Message text written by INTERNET:[log in to unmask]
>Quick question, single click answer, and please respond to give me a
decent number of replies for the stats:
Door to needle time 18 minutes - Excellent/good/average/poor/very poor?<
Fascinating to see the standards that people are applying and I would love
to know how the practicalities fit in to some of the assessments. I am
assuming that we are dealing with Departmental average rather than a single
case.
Triage - one minute to triage
Nursing - five minutes to undress the patient, get the ECG and get
a doctor to attend (remember the button may not have been pushed yet)
Medical - two minutes to get a quick story
one minute to look at the ECG
two minutes for the clinical examination
one minute to look for contraindications
two minutes to obtain valid consent
one minute to get vascular access
Nursing - two minutes ot mix the agent and set up the infusion
Total = 17 minutes
I accept that some some of these actions can and should be carried out
simultaneously, but I would be interested to see how, in a busy British
Emergency Department, 18 minutes can be regarded as anything other than
good to excellent.
Those that feel this is inadequate are perhaps being a little harsh. First
of all do no harm. Have you checked for melaena? Have you explained the
risk of stroke and put it into the correct context for the patient?
American standards for negligence are crossing the Atlantic gradually.
Many hospitals I have worked in would not allow us to thrombolyse in the
ED. While we can shave a minute or two off in "good" departments with an
efficient system, the overall results would benefit from addressing wider
issues that can save multiples of minutes to hours.
Best wishes,
Darren
%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%
|