ObjectivesEmergency departments (EDs) serve as a health care "safety net" and may be uniquely suited to screening for and addressing patients' unmet social needs. We aimed to better understand patient perspectives on ED-based screening and interventions related to housing instability, as a step toward improving future efforts. MethodsWe present findings from a qualitative study using in-depth, one-on-one interviews with ED patients who had become homeless in the past 6 months. Qualitative interviewees were asked their thoughts on ED staff asking about and helping to address homelessness and housing issues. Interviews were professionally transcribed verbatim. Multiple coders identified interview text segments focused on ED-based housing screening and intervention, which were then independently analyzed thematically and discussed to reach consensus. Researchers also categorized each participant's overall opinion on ED housing screening and interventions as positive, neutral, or negative. Results Qualitative interviews were conducted with 31 patients. Four themes related to ED-based housing screening and interventions emerged: (1) patients generally welcome ED staff/providers asking about and assisting with their housing situation, with caveats around privacy and respect; (2) ED conversations about housing have potential benefits beyond addressing unmet housing needs; (3) patients may not consider the ED as a site to obtain help with housing; (4) patients' experiences navigating existing housing services can inform best approaches for the ED. Most participants expressed overall positive views of ED staff/providers asking patients about their housing situation. Conclusions How to cite this article: Kelly A, Fazio D, Padgett D, . Patient views on emergency department screening and interventions related to housing.

The aim of this study was to assess the competence of senior medical students in recognizing and managing life-threatening ward emergencies and to compare the competence of a group that had received emergency medicine teaching with one that had not. This was achieved by asking 60 final year medical students to complete a structured written clinical examination designed to test these skills. Comparisons were made between the group that had received emergency medicine teaching (the 'taught' group) and that which had not (the 'untaught' group) with respect to numerical scores on the examination and the number of fatal management errors committed. The 'taught' group had an average total score of 285/400 compared with an average score of 223/400 for the 'untaught' group (P < 0.001). The 'untaught' group committed 0.25 fatal errors per student per case compared with the 'taught' group that committed 0.06 fatal errors per student per case (P < 0.001). There is considerable scope to improve the competence of senior medical students for dealing with life-threatening ward emergencies. Students who had received emergency medicine teaching scored significantly better than those who had not suggesting that emergency medicine teaching is a suitable tool to help equip medical students to deal with life threatening ward emergencies.

No abstract

The aim of this study was to determine the inter-rater agreement between physicians and nurses regarding eligibility for application of the Canadian C-Spine Rule (CCR) and assessment of the criteria of the CCR. Methods: In this observational study, nurses and physicians independently assessed the CCR criteria in a convenience sample of patients with potential C-spine injury. Data were entered onto separate data sheets. The outcomes of interest were the inter-rater agreement between nurse and physician regarding eligibility for application of the rule, for assessment of each component of the rule and for interpretation of the rule overall, assessed by kappa analysis. Results: In total, 88 cases were eligible for analysis. Physicians and nurses agreed on which patients were eligible for CCR application in 96.6% of cases. Inter-rater agreement for most CCR criteria was good (κ > 0.61), with the exception of midline tenderness (κ = 0.58) and range of motion, which most nurses did not test. Conclusion: This study shows that nurses have the potential to reliably apply the Canadian C-Spine Rule but require further training in the assessment of midline tenderness and range of motion. RÉSUMÉ Objectif : Cette étude avait comme objectif de déterminer la concordance inter-évaluateurs entre les médecins et les infirmières quant à l'admissibilité à l'application de la Règle canadienne concernant la colonne cervicale (Canadian C-Spine Rule) (CCR) et à l'évaluation des critères de la CCR. Méthodes : Lors de cette étude d'observation, des infirmières et des médecins évaluèrent indépendamment les critères de la CCR au sein d'un échantillon de commodité de patients atteints d'une blessure potentielle à la colonne cervicale. Les données furent notées sur des fiches de données séparées. Les résultats étudiés furent la concordance inter-évaluateurs entre l'infirmière et le médecin concernant l'admissibilité à l'application de la règle, l'évaluation de chaque composante de la règle et l'interprétation de la règle dans son ensemble, évaluée à l'aide de l'analyse statistique kappa. Résultats : Au total, 88 cas furent jugés admissibles à l'analyse. Les médecins et les infirmières s'entendaient sur les patients chez qui la CCR devrait être appliquée dans 96,6 % des cas. Le niveau de concordance inter-évaluateurs pour la plupart des critères de la CCR était bon (κ > 0,61), EM ADVANCES • INNOVATIONS EN MU

No abstract