decreased the workload for ED nursing staff charged with answering advice calls.

Emergency Service, Hospital↗

Effect of a rapid assessment clinic on the waiting time to be seen by a doctor and the time spent in the department, for patients presenting to an urban emergency department: a controlled prospective trial.

AIMS: To test the hypothesis that triaging certain emergency department (ED) patients through a rapid assessment clinic (RAC) improves the waiting times, and times in the department, for all patients presenting to the emergency department. METHODS: For ten weeks an additional nurse and doctor were rostered. On the odd weeks, these two staff ran a RAC and on even weeks, they did not, but simply joined the other medical and nursing staff, managing patients in the traditional way. Patients suitable for triage to the RAC were those for whom disposal was readily apparent, interventions required were quickly undertaken, and lengthy investigations or assessment were not required. After the ten-week period data from the five weeks of the RAC and the five weeks with no RAC, but the same staffing level, were analysed and compared. RESULTS: During the five weeks of the RAC clinic a total of 2263 patients attended the ED, and 361 of these were referred to the RAC clinic. During the five control weeks a total of 2204 patients attended the ED. There was no significant difference in the distribution across triage categories between the RAC and non-RAC periods. The waiting times to be seen by a doctor show no difference at Triage 2 and 3 and a difference of several minutes for Triage 4 and 5 categories. The times patients spent in the ED also show no difference for Triage 2 and 3 and about 20 to 25 minutes advantage for RAC-week patients in Triage categories 4 and 5. CONCLUSIONS: The rapid management of patients with problems which do not require prolonged assessment or decision making, is beneficial not only to those patients, but also to other patients sharing the same, limited resources.

Adolescent↗