Minor injuries unit: expanding the scope of accident and emergency provision

Beales, John; Baker, Benjamin G.

doi:10.1016/0965-2302(95)90085-3

Cited by 17 publications

(5 citation statements)

References 4 publications

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“…Overall, MIUs and nurse practitioners have been evaluated favourably ( Head 1988, Beales & Baker 1995, Beales 1997, Dolan et al . 1997 ), with patients stating increased satisfaction and an increase in quality of service ( Head 1988, Crowther & Lumley 1996).…”

Section: Resultsmentioning

confidence: 99%

A review of health professional attitudes and patient perceptions on ‘inappropriate’ accident and emergency attendances. The implications for current minor injury service provision in England and Wales

Sanders¹

2000

Journal of Advanced Nursing

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Increasing attendances in accident and emergency (A and E) departments in the United Kingdom have been attributed to a greater number of patients presenting with minor injuries. A and E staff believe this type of patient is suitable for primary care, and is 'inappropriate' for A and E management. Thus, A and E staff find 'inappropriate' attenders time-consuming and unrewarding, and are less motivated to help them, whilst 'inappropriate' patients believe they have attended the appropriate service for their medical needs and expectations. This review examines research into health professional and patient attitudes towards 'inappropriate' attendances in accident and emergency. It identifies a discrepancy between health professional and patient perspectives regarding 'inappropriate' attendances. However, the change in accident and emergency services with the development of minor injury units and nurse practitioners within A and E to treat minor injury patients away from the mainstream A and E service, appears to be based on the professional attitude of what constitutes an appropriate A and E attendance, and not on the patients' perspective. As negative attitude formation towards 'inappropriate' A and E attendances has occurred, there is concern that such attitudes could remain or develop again in the new units. Patients are generally not medically trained and may experience difficulty in ascertaining the severity of their own condition and attending the 'appropriate' service, as defined by trained professionals. This is exacerbated by the unclear boundaries and roles of minor injury units, nurse practitioners and general practitioners in minor injury care. Therefore research is required into current attendances in minor injury units, A and E departments and general practice, in order to develop clear roles and boundaries for these services. More importantly, research is warranted into the attitudes of all minor injury care providers towards attending patients, and into patient perceptions of the services offered.

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Section: Resultsmentioning

confidence: 99%

A review of health professional attitudes and patient perceptions on ‘inappropriate’ accident and emergency attendances. The implications for current minor injury service provision in England and Wales

Sanders¹

2000

Journal of Advanced Nursing

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“…Many A & E departments have extended the basic list of duties outlined in the RCN guidelines, and created their own protocols for ENP practice ( Dolan et al ., 1997 ), with ENPs now requesting and interpreting X‐rays ( Davies, 1994; Beales & Baker, 1995). However, there is no national consensus regarding the boundaries of ENP practice and omit limited empirical evidence which can be used to inform change.…”

Section: Literature Reviewmentioning

confidence: 99%

Patient satisfaction with emergency nurse practitioners in A & E

Byrne

Richardson

Brunsdon

et al. 2000

Journal of Clinical Nursing

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In recent years the complex process of managing services for patients requiring emergency care has been increasingly under scrutiny and considerable diversity has arisen in the organization of emergency care in both hospital and community settings. One innovation which has been particularly widespread is the development of Emergency Nurse Practitioners (ENPs): experienced Accident and Emergency nurses who assume entire responsibility for patients with minor injuries, in emergency settings. The present paper reports on a study which compared patients' satisfaction with care given by Emergency Nurse Practitioners with that provided by doctors and nurses working together in a traditional A & E. Patients were significantly more likely to have received health education and first aid advice from an ENP than from a doctor. They were also significantly more likely to have been given written instructions to take home and told whom to contact if they needed more help and advice following discharge. Those seen by an ENP also reported that they were subsequently significantly less worried about their health, than did patients seen in a traditional A & E.

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“…In particular, EDPPs recognised that self-neglect is a safeguarding concern. As 0.6% of all recorded UK ED visits concern self-harm, EDPP awareness can only prove useful in supporting those patients [29]. Recent international data suggests there has been an increase in ED visits due to self-harm, likely due to the mental health impact of the pandemic, but again data are generally limited to developed countries such the UK, US, Canada and South Korea [30].…”

Section: Discussionmentioning

confidence: 99%

What do Emergency Department Pharmacist Practitioners know and understand about patient safeguarding?

Greenwood

Steinke

Martin

et al. 2023

Preprint

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Background Pharmacists with additional clinical skills now work in UK emergency departments. Known as Emergency Department Pharmacist Practitioners, the role was developed in response to a shortage of doctors and nurses. They carry out activities typical of traditional hospital pharmacists, but also novel ‘practitioner’ activities such as examining patients, and acting as designated care provider. The role includes a responsibility to safeguard patients from harm. Professional competence, i.e. to safeguard patients, is underpinned by knowledge of the subject, but also the ability to apply that knowledge. Objective To investigate what Emergency Department Pharmacist Practitioners know and understand about safeguarding vulnerable children and adults. Methods Emergency Department Pharmacist Practitioners were interviewed to explore their knowledge and understanding of safeguarding. Interview questions were developed from review of relevant literature, as were vignettes with variables identified and altered to produce different scenarios. Template analysis was used to code data to a priori themes for each of the stages of the initial safeguarding process, and new themes that emerged throughout the process. Results Six themes were identified in addition to the four a priori themes. Overall, participants frequently described how safeguarding concerns are both recognised and responded to, but seemed more comfortable when responding to medicines related concerns. Factors thought to influence the safeguarding process included: resources and setting; and education, training and experiential learning; and culture. Conclusions While Emergency Department Pharmacist Practitioners interviewed were aware of the safeguarding process, there were some misconceptions as to the roles of different health workers.

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Minor injuries unit: expanding the scope of accident and emergency provision

Cited by 17 publications

References 4 publications

A review of health professional attitudes and patient perceptions on ‘inappropriate’ accident and emergency attendances. The implications for current minor injury service provision in England and Wales

A review of health professional attitudes and patient perceptions on ‘inappropriate’ accident and emergency attendances. The implications for current minor injury service provision in England and Wales

Patient satisfaction with emergency nurse practitioners in A & E

What do Emergency Department Pharmacist Practitioners know and understand about patient safeguarding?

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