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Exploring Emergency Department Provider Experiences With and Perceptions of Weight-Based Versus Individualized Vaso-Occlusive Treatment Protocols in Sickle Cell Disease.

Publication ,  Journal Article
Knight, LMJ; Onsomu, EO; Bosworth, HB; Crawford, RD; DeMartino, T; Glassberg, J; Paice, JA; Miller, CN; Richardson, L; Tanabe, P
Published in: Adv Emerg Nurs J
2019

Treatment of vaso-occlusive episodes (VOEs) is the most common reason for emergency department (ED) treatment of sickle cell disease (SCD). We (1) compared perceptions of the usability and ability to manage VOE pain between ED nurses and other ED provider types, ED sites, and VOE protocols (individualized vs. weight-based), and (2) identified ED nurse and other provider protocol suggestions. A secondary analysis of provider survey data collected immediately after caring for a patient enrolled in a randomized controlled trial comparing weight-based versus individualized opioid dosing for VOE. Research staff asked the ED nurses and other ED providers (nurse practitioners [NPs], physician assistants [PAs], residents, and attending physicians) 5 questions related to the protocol's ease of use and ability to manage pain. There were 236 surveys completed. Attending physicians (n = 15), residents (n = 88), PAs (n = 21), and NPs (n = l) were more satisfied than nurses (n = 111) with the clarity of the analgesic ordering (97.6% vs. 0%, p = 0.0001) and ability to manage the patient's VOE pain (91% vs. 0%, p = 0.0001). When comparing both protocols with the usual ED strategy in their ED to manage VOE, more nurses than other ED providers perceived the study patients' pain management protocol as better (100% vs. 35.2%, p = 0.0001). Other ED providers perceived the individualized versus weight-based protocol as better at managing pain than their usual ED strategy (70.3% vs. 59.5%, p = 0.04). The individualized protocol was perceived as better in managing VOE than the weight-based ED strategy. While physicians were satisfied with the clarity of the protocols, nurses were not. Improved protocol usability is required for widespread ED implementation.

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Published In

Adv Emerg Nurs J

DOI

EISSN

1931-4493

Publication Date

2019

Volume

41

Issue

1

Start / End Page

86 / 97

Location

United States

Related Subject Headings

  • Surveys and Questionnaires
  • Pain Measurement
  • Pain Management
  • Male
  • Humans
  • Health Knowledge, Attitudes, Practice
  • Female
  • Emergency Service, Hospital
  • Clinical Protocols
  • Body Weight
 

Citation

APA
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ICMJE
MLA
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Knight, L. M. J., Onsomu, E. O., Bosworth, H. B., Crawford, R. D., DeMartino, T., Glassberg, J., … Tanabe, P. (2019). Exploring Emergency Department Provider Experiences With and Perceptions of Weight-Based Versus Individualized Vaso-Occlusive Treatment Protocols in Sickle Cell Disease. Adv Emerg Nurs J, 41(1), 86–97. https://doi.org/10.1097/TME.0000000000000232
Knight, LaʼKita M. J., Elijah O. Onsomu, Hayden B. Bosworth, Regina D. Crawford, Theresa DeMartino, Jeffrey Glassberg, Judith A. Paice, Christopher N. Miller, Lynne Richardson, and Paula Tanabe. “Exploring Emergency Department Provider Experiences With and Perceptions of Weight-Based Versus Individualized Vaso-Occlusive Treatment Protocols in Sickle Cell Disease.Adv Emerg Nurs J 41, no. 1 (2019): 86–97. https://doi.org/10.1097/TME.0000000000000232.
Knight LMJ, Onsomu EO, Bosworth HB, Crawford RD, DeMartino T, Glassberg J, et al. Exploring Emergency Department Provider Experiences With and Perceptions of Weight-Based Versus Individualized Vaso-Occlusive Treatment Protocols in Sickle Cell Disease. Adv Emerg Nurs J. 2019;41(1):86–97.
Knight, LaʼKita M. J., et al. “Exploring Emergency Department Provider Experiences With and Perceptions of Weight-Based Versus Individualized Vaso-Occlusive Treatment Protocols in Sickle Cell Disease.Adv Emerg Nurs J, vol. 41, no. 1, 2019, pp. 86–97. Pubmed, doi:10.1097/TME.0000000000000232.
Knight LMJ, Onsomu EO, Bosworth HB, Crawford RD, DeMartino T, Glassberg J, Paice JA, Miller CN, Richardson L, Tanabe P. Exploring Emergency Department Provider Experiences With and Perceptions of Weight-Based Versus Individualized Vaso-Occlusive Treatment Protocols in Sickle Cell Disease. Adv Emerg Nurs J. 2019;41(1):86–97.

Published In

Adv Emerg Nurs J

DOI

EISSN

1931-4493

Publication Date

2019

Volume

41

Issue

1

Start / End Page

86 / 97

Location

United States

Related Subject Headings

  • Surveys and Questionnaires
  • Pain Measurement
  • Pain Management
  • Male
  • Humans
  • Health Knowledge, Attitudes, Practice
  • Female
  • Emergency Service, Hospital
  • Clinical Protocols
  • Body Weight