Evidence and Practice
The potential clinical challenges of caring for patients with mental health issues in the ED
Forearm fractures are most common fractures among children and young people aged up to 19
How vital signs measurements can identify patients with COVID who require early CPAP
Nurses working in ED need to know how to assess, manage and refer patients with a bone tumour
Zygomatic complex fractures can be missed on assessment and examination and left undiagnosed
Winged scapula can be painful and debilitating, resulting in loss of power and/or movement
Why you should read this article: • To identify the importance of preparation for autonomous practitioners when breaking bad news in the emergency department (ED) • To consider further training to improve autonomous practitioners’ expertise and skill in breaking bad news in the ED • To count towards revalidation as part of your 35 hours of CPD, or you may wish to write a reflective account (UK readers) • To contribute towards your professional development and local registration renewal requirements (non-UK readers) Breaking the news of potentially serious and new diagnoses to patients in the emergency department (ED) is a common but challenging aspect of the autonomous practitioner’s role. It is a complex process, requiring expertise and skill. If the news is delivered appropriately there is evidence to suggest a beneficial effect on the patient’s ability to cope, yet there is little formal training available and literature focused on the ED setting is limited. This article aims to guide and prepare autonomous practitioners in the ED to break bad news to patients, including during remote consultations introduced due to the coronavirus disease 2019 pandemic. It identifies the importance of preparation; different approaches to breaking bad news, namely the six-stage SPIKES framework and a case study exploring its application in practice; the range of potential patient reactions and how these can be managed, including the provision of support; and how to involve and communicate with other members of the multidisciplinary team. Suggestions for further training are outlined.
Concept of health promotion and its relevance to nurses working in the emergency department
Featuring a successful small-scale trial of body-worn cameras at an East London ED
To get care and treatment right it is essential to ‘ask and engage’ people
The care needs of homeless people attending EDs are frequently misunderstood
CPD article on the pathophysiology, signs, symptoms, diagnosis and management of mallet finger injuries
Mistakes made in healthcare settings and the challenges to staff that arise from them can harm service users, consume time and money, and often receive bad publicity. However, by learning from these mistakes and meeting these challenges, practitioners can improve the quality of the care they provide. This article explores what is meant by mistakes and challenges in the context of health care. It suggests that front line managers are best placed to prevent and learn from mistakes, and thereby improve care for patients.