ii. Pt w/AMS=check for a medical alert bracelet/necklace or a 2 person search of pt belongings in hopes of finding a name of a physician, pharmacy’ family contact or med list iii. Take steps to avoid hospital-acquired infections (wash hands!! &/or use sanitizers frequently) High risk pts: o Older adults: UTI & respiratory infections o Immune suppressed=esp if one chronic steroid tx or immune modulators III. Scope of Emergency Nursing Practice (all ages birth to death & all conditions) A. Core Competencies 1. Assessment - be able to rapidly & accurately interpret findings according to acuity & age 2. Adaptability - quickly react to either a pace change in the flow of pt or a sudden change in a pt’s status 3. Co-morbidities - Ge t the history & requires a broad knowledge base of how to react & tx certain long term conditions as well as emergency situations per hospital protocol 4. Priority se t ting -essential for triage setting! Need to be able to accurately assess, critically think & use solid clinical decision-making skills quickly for each pt/situation 5. Comm u nicat i on - the ED nurse must be able to communicate to an array of people (pts, family members, dr, ambulance workers, lab techs, rad techs, in-pt nurses, etc) 6. The need for "pr actice modifica t ions " (individualized care for each pt) a. Ex is cultural differences: Mexican Americans may not want their bodies exposed, but want family members nearby & are very affectionate towards one another b. Language barriers: use interpreters or telephone language lines c. Religious beliefs that may affect care: ex Jehovah’s Witness pt won’t accept blood transfusions B. Training & Certification (p 127 Table 10-1) 1. 2 General Types of certification “Certification” of successful completion of a particular course of study & emergency nursing specialty certification a. Usually need: i. BLS (Basic Life Support) -noninvasive assessment & skill mgmt for airway maintenance & cardiopulmonary resuscitation) ii. ACLS (Advanced Cardiac Life Support) -Invasive airway mgmt skills, pharmacology & electrical therapies & special resuscitation iii. PALS (Pediatric Advanced Life Support) -neonatal & pediatric resuscitation iv. CEN (Certified Emergency Nurse) -validates core emergency nursing knowledge base IV. Emergency Nursing Principles A. Triage - organized system for sorting/classifying pts into priority levels depending on illness or injury severity 1. ED is structured thru triage principles=highest acuity (chest pain, sx of stroke or pneumonia) needs receive quickest evaluation, tx & prioritized resource utilization (x-ray, lab work, CT scans, etc…) & have priority for OR or Cath lab a. Lower acuity pts may wait longer & the ED nurse may need to explain why to the pt or family 2. Regulatory standards RN, physician or PA must assess pt 1 st to determine triage priority (usually RN) 3. Triage nurse=gatekeeper to ED a. Initiates protocols for lab work or dx studies that may be done before pt sees dr b. May provide care to a pt on a stretcher in the hallway of an overcrowded ED 4. Emergent, Urgent & Nonurgent Categories (Table 10-2 p 128) a. Emergent triage
You've reached the end of your free preview.
Want to read all 14 pages?
- Winter '16
- Nursing, triage, A. Maintaining Pt, emergency pt mgmt