Objective:To evaluate the effectiveness of quality nursing in the management of reusable instruments in the Central Sterile Supply Department(CSSD).Methods:Eleven nurses from the CSSD department were selected from Jan...Objective:To evaluate the effectiveness of quality nursing in the management of reusable instruments in the Central Sterile Supply Department(CSSD).Methods:Eleven nurses from the CSSD department were selected from January to October 2024,and quality nursing activities were implemented in the management of reusable instruments.The completion of quality indicators was analyzed.The instrument quality management scores,department satisfaction,and nurses’professional ability scores before and after nursing management were compared.Results:After nursing intervention,the qualified rates of initial cleaning and final cleaning of sterilization instruments were 99.66%and 100%,respectively.The qualified rate of packaging was 99.97%,the wet package rate was 0.1‰,the loading qualified rate was 99.88%,and the qualified rate of distribution was 99.99%.After nursing intervention,the nurses’instrument quality management scores,department satisfaction,and nurses’professional ability scores were all higher than those before nursing intervention(P<0.05).Conclusion:Quality nursing activities can improve the cleaning,packaging,and sterilization qualified rates of reusable instruments in the CSSD,enhance the effect of instrument quality management,obtain higher department satisfaction from nurses,cultivate their professional abilities,and possess significant nursing management advantages.展开更多
Emergency department nurses face severe occupational stress leading to anxiety,depression,and burnout,which significantly impair their well-being and patientcare quality.This narrative review examined the role of mind...Emergency department nurses face severe occupational stress leading to anxiety,depression,and burnout,which significantly impair their well-being and patientcare quality.This narrative review examined the role of mindfulness-based stress reduction(MBSR)in addressing these challenges.Rooted in nonjudgmental present-moment awareness,MBSR enhances emotional regulation and reduces psychological distress by fostering adaptive coping strategies.Studies have demonstrated its efficacy in lowering anxiety,depressive symptoms,and emotional exhaustion,while improving workplace well-being,empathy,and job satisfaction.Mechanistically,MBSR improves interoceptive awareness and autonomic balance,as evidenced by physiological markers such as heart rate variability.However,gaps remain in long-term efficacy assessments,personalized interventions,and integration with multidisciplinary approaches.Future research should prioritize tailored biomarker-driven programs,longitudinal studies,and scalable implementation strategies in high-stress clinical settings.This review underscores MBSR’s potential as a sustainable,evidence-based tool to enhance emergency department nurses’mental health and professional performance,advocating for broader adoption and further refinement of its practical applications.展开更多
Objective:To evaluate laboratory findings that predict bacterial meningitis in emergency service and their diagnostic effectiveness.Methods:This retrospective cohort study analyzed data from patients presenting with m...Objective:To evaluate laboratory findings that predict bacterial meningitis in emergency service and their diagnostic effectiveness.Methods:This retrospective cohort study analyzed data from patients presenting with meningitis symptoms at a referral hospital in Mersin,Turkey,between January 2019 and January 2022.Clinical findings and laboratory results,including leukocyte count,C-reactive protein(CRP),and procalcitonin levels in blood,were examined.Logistic regression,Chi square test,and receiver operating characteristics(ROC)curve analyses assessed the predictive value of these parameters.Results:A total of 199 participants were included in the study;99 patients were diagnosed with meningitis after lumbar puncture and 100 served as controls.Patients with meningitis exhibited significantly higher leukocyte counts(median:11890×10^(3)/μL vs.7905×10^(3)/μL,P<0.001)and CRP levels(median:6.00 mg/dL vs.0.95 mg/dL,P<0.001)compared to controls.Procalcitonin levels were significantly elevated in meningitis patients(median:0.21 ng/mL vs.0.10 ng/mL,P<0.001).Logistic regression identified albumin(OR=0.16,95%CI=0.06-0.40),and CRP(OR=1.18,95%CI=1.08-1.28)as independent predictors of meningitis.ROC analysis for CRP demonstrated a sensitivity of 80.6%and specificity of 70.0%at a cut-off value of 2.23 mg/dL(AUC=0.792).Conclusions:Elevated albumin levels and CRP contents in the blood were significant predictors of meningitis in emergency service.Early identification of predictive markers may aid in timely lumbar puncture and management of atypical cases.展开更多
BACKGROUND Point-of-care ultrasound(POCUS)is the use of portable ultrasound devices by trained healthcare professionals to diagnose and monitor medical conditions directly at the patient's bedside,such as in emerg...BACKGROUND Point-of-care ultrasound(POCUS)is the use of portable ultrasound devices by trained healthcare professionals to diagnose and monitor medical conditions directly at the patient's bedside,such as in emergency settings.We described a case where POCUS use,in Pediatric Emergency Department,allowed an early diagnosis and timely management in the surgical department,with a favorable outcome for child.Therefore we write this case because it is desirable to po-pularize ultrasound as the fifth pillar of clinical examination especially in Emer-gency Department CASE SUMMARY A 13-year-old girl with acute gastrointestinal symptoms,such as vomit and abdominal and lumbar pains.Upon physical examination,the patient had lo-calized abdominal pain in the left lower quadrant.Ultrasonography performed at the bedside revealed an enlarged left ovary with an irregular structure containing a 3 cm cyst.These findings raised suspicion of ovarian torsion.The child tran-sferred to Gynecology Surgery Unit,where she was taken emergently to the ope-rating room CONCLUSION It is desirable to spread POCUS in emergency settings where it allows a sig-nificant saving of time in patient management.展开更多
Objective:To analyze the effect of optimizing the emergency nursing process on the nursing effect of patients with acute upper gastrointestinal bleeding(AUGB)in the emergency department.Methods:100 cases(Group A)were ...Objective:To analyze the effect of optimizing the emergency nursing process on the nursing effect of patients with acute upper gastrointestinal bleeding(AUGB)in the emergency department.Methods:100 cases(Group A)were randomly selected from AUGB patients who had undergone the routine emergency care process in the emergency department from January 2022 to December 2022,and 100 cases(Group B)were randomly selected from AUGB patients who had undergone the optimized emergency care process in the emergency department from January 2023 to December 2023.The nursing effects of the two groups were compared.Results:clinical indicators that include the emergency response time,time to open the infusion channel,time from diagnosis to specialty treatment,hospitalization time,resuscitation success rate,rebleeding rate,nursing satisfaction score,post-care SAS score,and SF-36 score in Group B were better than those in Group A(P<0.05).Conclusion:Optimization of the emergency care process for AUGB patients in the emergency department can improve the efficiency and success rate of resuscitation,reduce the risk of rebleeding,improve the mood and quality of life of patients,and make the patients more satisfied with the nursing service.展开更多
The proposal of carbon neutrality target makes decarbonization and hydrogenation typical features of future energy development in China.With a wide range of application scenarios,hydrogen energy will experience rapid ...The proposal of carbon neutrality target makes decarbonization and hydrogenation typical features of future energy development in China.With a wide range of application scenarios,hydrogen energy will experience rapid growth in production and consumption.To formulate an effective hydrogen energy development strategy for the future of China,this study employs the departmental scenario analysis method to calculate and evaluate the future consumption of hydrogen energy in China’s heavy industry,transportation,electricity,and other related fields.Multidimensional technical parameters are selected and predicted accurately and reliably in combination with different development scenarios.The findings indicate that the period from 2030 to 2050 will enjoy rapid development of hydrogen energy,having an average annual growth rate of 2%to 4%.The technological progress and breakthroughs scenario has the greatest potential for hydrogen demand scale among the four development scenarios.Under this scenario,the total demand for hydrogen energy is expected to reach 446.37Mt in 2060.Thetransportation sector will be the sector with the greatest potential for hydrogen deployment growth from 2023 to 2060,which is expected to rise from 0.038Mt to about 163.18Mt,with the ambitious growth in the future.Additionally,hydrogen energy has a considerable development potential in the steel sector,and the trend of de-refueling coke by hydrogenation in this sector will be imperative for this energy-intensive industries.展开更多
VEXAS(vacuoles,E1 enzyme,X-linked,autoinflammatory,somatic)syndrome is a severe and progressive disease,characterized by clinical features that bridge rheumatologic and hematologic conditions.[1]VEXAS syndrome is a ra...VEXAS(vacuoles,E1 enzyme,X-linked,autoinflammatory,somatic)syndrome is a severe and progressive disease,characterized by clinical features that bridge rheumatologic and hematologic conditions.[1]VEXAS syndrome is a rare condition that was not reported until 2020.[2]Since then,interest among dermatologists,hematologists,and rheumatologists with published works has increased,[3]but none of them reported in the emergency setting,nor have any cases arisen following COVID-19 infection.展开更多
Computer analysis of electrocardiograms(ECGs)was introduced more than 50 years ago,with the aim to improve efficiency and clinical workflow.[1,2]However,inaccuracies have been documented in the literature.[3,4]Researc...Computer analysis of electrocardiograms(ECGs)was introduced more than 50 years ago,with the aim to improve efficiency and clinical workflow.[1,2]However,inaccuracies have been documented in the literature.[3,4]Research indicates that emergency department(ED)clinician interruptions occur every 4-10 min,which is significantly more common than in other specialties.[5]This increases the cognitive load and error rates and impacts patient care and clinical effi ciency.[1,2,5]De-prioritization protocols have been introduced in certain centers in the United Kingdom(UK),removing the need for clinician ECG interpretation where ECGs have been interpreted as normal by the machine.展开更多
BACKGROUND:The problem of prolonged emergency department length of stay(EDLOS) is becoming increasingly crucial.This study aims to develop a machine learning(ML) model to predict EDLOS,with EDLOS as the outcome variab...BACKGROUND:The problem of prolonged emergency department length of stay(EDLOS) is becoming increasingly crucial.This study aims to develop a machine learning(ML) model to predict EDLOS,with EDLOS as the outcome variable and demographic characteristics,triage level,and medical resource utilization as predictive factors.METHODS:A retrospective analysis was performed on the patients who visited the emergency department of the Second Affiliated Hospital of Guangzhou Medical University from March 2019to September 2021,and a total of 321,012 cases were identified.According to the inclusion and exclusion criteria,187,028 cases were finally included in the analysis.ML analysis was performed using R-squared(R^(2)),and the predictive factors and the EDLOS were used as independent variables and dependent variables,respectively,to establish models.The performance evaluation of the ML models was conducted through the utilization of the mean absolute error(MAE),root mean square error(RMSE),and R^(2),enabling an objective comparative analysis.RESULTS:In the comparative analysis of the six ML models,light gradient boosting machine(LightGBM) model demonstrated the lowest MAE(443.519) and RMSE(826.783),and the highest R^(2) value(0.48),indicating better model fit and predictive performance.Among the top 10 predictive factors associated with EDLOS according to the LightGBM model,the emergency waiting time,age,and emergency arrival time had the most significant impact on the EDLOS.CONCLUSION:The LightGBM model suggests that the emergency waiting time,age,and emergency arrival time may be used to predict the EDLOS.展开更多
Patients with cheiro-oral syndrome(COS) often present with minor perioral and upper extremity sensory disturbances,which can be easily overlooked in busy emergency departments(EDs).^([1]) COS,a rare spectrum of stroke...Patients with cheiro-oral syndrome(COS) often present with minor perioral and upper extremity sensory disturbances,which can be easily overlooked in busy emergency departments(EDs).^([1]) COS,a rare spectrum of stroke syndromes,necessitates expeditious and aggressive modification of risk factors.展开更多
The quality of care and treatment can be impacted by a number of factors, including the rate of missed care. The present study was conducted with the aim to evaluate missed nursing care (MNC) and its association with ...The quality of care and treatment can be impacted by a number of factors, including the rate of missed care. The present study was conducted with the aim to evaluate missed nursing care (MNC) and its association with patient safety culture in the emergency department (ED). Until September 2024, the international databases MEDLINE (PubMed and Ovid), Embase and Cochrane, Scopus, Wiley Online Library, Web of Science, Cochrane Central Register of Controlled Trials, EBSCO, ISI, Elsevier, and Google Scholar were searched using the search terms including patient safety culture and MNC. A total of eight articles were reviewed. In the fixed-effect model with low heterogeneity (I^(2) = 0%, P = 1), the mean score of overall MNC was 2.07 (ES, 2.97;95% confidence interval: −2.21-6.35). According to meta-regression analyses, MNC significantly inversely correlated with patient safety culture, age, and work experience (P < 0.01). By improving the working conditions of ED nurses and providing training related to patient safety, the amount of lost nursing care will decrease.展开更多
With the increasing complexity of social public affairs,cross-departmental collaborative governance has become an important model of modern administrative management.However,conflicts of interest frequently occur duri...With the increasing complexity of social public affairs,cross-departmental collaborative governance has become an important model of modern administrative management.However,conflicts of interest frequently occur during the collaboration process,which are mainly reflected in resource allocation,goal differences,and power games.These conflicts are caused by factors such as cultural differences within departments,inconsistent performance evaluation systems,and personal interests of department members.To address these issues,it is necessary to design multi-level integration mechanisms,including establishing stable communication channels and unified goals and evaluation systems.Successful integration cases in various fields,such as food safety supervision,environmental protection,and urban transportation governance,show that effective integration mechanisms need to establish institutionalized communication carriers,form a consensus target system,and design guarantee measures with both incentives and constraints.Although current research has achieved certain results,there are still limitations,such as insufficient attention to underdeveloped regions,a lack of consideration of cultural factors,and a narrow focus on internal government collaboration.Future research can explore differentiated integration models,introduce third-party assessment institutions,and strengthen research on the participation mechanism of enterprises and social organizations.展开更多
Objective:To explore the application effect and value of characteristic traditional Chinese medicine(TCM)nursing techniques in the colorectal department in clinical practice,in order to provide references for improvin...Objective:To explore the application effect and value of characteristic traditional Chinese medicine(TCM)nursing techniques in the colorectal department in clinical practice,in order to provide references for improving the nursing quality of patients and promoting their rehabilitation.Method:The colorectal department of Hospital A began to implement characteristic TCM nursing techniques in January 2023.Therefore,100 patients admitted to the colorectal department from September 2022 to December 2022 were set as the control group,and 100 patients admitted from January 2023 to April 2023 were taken as the experimental group.The experimental group adopted characteristic TCM nursing techniques,including comprehensive measures such as herbal enema therapy,TCM hip bath,acupoint massage and application,and emotional care;the control group adopted conventional Western medicine nursing methods.The application effect and value of characteristic TCM nursing techniques in the clinical practice of the colorectal department were evaluated by comparing indicators such as the frequency of use,the proportion of treated patients,the number of types,and patient satisfaction between the two groups.Result:After using the characteristic TCM nursing techniques,the recovery speed of the patients in the experimental group was significantly accelerated,and the incidence of complications was significantly reduced.Specifically,the average hospital stay of the patients in the experimental group was shortened by approximately 20%compared with the control group.At the same time,the pain score of the patients in the experimental group was also significantly lower than that of the control group.In addition,the satisfaction rate of the patients in the experimental group with the nursing service was as high as 95%,significantly higher than 80%of the control group.Conclusion:The application and practice of the characteristic TCM nursing techniques in the colorectal department have shown significant advantages in improving the recovery speed of patients and the quality of nursing services,and can be further promoted in clinical practice.展开更多
BACKGROUND:Sepsis is one of the main causes of mortality in intensive care units(ICUs).Early prediction is critical for reducing injury.As approximately 36%of sepsis occur within 24 h after emergency department(ED)adm...BACKGROUND:Sepsis is one of the main causes of mortality in intensive care units(ICUs).Early prediction is critical for reducing injury.As approximately 36%of sepsis occur within 24 h after emergency department(ED)admission in Medical Information Mart for Intensive Care(MIMIC-IV),a prediction system for the ED triage stage would be helpful.Previous methods such as the quick Sequential Organ Failure Assessment(qSOFA)are more suitable for screening than for prediction in the ED,and we aimed to fi nd a light-weight,convenient prediction method through machine learning.METHODS:We accessed the MIMIC-IV for sepsis patient data in the EDs.Our dataset comprised demographic information,vital signs,and synthetic features.Extreme Gradient Boosting(XGBoost)was used to predict the risk of developing sepsis within 24 h after ED admission.Additionally,SHapley Additive exPlanations(SHAP)was employed to provide a comprehensive interpretation of the model's results.Ten percent of the patients were randomly selected as the testing set,while the remaining patients were used for training with 10-fold cross-validation.RESULTS:For 10-fold cross-validation on 14,957 samples,we reached an accuracy of 84.1%±0.3%and an area under the receiver operating characteristic(ROC)curve of 0.92±0.02.The model achieved similar performance on the testing set of 1,662 patients.SHAP values showed that the fi ve most important features were acuity,arrival transportation,age,shock index,and respiratory rate.CONCLUSION:Machine learning models such as XGBoost may be used for sepsis prediction using only a small amount of data conveniently collected in the ED triage stage.This may help reduce workload in the ED and warn medical workers against the risk of sepsis in advance.展开更多
BACKGROUND:This study aimed to evaluate the discriminatory performance of 11 vital sign-based early warning scores(EWSs)and three shock indices in early sepsis prediction in the emergency department(ED).METHODS:We per...BACKGROUND:This study aimed to evaluate the discriminatory performance of 11 vital sign-based early warning scores(EWSs)and three shock indices in early sepsis prediction in the emergency department(ED).METHODS:We performed a retrospective study on consecutive adult patients with an infection over 3 months in a public ED in Hong Kong.The primary outcome was sepsis(Sepsis-3 definition)within 48 h of ED presentation.Using c-statistics and the DeLong test,we compared 11 EWSs,including the National Early Warning Score 2(NEWS2),Modified Early Warning Score,and Worthing Physiological Scoring System(WPS),etc.,and three shock indices(the shock index[SI],modified shock index[MSI],and diastolic shock index[DSI]),with Systemic Inflammatory Response Syndrome(SIRS)and quick Sequential Organ Failure Assessment(qSOFA)in predicting the primary outcome,intensive care unit admission,and mortality at different time points.RESULTS:We analyzed 601 patients,of whom 166(27.6%)developed sepsis.NEWS2 had the highest point estimate(area under the receiver operating characteristic curve[AUROC]0.75,95%CI 0.70-0.79)and was significantly better than SIRS,qSOFA,other EWSs and shock indices,except WPS,at predicting the primary outcome.However,the pooled sensitivity and specificity of NEWS2≥5 for the prediction of sepsis were 0.45(95%CI 0.37-0.52)and 0.88(95%CI 0.85-0.91),respectively.The discriminatory performance of all EWSs and shock indices declined when used to predict mortality at a more remote time point.CONCLUSION:NEWS2 compared favorably with other EWSs and shock indices in early sepsis prediction but its low sensitivity at the usual cut-off point requires further modification for sepsis screening.展开更多
BACKGROUND:To describe trends in oxycodone and oxycodone-containing analgesic prescribing for the treatment of back pain among adults in emergency departments(EDs) in the USA from 2007 to 2018.METHODS:Data were gather...BACKGROUND:To describe trends in oxycodone and oxycodone-containing analgesic prescribing for the treatment of back pain among adults in emergency departments(EDs) in the USA from 2007 to 2018.METHODS:Data were gathered from the National Hospital Ambulatory Medical Care Survey(NHAMCS) from 2007 to 2018.The study population included individuals of all ages presenting to USA EDs.The NHAMCS reasons for visit and oxycodone drug ID codes were used to isolate patients with back pain.The main outcome was the proportion of oxycodone and oxycodone-containing analgesics prescribed for back pain in the EDs over the specified time period.RESULTS:There was a relative decrease in the overall administration of oxycodone for back pain in the EDs by 62.3% from 2007(244,000 visits) to 2018(92,000 visits).The proportion of ED patients prescribed with oxycodone-containing analgesics for back pain increased among patients aged 45 years and older(from 43.8% to 57.6%),female patients(from 54.5% to 62.0%),black patients(from 22.5% to 30.4%),and Hispanic/Latino patients(from 9.4% to 19.6%).Oxycodone/acetaminophen was most prescribed and accounted for 90.2% of all oxycodone-containing analgesics in 2007,with a decrease to 68.5% in 2018.Pure oxycodone was the second most prescribed medication,accounting for 6.1% in 2007 and 31.5% in 2018.CONCLUSION:The overall number of oxycodone-containing analgesics decreased significantly from 2007 to 2018.However,that number trended upward in 45-year-old and older,female,black,or Hispanic/Latino patients from 2007 to 2018.The total amount of pure oxycodone increased significantly from 2007 to 2008.展开更多
Objective:To assess the correlation between atmospheric pollutants,meteorological factors,and emergency department visits for respiratory diseases in Haikou City.Methods:Daily data on atmospheric pollutants,meteorolog...Objective:To assess the correlation between atmospheric pollutants,meteorological factors,and emergency department visits for respiratory diseases in Haikou City.Methods:Daily data on atmospheric pollutants,meteorological factors,and emergency department visits for respiratory diseases in Haikou City from 2018 to 2021 were collected.The Spearman rank correlation test was used to analyze the correlation,and a distributed lag non-linear model was employed to analyze the health effects and lag impacts of environmental factors.Subgroup analyses were conducted based on sex and age.Results:According to the criteria of International Classification of Diseases(ICD-10:J00-J99),a total of 221913 cases were included,accounting for 21.3%of the total emergency department visits in Haikou City.For every 1℃increase in temperature,the risk of emergency department visits increased by 1.029%(95%CI 1.016%-1.042%).Relative humidity greater than 80%reduced the risk of visits,while higher atmospheric pressure(>1010 hpa)also decreased the likelihood of daily emergency department visits.Higher concentrations of PM_(2.5)(30-50μg/m^(3)),PM10(>60μg/m^(3)),and O_(3)(75-125μg/m^(3))were associated with increased visits.Higher temperatures(>25℃)have a greater impact on females and children aged 0-14 years,while males are more sensitive to low atmospheric pressure.Individuals aged 65 and above exhibited increased sensitivity to O_(3)concentration,and the effects of PM2.5,PM10,and O_(3)are more pronounced in individuals over 14 years old.Conclusions:Short-term exposure to high temperatures,particulate matter pollutants(PM_(2.5)and PM_(10)),and ozone(O_(3))is associated with increased emergency department visits for respiratory diseases.展开更多
In the very beginning,the Computer Laboratory of the University of Cambridge was founded to provide computing service for different disciplines across the university.As computer science developed as a discipline in it...In the very beginning,the Computer Laboratory of the University of Cambridge was founded to provide computing service for different disciplines across the university.As computer science developed as a discipline in its own right,boundaries necessarily arose between it and other disciplines,in a way that is now often detrimental to progress.Therefore,it is necessary to reinvigorate the relationship between computer science and other academic disciplines and celebrate exploration and creativity in research.To do this,the structures of the academic department have to act as supporting scaffolding rather than barriers.Some examples are given that show the efforts being made at the University of Cambridge to approach this problem.展开更多
Objective: To explore the practice and application of infection prevention and control strategies in risk departments during the COVID-19 epidemic, and to formulate the infection prevention and control measures to pro...Objective: To explore the practice and application of infection prevention and control strategies in risk departments during the COVID-19 epidemic, and to formulate the infection prevention and control measures to provide advice and guidance in risk departments. Methods: According to the latest plan of diagnosis and treatment, prevention and control issued by the National Health Commission, expert advice and consensus, combined with the actual situation in our hospital, a series of infection prevention and control measures of COVID-19 in risk department was formulated. Results: During the epidemic period, the prevention and control measures of nine risk departments including emergency operation, anesthesiology, endoscopy center, blood purification center, otolaryngology, stomatology, medical imaging department, medical cosmetology department and pulmonary function room were established from six aspects, including pre-examination and screening, medical technology control, personnel management, personal protection, environmental disinfection, medical waste disposal, etc. Conclusion: During the epidemic period, the infection prevention and control strategy of risk departments is one of the key links to control the spread of the epidemic, and risk departments must pay attention to and strictly implement various infection prevention and control measures.展开更多
Background: Maternal and neonatal mortality remains a public health problem in Benin. Each year, approximately 1500 maternal deaths and more than 12,000 newborn deaths are recorded there. In order to correct the situa...Background: Maternal and neonatal mortality remains a public health problem in Benin. Each year, approximately 1500 maternal deaths and more than 12,000 newborn deaths are recorded there. In order to correct the situation, strategies such as the implementation of Emergency Obstetric and Neonatal Care (EmONC) were initiated. Objective: Determine the rates of maternal deaths in EmONC centers in the Collines department from 2018 to 2022. Framework and Methods: The study took place in Benin precisely in the Collines department. This was a descriptive cross-sectional study. Data collection was carried out during the first two weeks of January 2023 and covered data from the 09 Basic Emergency Obstetric and Neonatal Care centers (BEMONC) and the Obstetric and Neonatal Care centers of Complete Emergency (CEmONC) of the Collines department from 2018 to 2022. An estimate of the ratios of maternal deaths occurring at the level of the EmONC centers of the Collines department from 2018-2022 was carried out followed by constructive suggestions. Results: During the five years (2018 to 2022), the Collines department recorded 42,582 live births with 148 maternal deaths, i.e. a ratio of 348 maternal deaths per 100,000 live births. Between 2018 and 2022, the highest maternal death ratio was recorded in 2019, i.e. 425 maternal deaths per 100,000 live births for all EmONC centers and 607 maternal deaths per 100,000 live births in EmONC centers. The highest maternal death ratio at the BEmONC center level was recorded in 2020, i.e. 129 maternal deaths per 100,000 births. Conclusion: These results suggest that despite the implementation of EmONC in the Collines department, maternal deaths have not decreased. To improve these outcomes for a reduction in maternal deaths, urgent action must be taken.展开更多
文摘Objective:To evaluate the effectiveness of quality nursing in the management of reusable instruments in the Central Sterile Supply Department(CSSD).Methods:Eleven nurses from the CSSD department were selected from January to October 2024,and quality nursing activities were implemented in the management of reusable instruments.The completion of quality indicators was analyzed.The instrument quality management scores,department satisfaction,and nurses’professional ability scores before and after nursing management were compared.Results:After nursing intervention,the qualified rates of initial cleaning and final cleaning of sterilization instruments were 99.66%and 100%,respectively.The qualified rate of packaging was 99.97%,the wet package rate was 0.1‰,the loading qualified rate was 99.88%,and the qualified rate of distribution was 99.99%.After nursing intervention,the nurses’instrument quality management scores,department satisfaction,and nurses’professional ability scores were all higher than those before nursing intervention(P<0.05).Conclusion:Quality nursing activities can improve the cleaning,packaging,and sterilization qualified rates of reusable instruments in the CSSD,enhance the effect of instrument quality management,obtain higher department satisfaction from nurses,cultivate their professional abilities,and possess significant nursing management advantages.
文摘Emergency department nurses face severe occupational stress leading to anxiety,depression,and burnout,which significantly impair their well-being and patientcare quality.This narrative review examined the role of mindfulness-based stress reduction(MBSR)in addressing these challenges.Rooted in nonjudgmental present-moment awareness,MBSR enhances emotional regulation and reduces psychological distress by fostering adaptive coping strategies.Studies have demonstrated its efficacy in lowering anxiety,depressive symptoms,and emotional exhaustion,while improving workplace well-being,empathy,and job satisfaction.Mechanistically,MBSR improves interoceptive awareness and autonomic balance,as evidenced by physiological markers such as heart rate variability.However,gaps remain in long-term efficacy assessments,personalized interventions,and integration with multidisciplinary approaches.Future research should prioritize tailored biomarker-driven programs,longitudinal studies,and scalable implementation strategies in high-stress clinical settings.This review underscores MBSR’s potential as a sustainable,evidence-based tool to enhance emergency department nurses’mental health and professional performance,advocating for broader adoption and further refinement of its practical applications.
文摘Objective:To evaluate laboratory findings that predict bacterial meningitis in emergency service and their diagnostic effectiveness.Methods:This retrospective cohort study analyzed data from patients presenting with meningitis symptoms at a referral hospital in Mersin,Turkey,between January 2019 and January 2022.Clinical findings and laboratory results,including leukocyte count,C-reactive protein(CRP),and procalcitonin levels in blood,were examined.Logistic regression,Chi square test,and receiver operating characteristics(ROC)curve analyses assessed the predictive value of these parameters.Results:A total of 199 participants were included in the study;99 patients were diagnosed with meningitis after lumbar puncture and 100 served as controls.Patients with meningitis exhibited significantly higher leukocyte counts(median:11890×10^(3)/μL vs.7905×10^(3)/μL,P<0.001)and CRP levels(median:6.00 mg/dL vs.0.95 mg/dL,P<0.001)compared to controls.Procalcitonin levels were significantly elevated in meningitis patients(median:0.21 ng/mL vs.0.10 ng/mL,P<0.001).Logistic regression identified albumin(OR=0.16,95%CI=0.06-0.40),and CRP(OR=1.18,95%CI=1.08-1.28)as independent predictors of meningitis.ROC analysis for CRP demonstrated a sensitivity of 80.6%and specificity of 70.0%at a cut-off value of 2.23 mg/dL(AUC=0.792).Conclusions:Elevated albumin levels and CRP contents in the blood were significant predictors of meningitis in emergency service.Early identification of predictive markers may aid in timely lumbar puncture and management of atypical cases.
文摘BACKGROUND Point-of-care ultrasound(POCUS)is the use of portable ultrasound devices by trained healthcare professionals to diagnose and monitor medical conditions directly at the patient's bedside,such as in emergency settings.We described a case where POCUS use,in Pediatric Emergency Department,allowed an early diagnosis and timely management in the surgical department,with a favorable outcome for child.Therefore we write this case because it is desirable to po-pularize ultrasound as the fifth pillar of clinical examination especially in Emer-gency Department CASE SUMMARY A 13-year-old girl with acute gastrointestinal symptoms,such as vomit and abdominal and lumbar pains.Upon physical examination,the patient had lo-calized abdominal pain in the left lower quadrant.Ultrasonography performed at the bedside revealed an enlarged left ovary with an irregular structure containing a 3 cm cyst.These findings raised suspicion of ovarian torsion.The child tran-sferred to Gynecology Surgery Unit,where she was taken emergently to the ope-rating room CONCLUSION It is desirable to spread POCUS in emergency settings where it allows a sig-nificant saving of time in patient management.
文摘Objective:To analyze the effect of optimizing the emergency nursing process on the nursing effect of patients with acute upper gastrointestinal bleeding(AUGB)in the emergency department.Methods:100 cases(Group A)were randomly selected from AUGB patients who had undergone the routine emergency care process in the emergency department from January 2022 to December 2022,and 100 cases(Group B)were randomly selected from AUGB patients who had undergone the optimized emergency care process in the emergency department from January 2023 to December 2023.The nursing effects of the two groups were compared.Results:clinical indicators that include the emergency response time,time to open the infusion channel,time from diagnosis to specialty treatment,hospitalization time,resuscitation success rate,rebleeding rate,nursing satisfaction score,post-care SAS score,and SF-36 score in Group B were better than those in Group A(P<0.05).Conclusion:Optimization of the emergency care process for AUGB patients in the emergency department can improve the efficiency and success rate of resuscitation,reduce the risk of rebleeding,improve the mood and quality of life of patients,and make the patients more satisfied with the nursing service.
基金supported by the National Natural Science Foundation of China(No.71704178)Beijing Municipal Excellent Talents Foundation(No.2017000020124G133)Major consulting project of the Chinese Academy of Engineering(Nos.2023-JB-08,2022-PP-03).
文摘The proposal of carbon neutrality target makes decarbonization and hydrogenation typical features of future energy development in China.With a wide range of application scenarios,hydrogen energy will experience rapid growth in production and consumption.To formulate an effective hydrogen energy development strategy for the future of China,this study employs the departmental scenario analysis method to calculate and evaluate the future consumption of hydrogen energy in China’s heavy industry,transportation,electricity,and other related fields.Multidimensional technical parameters are selected and predicted accurately and reliably in combination with different development scenarios.The findings indicate that the period from 2030 to 2050 will enjoy rapid development of hydrogen energy,having an average annual growth rate of 2%to 4%.The technological progress and breakthroughs scenario has the greatest potential for hydrogen demand scale among the four development scenarios.Under this scenario,the total demand for hydrogen energy is expected to reach 446.37Mt in 2060.Thetransportation sector will be the sector with the greatest potential for hydrogen deployment growth from 2023 to 2060,which is expected to rise from 0.038Mt to about 163.18Mt,with the ambitious growth in the future.Additionally,hydrogen energy has a considerable development potential in the steel sector,and the trend of de-refueling coke by hydrogenation in this sector will be imperative for this energy-intensive industries.
基金National High Level Hospital Clinical Research Funding(Scientific Research Seed Fund of Peking University First Hospital).
文摘VEXAS(vacuoles,E1 enzyme,X-linked,autoinflammatory,somatic)syndrome is a severe and progressive disease,characterized by clinical features that bridge rheumatologic and hematologic conditions.[1]VEXAS syndrome is a rare condition that was not reported until 2020.[2]Since then,interest among dermatologists,hematologists,and rheumatologists with published works has increased,[3]but none of them reported in the emergency setting,nor have any cases arisen following COVID-19 infection.
文摘Computer analysis of electrocardiograms(ECGs)was introduced more than 50 years ago,with the aim to improve efficiency and clinical workflow.[1,2]However,inaccuracies have been documented in the literature.[3,4]Research indicates that emergency department(ED)clinician interruptions occur every 4-10 min,which is significantly more common than in other specialties.[5]This increases the cognitive load and error rates and impacts patient care and clinical effi ciency.[1,2,5]De-prioritization protocols have been introduced in certain centers in the United Kingdom(UK),removing the need for clinician ECG interpretation where ECGs have been interpreted as normal by the machine.
基金supported by Guangzhou Municipal Health Science and Technology General Program (20221A011083)the Key Medical Disciplines and Specialties Program of Guangzhou(2021-2023)Guangdong University Innovation Team Project(2024KCXTD029)。
文摘BACKGROUND:The problem of prolonged emergency department length of stay(EDLOS) is becoming increasingly crucial.This study aims to develop a machine learning(ML) model to predict EDLOS,with EDLOS as the outcome variable and demographic characteristics,triage level,and medical resource utilization as predictive factors.METHODS:A retrospective analysis was performed on the patients who visited the emergency department of the Second Affiliated Hospital of Guangzhou Medical University from March 2019to September 2021,and a total of 321,012 cases were identified.According to the inclusion and exclusion criteria,187,028 cases were finally included in the analysis.ML analysis was performed using R-squared(R^(2)),and the predictive factors and the EDLOS were used as independent variables and dependent variables,respectively,to establish models.The performance evaluation of the ML models was conducted through the utilization of the mean absolute error(MAE),root mean square error(RMSE),and R^(2),enabling an objective comparative analysis.RESULTS:In the comparative analysis of the six ML models,light gradient boosting machine(LightGBM) model demonstrated the lowest MAE(443.519) and RMSE(826.783),and the highest R^(2) value(0.48),indicating better model fit and predictive performance.Among the top 10 predictive factors associated with EDLOS according to the LightGBM model,the emergency waiting time,age,and emergency arrival time had the most significant impact on the EDLOS.CONCLUSION:The LightGBM model suggests that the emergency waiting time,age,and emergency arrival time may be used to predict the EDLOS.
文摘Patients with cheiro-oral syndrome(COS) often present with minor perioral and upper extremity sensory disturbances,which can be easily overlooked in busy emergency departments(EDs).^([1]) COS,a rare spectrum of stroke syndromes,necessitates expeditious and aggressive modification of risk factors.
文摘The quality of care and treatment can be impacted by a number of factors, including the rate of missed care. The present study was conducted with the aim to evaluate missed nursing care (MNC) and its association with patient safety culture in the emergency department (ED). Until September 2024, the international databases MEDLINE (PubMed and Ovid), Embase and Cochrane, Scopus, Wiley Online Library, Web of Science, Cochrane Central Register of Controlled Trials, EBSCO, ISI, Elsevier, and Google Scholar were searched using the search terms including patient safety culture and MNC. A total of eight articles were reviewed. In the fixed-effect model with low heterogeneity (I^(2) = 0%, P = 1), the mean score of overall MNC was 2.07 (ES, 2.97;95% confidence interval: −2.21-6.35). According to meta-regression analyses, MNC significantly inversely correlated with patient safety culture, age, and work experience (P < 0.01). By improving the working conditions of ED nurses and providing training related to patient safety, the amount of lost nursing care will decrease.
文摘With the increasing complexity of social public affairs,cross-departmental collaborative governance has become an important model of modern administrative management.However,conflicts of interest frequently occur during the collaboration process,which are mainly reflected in resource allocation,goal differences,and power games.These conflicts are caused by factors such as cultural differences within departments,inconsistent performance evaluation systems,and personal interests of department members.To address these issues,it is necessary to design multi-level integration mechanisms,including establishing stable communication channels and unified goals and evaluation systems.Successful integration cases in various fields,such as food safety supervision,environmental protection,and urban transportation governance,show that effective integration mechanisms need to establish institutionalized communication carriers,form a consensus target system,and design guarantee measures with both incentives and constraints.Although current research has achieved certain results,there are still limitations,such as insufficient attention to underdeveloped regions,a lack of consideration of cultural factors,and a narrow focus on internal government collaboration.Future research can explore differentiated integration models,introduce third-party assessment institutions,and strengthen research on the participation mechanism of enterprises and social organizations.
文摘Objective:To explore the application effect and value of characteristic traditional Chinese medicine(TCM)nursing techniques in the colorectal department in clinical practice,in order to provide references for improving the nursing quality of patients and promoting their rehabilitation.Method:The colorectal department of Hospital A began to implement characteristic TCM nursing techniques in January 2023.Therefore,100 patients admitted to the colorectal department from September 2022 to December 2022 were set as the control group,and 100 patients admitted from January 2023 to April 2023 were taken as the experimental group.The experimental group adopted characteristic TCM nursing techniques,including comprehensive measures such as herbal enema therapy,TCM hip bath,acupoint massage and application,and emotional care;the control group adopted conventional Western medicine nursing methods.The application effect and value of characteristic TCM nursing techniques in the clinical practice of the colorectal department were evaluated by comparing indicators such as the frequency of use,the proportion of treated patients,the number of types,and patient satisfaction between the two groups.Result:After using the characteristic TCM nursing techniques,the recovery speed of the patients in the experimental group was significantly accelerated,and the incidence of complications was significantly reduced.Specifically,the average hospital stay of the patients in the experimental group was shortened by approximately 20%compared with the control group.At the same time,the pain score of the patients in the experimental group was also significantly lower than that of the control group.In addition,the satisfaction rate of the patients in the experimental group with the nursing service was as high as 95%,significantly higher than 80%of the control group.Conclusion:The application and practice of the characteristic TCM nursing techniques in the colorectal department have shown significant advantages in improving the recovery speed of patients and the quality of nursing services,and can be further promoted in clinical practice.
基金supported by the National Key Research and Development Program of China(2021YFC2500803)the CAMS Innovation Fund for Medical Sciences(2021-I2M-1-056).
文摘BACKGROUND:Sepsis is one of the main causes of mortality in intensive care units(ICUs).Early prediction is critical for reducing injury.As approximately 36%of sepsis occur within 24 h after emergency department(ED)admission in Medical Information Mart for Intensive Care(MIMIC-IV),a prediction system for the ED triage stage would be helpful.Previous methods such as the quick Sequential Organ Failure Assessment(qSOFA)are more suitable for screening than for prediction in the ED,and we aimed to fi nd a light-weight,convenient prediction method through machine learning.METHODS:We accessed the MIMIC-IV for sepsis patient data in the EDs.Our dataset comprised demographic information,vital signs,and synthetic features.Extreme Gradient Boosting(XGBoost)was used to predict the risk of developing sepsis within 24 h after ED admission.Additionally,SHapley Additive exPlanations(SHAP)was employed to provide a comprehensive interpretation of the model's results.Ten percent of the patients were randomly selected as the testing set,while the remaining patients were used for training with 10-fold cross-validation.RESULTS:For 10-fold cross-validation on 14,957 samples,we reached an accuracy of 84.1%±0.3%and an area under the receiver operating characteristic(ROC)curve of 0.92±0.02.The model achieved similar performance on the testing set of 1,662 patients.SHAP values showed that the fi ve most important features were acuity,arrival transportation,age,shock index,and respiratory rate.CONCLUSION:Machine learning models such as XGBoost may be used for sepsis prediction using only a small amount of data conveniently collected in the ED triage stage.This may help reduce workload in the ED and warn medical workers against the risk of sepsis in advance.
基金supported by the Health and Medical Research Fund of the Food and Health Bureau of the Hong Kong Special Administrative Region(Project No.19201161)Seed Fund from the University of Hong Kong.
文摘BACKGROUND:This study aimed to evaluate the discriminatory performance of 11 vital sign-based early warning scores(EWSs)and three shock indices in early sepsis prediction in the emergency department(ED).METHODS:We performed a retrospective study on consecutive adult patients with an infection over 3 months in a public ED in Hong Kong.The primary outcome was sepsis(Sepsis-3 definition)within 48 h of ED presentation.Using c-statistics and the DeLong test,we compared 11 EWSs,including the National Early Warning Score 2(NEWS2),Modified Early Warning Score,and Worthing Physiological Scoring System(WPS),etc.,and three shock indices(the shock index[SI],modified shock index[MSI],and diastolic shock index[DSI]),with Systemic Inflammatory Response Syndrome(SIRS)and quick Sequential Organ Failure Assessment(qSOFA)in predicting the primary outcome,intensive care unit admission,and mortality at different time points.RESULTS:We analyzed 601 patients,of whom 166(27.6%)developed sepsis.NEWS2 had the highest point estimate(area under the receiver operating characteristic curve[AUROC]0.75,95%CI 0.70-0.79)and was significantly better than SIRS,qSOFA,other EWSs and shock indices,except WPS,at predicting the primary outcome.However,the pooled sensitivity and specificity of NEWS2≥5 for the prediction of sepsis were 0.45(95%CI 0.37-0.52)and 0.88(95%CI 0.85-0.91),respectively.The discriminatory performance of all EWSs and shock indices declined when used to predict mortality at a more remote time point.CONCLUSION:NEWS2 compared favorably with other EWSs and shock indices in early sepsis prediction but its low sensitivity at the usual cut-off point requires further modification for sepsis screening.
文摘BACKGROUND:To describe trends in oxycodone and oxycodone-containing analgesic prescribing for the treatment of back pain among adults in emergency departments(EDs) in the USA from 2007 to 2018.METHODS:Data were gathered from the National Hospital Ambulatory Medical Care Survey(NHAMCS) from 2007 to 2018.The study population included individuals of all ages presenting to USA EDs.The NHAMCS reasons for visit and oxycodone drug ID codes were used to isolate patients with back pain.The main outcome was the proportion of oxycodone and oxycodone-containing analgesics prescribed for back pain in the EDs over the specified time period.RESULTS:There was a relative decrease in the overall administration of oxycodone for back pain in the EDs by 62.3% from 2007(244,000 visits) to 2018(92,000 visits).The proportion of ED patients prescribed with oxycodone-containing analgesics for back pain increased among patients aged 45 years and older(from 43.8% to 57.6%),female patients(from 54.5% to 62.0%),black patients(from 22.5% to 30.4%),and Hispanic/Latino patients(from 9.4% to 19.6%).Oxycodone/acetaminophen was most prescribed and accounted for 90.2% of all oxycodone-containing analgesics in 2007,with a decrease to 68.5% in 2018.Pure oxycodone was the second most prescribed medication,accounting for 6.1% in 2007 and 31.5% in 2018.CONCLUSION:The overall number of oxycodone-containing analgesics decreased significantly from 2007 to 2018.However,that number trended upward in 45-year-old and older,female,black,or Hispanic/Latino patients from 2007 to 2018.The total amount of pure oxycodone increased significantly from 2007 to 2008.
基金the National Natural Science Foundation of China(No:81960351)Research Foundation for Advanced Talents of Hainan(No:822RC835)Province Natural Science Key Foundation of Hainan(No:ZDYF 2019125).
文摘Objective:To assess the correlation between atmospheric pollutants,meteorological factors,and emergency department visits for respiratory diseases in Haikou City.Methods:Daily data on atmospheric pollutants,meteorological factors,and emergency department visits for respiratory diseases in Haikou City from 2018 to 2021 were collected.The Spearman rank correlation test was used to analyze the correlation,and a distributed lag non-linear model was employed to analyze the health effects and lag impacts of environmental factors.Subgroup analyses were conducted based on sex and age.Results:According to the criteria of International Classification of Diseases(ICD-10:J00-J99),a total of 221913 cases were included,accounting for 21.3%of the total emergency department visits in Haikou City.For every 1℃increase in temperature,the risk of emergency department visits increased by 1.029%(95%CI 1.016%-1.042%).Relative humidity greater than 80%reduced the risk of visits,while higher atmospheric pressure(>1010 hpa)also decreased the likelihood of daily emergency department visits.Higher concentrations of PM_(2.5)(30-50μg/m^(3)),PM10(>60μg/m^(3)),and O_(3)(75-125μg/m^(3))were associated with increased visits.Higher temperatures(>25℃)have a greater impact on females and children aged 0-14 years,while males are more sensitive to low atmospheric pressure.Individuals aged 65 and above exhibited increased sensitivity to O_(3)concentration,and the effects of PM2.5,PM10,and O_(3)are more pronounced in individuals over 14 years old.Conclusions:Short-term exposure to high temperatures,particulate matter pollutants(PM_(2.5)and PM_(10)),and ozone(O_(3))is associated with increased emergency department visits for respiratory diseases.
文摘In the very beginning,the Computer Laboratory of the University of Cambridge was founded to provide computing service for different disciplines across the university.As computer science developed as a discipline in its own right,boundaries necessarily arose between it and other disciplines,in a way that is now often detrimental to progress.Therefore,it is necessary to reinvigorate the relationship between computer science and other academic disciplines and celebrate exploration and creativity in research.To do this,the structures of the academic department have to act as supporting scaffolding rather than barriers.Some examples are given that show the efforts being made at the University of Cambridge to approach this problem.
文摘Objective: To explore the practice and application of infection prevention and control strategies in risk departments during the COVID-19 epidemic, and to formulate the infection prevention and control measures to provide advice and guidance in risk departments. Methods: According to the latest plan of diagnosis and treatment, prevention and control issued by the National Health Commission, expert advice and consensus, combined with the actual situation in our hospital, a series of infection prevention and control measures of COVID-19 in risk department was formulated. Results: During the epidemic period, the prevention and control measures of nine risk departments including emergency operation, anesthesiology, endoscopy center, blood purification center, otolaryngology, stomatology, medical imaging department, medical cosmetology department and pulmonary function room were established from six aspects, including pre-examination and screening, medical technology control, personnel management, personal protection, environmental disinfection, medical waste disposal, etc. Conclusion: During the epidemic period, the infection prevention and control strategy of risk departments is one of the key links to control the spread of the epidemic, and risk departments must pay attention to and strictly implement various infection prevention and control measures.
文摘Background: Maternal and neonatal mortality remains a public health problem in Benin. Each year, approximately 1500 maternal deaths and more than 12,000 newborn deaths are recorded there. In order to correct the situation, strategies such as the implementation of Emergency Obstetric and Neonatal Care (EmONC) were initiated. Objective: Determine the rates of maternal deaths in EmONC centers in the Collines department from 2018 to 2022. Framework and Methods: The study took place in Benin precisely in the Collines department. This was a descriptive cross-sectional study. Data collection was carried out during the first two weeks of January 2023 and covered data from the 09 Basic Emergency Obstetric and Neonatal Care centers (BEMONC) and the Obstetric and Neonatal Care centers of Complete Emergency (CEmONC) of the Collines department from 2018 to 2022. An estimate of the ratios of maternal deaths occurring at the level of the EmONC centers of the Collines department from 2018-2022 was carried out followed by constructive suggestions. Results: During the five years (2018 to 2022), the Collines department recorded 42,582 live births with 148 maternal deaths, i.e. a ratio of 348 maternal deaths per 100,000 live births. Between 2018 and 2022, the highest maternal death ratio was recorded in 2019, i.e. 425 maternal deaths per 100,000 live births for all EmONC centers and 607 maternal deaths per 100,000 live births in EmONC centers. The highest maternal death ratio at the BEmONC center level was recorded in 2020, i.e. 129 maternal deaths per 100,000 births. Conclusion: These results suggest that despite the implementation of EmONC in the Collines department, maternal deaths have not decreased. To improve these outcomes for a reduction in maternal deaths, urgent action must be taken.
