Evidence and Practice

Clinical

Care of patients with mental health issues in the emergency department: a quality improvement project

Care of patients with mental health issues in the ED: a quality improvement project

The potential clinical challenges of caring for patients with mental health issues in the ED

Managing children’s forearm fractures in the emergency department

Managing children’s forearm fractures in the emergency department

Forearm fractures are most common fractures among children and young people aged up to 19

Person in mask

Identifying patients with COVID-19 who require early continuous positive airway pressure

How vital signs measurements can identify patients with COVID who require early CPAP

Bone tumour

Assessing and investigating patients with a suspected bone tumour

Nurses working in ED need to know how to assess, manage and refer patients with a bone tumour

Zygomatic complex fractures in the emergency department: diagnosis and management

Zygomatic complex fractures in the emergency department: diagnosis and management

Zygomatic complex fractures can be missed on assessment and examination and left undiagnosed

Winged scapula: an overview of pathophysiology, diagnosis and management

Winged scapula: an overview of pathophysiology, diagnosis and management

Winged scapula can be painful and debilitating, resulting in loss of power and/or movement

CPD articles

Breaking bad news to patients in the emergency department

Breaking bad news to patients in the emergency department

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.

Health promotion in emergency care: rationale, strategies and activities

Health promotion in emergency care: rationale, strategies and activities

Concept of health promotion and its relevance to nurses working in the emergency department

Managing violence and aggression in the emergency department

Managing violence and aggression in the emergency department

Featuring a successful small-scale trial of body-worn cameras at an East London ED

How to get care right for people with learning disabilities in the emergency department

To get care and treatment right it is essential to ‘ask and engage’ people

Meeting the needs of homeless people attending the emergency department

Meeting the needs of homeless people attending the emergency department

The care needs of homeless people attending EDs are frequently misunderstood

Mallet finger injuries: the signs, symptoms, diagnosis and management

Mallet finger injuries: the signs, symptoms, diagnosis and management

CPD article on the pathophysiology, signs, symptoms, diagnosis and management of mallet finger injuries

How to

Reflective discussion

How to improve patient care by learning from mistakes

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.

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