Assessment of user embracement with risk rating in emergency hospital services

Abstract

Cross-sectional and quantitative study, conducted in 2013, aiming to evaluate the implementation of User Embracement with Risk Rating (ACCR) in four Emergency Hospital Services. One hundred fifty six nurses participated and answered the questionnaire "User Embracement with Risk Rating". The data were treated through descriptive and inferential statistics, from the Kruskal-Wallis test. The implementation of ACCR was assessed as precarious, mainly due to the lack of referral of low complexity cases to the basic health system, the inadequate physical space for companions and the lack of discussion and periodic assessment of the flow of care in ACCR. The dimension Result of Implementation obtained a slightly higher score and Structure was the dimension with the lowest score. It was concluded that the negative assessments by nursing professionals of the referred dimensions in the investigated sites suggests the need for improvements, especially in the dimension Structure.

Sentimentos do enfermeiro ao acolher paciente psiquiátrico agitado e agressivo

“…11 It is inferred, according to studies carried out with EU nurses, that the participants were reluctant, avoiding handling psychiatric patients, mainly due to lack of knowledge and previous experiences of fear and intimidation, which corroborates the findings of this study when a nurse demonstrates fear of seeing the patient alone in his room, for example. 6, The imminent risk of physical and psychological injuries is increased, in addition, due to this limited knowledge of the team and the lack of confidence perceived in the notes of lack of personal preparation to deal with aggressive patients and with invasive behaviors. 16 Fast and safe interventions are required by agitation.…”

“…The difficulty in managing these patients increases as it is understood that the busy nature of the EU, with excess of people and environmental stimuli, combined with long waiting times, often intensifies agitation and aggression behaviors by patients. [5][6][7] It is pointed out that agitation is a dynamic situation that can quickly increase from anxiety to aggressive or violent behavior, which requires immediate and safe intervention. It is advised, first, that the health professional should never put himself in an unsafe situation (for example, in a closed room or where access to doors is blocked or other compromising places).…”

Manchester Triage System: assessment in an emergency hospital service

“…In this context, the use of a triage system, nationally called risk stratification (RS), has great relevance in prioritizing patients with greater severity and in preserving the safety of patients cared for in ES (6)(7) . Among the various recognized RS systems, the Manchester Triage System (MTS) (8) has wide international dissemination, being adopted by Brazilian institutions (9)(10) and widely used in European countries (11) , to direct the best clinical care to patients with greater urgency, to ensure that resources are applied efficiently (11)(12) and to reduce the bias of subjectivity involved in the clinical decision-making process of nurses (9) .…”

O cuidado à pessoa com comorbidade psiquiátrica em emergência geral: visão dos enfermeiros

“…These services are available to people with clinical or surgical problems with the aim of reducing morbidity and mortality and disabling sequelae. The overall population seeks these services as an alternative to conventional health care since they believe the emergency unit has the resources they need, such as consultations, medication, nursing procedures, laboratory tests, and admissions, to solve their health problems more rapidly (1) .…”

“…Moreover, they have difficulties accessing out-of-hospital services due to financial restrictions and geographical distance, in addition to the resistance of other services in assisting these people, especially in primary care (1) . Such a situation resembles a study conducted in Bogotá that highlighted the inability of the service to absorb the demand of psychiatric patients (4) .…”