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Dissertations / Theses on the topic 'Accident and emergency'

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Published: 4 June 2021
Last updated: 1 February 2022

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1

Riley, Jacqueline. "Creating a generic model of accident and emergency departments." Thesis, Glasgow Caledonian University, 2001. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.364778.

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2

To, Mei-kuen Erica, and 杜美娟. "Workplace violence in Accident & Emergency Department of Hong Kong." Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 2004. http://hub.hku.hk/bib/B42577469.

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3

Byrne, Geraldine. "The accident and emergency department : nurses' priorities and patients' anxieties." Thesis, Northumbria University, 1992. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.316497.

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This study investigated the sources of anxiety for patients in the Accident and Emergency Department and explored how patients' anxiety was influenced by their experiences in the department and the attitudes, behaviour and communication patterns of nurses and other staff. The research was carried out in twO Accident and Emergency Departments and consisted of three stages. Stage One employed structured interviews with 96 patients to identify sources of anxiety for patients in the Accident and Emergency Department and to examine the relationship between anxiety and the patient variables of age, sex, condition and department. In Stage Two in-depth interviews were conducted with 21 qualified nurses to explore their perceptions of their work and patients. Stage Three was an observational study, involving 23 patients, which examined the nature of nurse-patient communication in the Accident and Emergency Department. A Symbolic Interactionist framework was used in order to understand events from the perspective of those involved. Patients appeared to view their stay in the Accident and Emergency Department as an event occurring within the wider context of their daily lives and were concerned with social factors related to admission and the consequences of their illness or injury. Nurses held a different perspective and were more concerned with physical care and the organisation of the patients' stay in the department. In contrast to the patients, the nurses were concerned with short-term problems. Interaction between nurses and patients consisted predominantly of brief encounters which focused on the patients' illness or injury and their progress through the department. There was little attention explicitly directed towards dealing with patients' anxieties. A complex range of factors - interpersonal, cultural, interprofessional and structural - were found to influence communication. A number of recommendations are made identifying ways to enhance nurses' ability to deal with patients' anxieties.
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4

To, Mei-kuen Erica. "Workplace violence in Accident & Emergency Department of Hong Kong." Click to view the E-thesis via HKUTO, 2004. http://sunzi.lib.hku.hk/hkuto/record/B42577469.

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5

Brookes, Marie T. "Paediatric head injury decisions in the accident and emergency department." Thesis, University of Liverpool, 1997. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.367030.

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6

Wong, Chi-pang, and 黃志鵬. "The impact of the establishment of emergency medicine ward at accident& emergency department on hospital admission." Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 2010. http://hub.hku.hk/bib/B45174416.

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7

Leung, Chi-hang Vincent. "Consultation pattern of non-urgent patients of Accident & Emergency Department." Click to view the E-thesis via HKUTO, 2005. http://sunzi.lib.hku.hk/hkuto/record/b39724189.

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8

Leung, Chi-hang Vincent, and 梁志鏗. "Consultation pattern of non-urgent patients of Accident & Emergency Department." Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 2005. http://hub.hku.hk/bib/B39724189.

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9

Bentley, Jackie. "The experience of children attending accident and emergency with minor injuries." Thesis, University of the West of England, Bristol, 2002. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.249141.

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10

Hetherington, Angela. "Stress in accident and emergency personnel and road traffic patrol officers." Thesis, Cranfield University, 1994. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.385778.

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11

Steedman, David James. "Profile of an accident flying squad : analysis by injury severity scoring systems." Thesis, University of Edinburgh, 1988. http://hdl.handle.net/1842/24337.

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12

James, Kirstin. "The lived experience of occupational therapists in Scottish Accident and Emergency Departments." Thesis, Glasgow Caledonian University, 2014. http://researchrepository.napier.ac.uk/Output/1410459.

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Emergency Departments (EDs) deliver urgent treatment at the ‘front-door' of acute hospitals. In Scotland, occupational therapists have had an increasing presence in EDs, an emerging role with limited evidence to guide its development. There are no predetermined philosophies or existing theories of ED occupational therapy. Therefore, this exploratory study examined the lived experience of ED occupational therapists in order to make an original contribution to knowledge, and to inform practice. Ethical approval was granted from Glasgow Caledonian University. Research methods were framed by Interpretative Phenomenological Analysis (IPA), and purposive sampling was used to recruit nine ED occupational therapists from across Scotland. Individual, semi-structured interviews were audio-recorded and transcribed verbatim. Interview transcripts were analysed line-by-line and interpreted using IPA methods. Two over-arching themes emerged from the data. Theme 1: 'On the Factory Floor' captured the experience of working in an ED. EDs are highly organised, likened to factory production-lines, but also unpredictable, even chaotic. The participants contributed their professional skills to make sense of both the order and the chaos. Theme 2: 'A Stranger in a Strange Land' encapsulated what it was like to enter the ED environment, and the participants were still discovering how they might acculturate. They experienced EDs as challenging environments, which potentially threatened the delivery of occupational therapy in terms of its core-constructs. However, they were able to maintain the values of occupational therapy, though they applied them with constraints. In addition, challenges placed clinicians at high risk of burn-out. Despite this, there were personal and professional rewards, especially enjoyment, being valued and being recognised. Occupational therapy is still emerging in the ED context, professional identity is forming and models of practice are not fully developed. Implications arising from the study are discussed in relation to health policy, future research, occupational therapy practice and occupational therapy education.
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13

Forge, Joyce Agatha. "Safeguarding children? : child records in Accident and Emergency : the perspectives of staff." Thesis, Anglia Ruskin University, 2013. http://arro.anglia.ac.uk/295482/.

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This case study of the use of hospital accident and emergency records to safeguard children was triggered by Lord Laming’s inquiry into the care of Victoria Climbié, his follow up report, and government legislation since 1948. Research on the use of documentation for safeguarding children is limited, although serious case reviews consistently indicate, that across agencies, record keeping, and the sharing of pertinent information to identify patterns of maltreatment is poor. The social constructed meaning people place on hospital documentation relating to children’s safety and the perceived intentions of conveying that information within and between social environments are the focus of this research. A hermeneutic framework was used to identify how staff in A&E and other agencies perceive the use of A&E child records (birth -16 years). The investigation was in three stages (a) analysis of a purposive sample of 378 A&E children’s records, (b) a focus group with twelve A&E staff on the case study site and (c) another group with twelve members of the Local Operational Child Protection group. Colaizzi’s approach and the hermeneutic circle were the methods utilised to provide a rich description of the essential structure of the phenomenon. The results reveal that although written records are good tools for communication, records are not sufficiently child focused and risks factors are not always recognised. Consequently, the ability of the professional to provide information to safeguard children is limited. The data also highlights professional communication as the central theme, because this seemed to describe and unify the participants’ practices in a way that made sense. The findings of this study indicate that the behaviour of staff plays a crucial role in recording information. They are influenced by factors that are multi-faceted with the complexities of meanings that include social, economic, emotional, cultural, political and technical elements. A new theoretical framework to understand the complex interaction of professional perspectives within the varied situations that occur in clinical practice is proposed. This is underpinned by a constructivist epistemology. This provides an efficient method for evaluating the overall behaviour of the major components that affect documentation and communication, and highlights the recurring problems that arise from these areas when safeguarding children. Hence, this study provides an original contribution to knowledge concerning information sharing in the field of child protection. As a result of the findings of this study A&E records have been redesigned locally.
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14

Battison, Graeme Keith. "Talking about parasuicide : attributions among parasuicide patients and Accident and Emergency staff." Thesis, University of Cambridge, 1997. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.627387.

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15

Phipps, Valerie Lily. "The psychological effects of road traffic accidents on children and adolescents following admission to an Accident and Emergency Department." Thesis, Open University, 2000. http://oro.open.ac.uk/58073/.

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Objectives: - The present research attempts to elicit children's perceptions and experiences of enduring a road traffic accident (RTA). It also examined their parents experiences of parenting such children and their own experiences and perceptions of the accident. Participants: - The study focussed on 14 children, aged from 9 years 9 months - 14 years and 4 months of age who had endured a RTA from between 9-33 months previously and their parents. Design: - The study employed a non-experimental design with a combination of quantitative and qualitative paradigms. Method: - The participants were identified via the hospital database of all children who had endured a RTA from between 6-24 months previously. Both the children and their parents were interviewed on specifically designed semi-structured interview schedules. Each interview was then tape-recorded and transcribed in its entirety. These transcripts then provided the universe of material for subsequent qualitative analysis. Results:- The results of this study demonstrated that approximately half of the children who had experienced a RTA were suffering from a post traumatic stress disorder (PTSD). In addition, the PTSD case children differed from the non-case children on factors such as awareness of the inpending RTA, feelings of self-blame regarding the accident, and more negative thoughts regarding their experience immediately after the impact and at the time of the assessment. In addition, the parents of the case children displayed similar responses to that of their children. Conclusion: - A theoretical Model was presented to account for the main findings in response to the research questions, also drawing on existing research. It is emphasised that this model is speculative due to the small sample size insofar as it draws upon the present findings, and as such can only relate to this study sample and further research would be required to fully test and validate it. In addition, recommendations were made for service delivery and clinical practice.
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16

Edwards, Bernard. "The process of nurse triage : a grounded theory exploration." Thesis, London South Bank University, 2003. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.288107.

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17

Okpanum, Innocent. "The role of design guidelines for accident and emergency facilities in South Africa." Thesis, University of Newcastle Upon Tyne, 2011. http://hdl.handle.net/10443/1042.

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This study is focused on design guidelines (DGs) for healthcare facilities development in South Africa which date to the apartheid era, the consequence of which is inadequate provision of healthcare facilities in urban areas where the poor black majority live and work. It aims to assess the role of DGs in the development and provision of healthcare facilities; and more specifically to assess the role of design guidelines for accident and emergency facilities (DGAEF) so as to make recommendations on how to improve their design and project development process. Informed and guided by philosophical and theoretical frameworks and a conceptual model of DGAEF, the empirical research was conducted between 2006 and 2007 using the following methodologies: questionnaire and interview surveys, floor plan analyses and observational studies. Owing to geographical, financial and time constraints, the study was restricted to two case study accident and emergency (A&E) facilities—Chris Hani Baragwanath Hospital (CHBH) in Soweto, Johannesburg and Pretoria Academic Hospital in Pretoria. The information gathered was analysed using descriptive statistics, content analysis, Space Syntax analysis, hierarchical task analysis and link analysis. A SWOT (Strength- Weaknesses-Opportunities-Threats) analysis was also conducted. The main findings are that there is inadequate policy attention to DGAEF update; lack of integration of the project brief, design and construction processes; excessive timeframes for project development; quality issues; and lack of post-occupancy evaluation (POE). Thus, the findings underscore the need to develop and introduce design quality indicators (DQIs) and key performance indicators (KPIs) in the general and specific design requirements in the DGAEF used for space design and provision, functional suitability and spatial relationships. The key recommendation of this research is that, to improve access to adequate A&E facilities and achieve measurable positive outcomes in healthcare services delivery in South Africa, the DGAEF should be updated based on evidence. To this end, research-based guiding principles, based on Planetree principles, are presented—which emphasise improved project communication approaches; understanding of value systems; participatory design processes; constant use and update of information systems through technology innovation; standardisation of the overall project development process from briefing through to POE; and institutional transformation based on societal change.
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18

Hemingway, Philippa. "Determining why parents with sick children attend Accident and Emergency and general practice." Thesis, University of Nottingham, 2004. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.408602.

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19

Forbes, Lindsay Jean Lesley. "Accident and emergency attendance for asthma in children living in the inner city." Thesis, King's College London (University of London), 2004. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.414770.

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20

Chan, Man-yan Esther. "A comprehensive intervention for mild head injury patients in accident and emergency department." Click to view the E-thesis via HKUTO, 2009. http://sunzi.lib.hku.hk/hkuto/record/B43251018.

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21

Virtue, Anthony. "A healthcare space planning simulation model for Accident and Emergency (A&E)." Thesis, University of Westminster, 2013. https://westminsterresearch.westminster.ac.uk/item/8z1y4/a-healthcare-space-planning-simulation-model-for-accident-and-emergency-a-e.

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The National Health Service (NHS) in the United Kingdom provides a range service for its population including primary care and hospital services. The impact of the 2008 economic and financial crises prompted a tightening of public budgets including health. Over the next few years, and most likely beyond, the NHS is planning for unprecedented levels of efficiency saving in the order of £ billions. With little doubt, the NHS will need to review its way of working will need to do more with less. Simulation is an established technique with applications in many industries including healthcare. Potentially, there are huge opportunities for simulation use to make further inroads in the field of healthcare. Despite the potential, arguably, simulation has failed to make a significant impact in health. Some evidence has tended to suggest that within health there has been poor adaption along with poor linkage to real-world problems, as perceived by healthcare stakeholders. The aim of this thesis is to develop a model to help address real-world healthcare issues as recognised by healthcare stakeholders. In doing so, this thesis will focus on a couple of real-world problems, namely:  What space is needed to meet service demand, when is it needed and what will it cost?  What space do we have, how can it be used to meet service demand and at what cost? The developed simulation space demand model will demonstrate its value modelling dynamic systems over static models. The developed models will also show its value highlighting space demand issues by groups of patients, by time of day. Real, readily available data (arrival and length of stay, by patient group) would drive the model inputs, supporting ease of use and clarity for healthcare stakeholders. The model was modular by design to support rapid reconfiguration. Dynamically modelled space information allows service managers and Healthcare Planners to better manage and organise their space in a flexible way to meet service requirements. This work will also describe how space demand can linked with building notes to determine Schedules of Accommodation which can be used to cost floor space and consequent building or refurbishment costs. Furthermore, this information could be used to drive business plans and to develop operational cost pertaining to the floor area. This body of work debates using function-to-space ratios and attaching facilities management cost. Our findings suggest great variance in function-to-space ratios. Our findings also suggest that moving to median or lower quartile function-to-space ratios could potentially save hospitals £ millions in facilities management costs. This thesis will reflect on the level of modelling taking place in the healthcare industry by non-academic healthcare modellers, sometimes collectively known as Healthcare Planners, the Healthcare Planning role in space planning and their links with healthcare stakeholders. This reflection will also consider whether healthcare stakeholders perceive a great need for academic healthcare modelling, if they believe their modelling needs are met by Healthcare Planners. A central theme of this thesis is that academic modelling and Healthcare Planning have great synergy and that bringing together Healthcare Planners’ industry knowledge and stakeholder relationships with academic know-how, can make a significant contribution to the healthcare simulation modelling arena.
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22

Tye, Christopher Charles. "The emergency nurse practitioner role in major accident and emergency departments : a United Kingdom postal survey and case study evaluation." Thesis, St George's, University of London, 2001. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.271476.

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23

Hui, Pui-yan. "Nurses' attitudes towards abused women in an Accident and Emergency Department in Hong Kong /." View the Table of Contents & Abstract, 2006. http://sunzi.lib.hku.hk/hkuto/record/B36396709.

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24

Shea, Christine E. "The organizationof work in a complex and dynamic environment : the accident and emergency department." Thesis, University of Manchester, 1996. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.556318.

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25

Hui, Pui-yan, and 許佩欣. "Nurses' attitudes towards abused women in an Accident and Emergency Department in Hong Kong." Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 2006. http://hub.hku.hk/bib/B45011783.

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26

Fletcher, Adrian. "Generic simulation modelling of accident and emergency patient flows in acute hospitals in England." Thesis, Lancaster University, 2012. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.606344.

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Accident and Emergency (A&E) departments deal with emergency patients in NHS acute hospitals in England. They have access to diagnostics facilities and inpatient beds. A previous government target was that 98% of A&E patients should be completed within four hours. The author was the analytical lead for emergency care in the Department of Health (DH) in 2003 and 2004, responsible for analytical support to ministers on issues faced by the NHS in managing A&E patient flow. A so-called 'generic' discrete event simulation model of A&E services was developed at this time. It described a 'typical' A&E de~artment and enabled detailed investigation and facilitated workshop discussions of potential interventions. It helped advise whether the target was achievable. The development and use of this model at national level is described. An opportunity is also described to use the model in hospital trusts where it was also found to be useful. The experiences with this model provided the motivation to investigate this area further. Simulation is widely used to model A&E services, but very few models are 'generic'- they are usually designed for specific trusts. Three particular research questions are investigated: 1 What are generic hospital simulation models? 2 How can generic hospital simulation models be built? 3 Can they be useful? This research uses a literature review and an informal survey of health OR academics and experienced DH modellers to generate two answers to question 1: a broad four level classification of model types, and a more detailed framework of typical characteristics of generic hospital simulation models. An improved 'generic' A&E patient flow simulation model was then developed to address the shortcomings of the first model, particularly through increased scope and detail. Experiences with,both the original DH model and this improved model provide answers to the second question in identifying different build techniques and important issues to consider when developing generic models. The improved model was used with DH on two case studies: possible NHS responses to a potential swine flu pandemic, and the impact of patient mix and resuscitation patients on A&E performance. This experience, and that with the first model, provide answers to the third question by examining the successes and failures of the use of the models at national and hospital trust level. Possible reasons for the relative levels of success are discussed
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27

Alwani, G. M. J. "The design of hospital accident and emergency departments regarded as a problem of engineering." Thesis, University of Leeds, 1987. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.377855.

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28

Chau, Wai-lin Dorothy, and 周偉蓮. "Routine screening of intimate partner violence in the accident & emergency department of Hong Kong." Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 2012. http://hub.hku.hk/bib/B48335204.

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Intimate partner violence (IPV) is a worldwide public health problem that causes a devastating effect on the survivors and their families, society and health care services. World Health Organization (2004) conducted multi-country study which shows the prevalence of female who were the survivors of IPV among the world ranged from 15% to 71%. Smith and Farole (2009) reflected that about 86% IPV was committed against women by men. Lau (2008) found the male to female ratio of IPV in Hong Kong was 1 to 7. In order to reduce IPV, the first step is screening (Leppa?koski, Astedt-Kurki, & Paavilainen, 2011). Self-disclosure of IPV is rare and unlikely (Todahl & Walters, 2011; Phelan, 2007; Schimanski & Hedgecock, 2009; Stith et al., 2004). Most of the survivors of IPV were not easily identified by nurses and doctors (Leppa?koski, Astedt-Kurki, & Paavilainen, 2011). Human, social, and economic cost of IPV is high. Early IPV screening is important. Early detection of IPV can help the survivors of IPV to have early intervention and prevention of future episodes (Perciaccante, Carey, & Dodson, 2010). Campbell (2002) also stated that routine screening maybe the most effective way to identify IPV. Mortality and morbidity can be reducing and it does more good than harm (Schimanski & Hedgecock, 2009). Lau (2008) stated that Emergency Department (ED) was an ideal place to study IPV in Hong Kong as police, primary care, social workers referred most IPV survivors to ED for further management. However, there is no routine screening of IPV in Hong Kong ED. The objectives of the dissertation are to search the literatures of screening of female IPV in ED and then conduct a quality assessment from these chosen literatures to synthesis the findings. The transferability and feasibility of the findings of the selected is assessed. The last objective is to develop an evidence based guideline, implementation and evaluation plan for application of routine IPV screening in Hong Kong ED.
published_or_final_version
Nursing Studies
Master
Master of Nursing
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29

So, Wing-hong, and 蘇永康. "The use of music therapy in reducing anxiety on patients attending accident and emergency department." Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 2013. http://hdl.handle.net/10722/193051.

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In Hong Kong, there has about 70% patients who attend Accident and Emergency Department (AED) is categorized as semi- or non-urgent cases. The medical conditions with the relative longer waiting time provoke the anxiety level. Furthermore the anxiety is worsen by the noisy waiting environment. These phenomena not only affect the psychological but also the physiological changes of patients. Therefore, there is a need to develop an evidence-based intervention that can effectively reduce the anxiety level during the waiting time. The music intervention is proposed to be implemented to reduce the anxiety in the AED setting as this intervention has been proven with a significant anxiolytic effect in variety of healthcare setting. This dissertation is a translational research that aims to identify the advantages or music intervention, develop an evidence-based practice (EBP) guideline for health care providers, and design an evaluation plan for evaluating the protocol effectiveness. The transferability and feasibility of the literature were high. The target setting is one of the AEDs in Hong Kong and the music intervention can be given in cubicle or waiting room by using Mp3 or speakers respectively. The music album is preferably chosen by patients and the intervention last for about 30-60 minutes. An implementation plan for pilot testing was developed to trying out the guideline and to reduce the potential problems during implementation. Comprehensive evaluation plans on stakeholders were developed. This dissertation contributes to develop an evidence-based protocol for healthcare-providers to follow and demonstrate in real situation.
published_or_final_version
Nursing Studies
Master
Master of Nursing
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30

Eastham, Joe. "Workload measurement and costs in a U.K. accident & emergency department : a health economics analysis." Thesis, Keele University, 2006. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.421646.

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31

Heyns, Tanya. "Core competencies of the A&E (accident and emergency) nurse in life-threatening situations in the emergency care environment in South Africa." Diss., University of Pretoria, 2003. http://hdl.handle.net/2263/28216.

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32

Wong, Hay-tai. "Attitudes of accident and emergency department nurses towards extending and expanding their professional roles in Hong Kong a pilot study /." Click to view the E-thesis via HKUTO, 2003. http://sunzi.lib.hku.hk/hkuto/record/B3197286X.

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33

Downing, Amy. "An investigation into the accident and emergency commissioning data set and its use in enhancing the knowledge of patients' use of emergency health services." Thesis, University of Birmingham, 2004. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.403921.

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34

Piper, Elizabeth. "Investigating the experiences of people with learning disabilities in accident & emergency from a carer perspective." Thesis, University of Hull, 2008. http://hydra.hull.ac.uk/resources/hull:5754.

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Primary and secondary health services have a duty to provide for the health needs of people with learning disabilities. Previously this group of the population may have experienced segregated and/or a lack of adequate health services. However a combination of legislation, Government policies and guidelines and improved advocacy has placed pressure on primary and secondary healthcare to provide more equitable services. Much of the research already undertaken has focused on primary care or planned admissions within mainstream hospital. The following research sought to investigate emergency healthcare - as delivered via Accident & Emergency - from the perspective of the carers of people with learning disabilities. The work was undertaken in two separate A&E departments. An Interpretative Phenomenological Approach was used to analyse interviews undertaken with carers. Some of the findings which emerged were in keeping with past literature. However some differed from that previously reported - major concerns were not raised by carers about consent or staff attitudes, although the relationship staff had with both service users and carers was considered to be fundamental to a high quality service. The themes identified included Interactions that are valuing, Emotional responsiveness, Support, Compliance and Responsibilities. Given accounts in previous literature, most participants were surprisingly positive about their experiences.
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35

Brummell, Stephen Philip. "Clinical decision-making in action, the use of cardiopulmonary resuscitation in the accident and emergency department." Thesis, University of Nottingham, 2013. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.594830.

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This thesis uses an ethnographic approach to examine resuscitation practices within the emergency department (ED). A wider understanding of cardiopulmonary resuscitation and the reasons for its use are required. This study builds on a small but important body of ethnographic work which locates the role of advanced technology within the broader context of death and dying. Participant observation of resuscitation attempts was undertaken in a semi-urban ED. Semistructured interviews provided a detailed description of staff roles and their perception of the event and were also undertaken in an urban ED to validate the interpretation of initial findings. Findings from this study are considered in relation to existing theories and literature and its contribution to the development of these theoretica1 perspectives is identified. Resuscitation decisions are shown to involve complex, tacit processes of categorisation, by which staff differentiate resuscitation situations. These categories are constructed by combining bodily and technical information that are indicative of dying, but given meaning by their social context. It is shown that in decision making staff employ concepts such as "downtime" and draw on their perceptions of "elderly" and "young". Resuscitation sometimes 'buys time' for emotional adjustment by the family but also enables staff to align "technical" with "bodily" dying. The process of alignment determines the point when resuscitation should be withdrawn, and provides time to facilitate dying and the construction of an acceptable death. Practices following unsuccessful resuscitation and dealing with the body are investigated. The enactment of laying-out is revealed to be appropriated by nursing staff, providing an intimate, informal "space" to unite bodily dying with social death. Body care remains relatively clandestine, and the importance of augmenting its status is considered. It is also shown how the formal clinical procedure of last-offices is an important means by which a "dead body" is constructed.
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梁寶珊 and Po-shan Melissa Leung. "The prevalence of domestic violence among the female Chinese population in the accident and emergency department." Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 2002. http://hub.hku.hk/bib/B25910681.

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37

Wong, Lai-hung, and 黃麗虹. "An evidence-based guideline in preventing hypothermia for adult trauma patients in accident and emergency department." Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 2013. http://hdl.handle.net/10722/193084.

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Hypothermia is commonly found in injured victims who suffer from central nervous system injury, hypovolemic shock, exposure to environment, administration of anesthetic drugs and cold intravenous fluid. All these factors decrease the abilities of trauma victims to maintain normothermia and conserve body heat. Hypothermia in injured victim is a significant contributor to a well known cycle—triad of death and associated with increased mortality, morbidity and length of hospital stay. Hypothermia is one of the preventable complications in trauma patients. Therefore nurse plays a vital role to evaluate the methods of preventing hypothermia. However, there is no systematic review of effectiveness of different warming methods in local setting. The purpose of this dissertation is to develop an evidence-based guideline to prevent hypothermia in trauma patients by reviewing existing evidence, to assess the feasibility and transferability of implementing the guideline and to develop its implementation and evaluation plan. Five articles meeting the inclusion and exclusion criteria are identified after a systematic research of six electronic databases. Among these articles, four of them are randomized controlled trials while the remaining one is quasi-experimental design with prospective randomized assignment. The quality of these identified articles is evaluated with the methodology checklist for randomized controlled trials which is developed by Scottish Intercollegiate Guideline Network (SIGN). All studies of medium and high quality would be considered as sufficient evidence to support the proposed innovation in preventing hypothermia for trauma patients in Accident & Emergency Department. After assessing the implementation potential, an evidence-based guideline in preventing hypothermia for adult trauma patients is established. The proposed innovation is necessary and beneficial for adult trauma patients to prevent hypothermia. The grade of recommendation in the guideline is rated based on the SIGN grading system from A to D. Communication plans with stakeholders and 3-month pilot study on 20 patients are conducted before implementing the innovation into clinical setting. Evaluation is made to assess the effectiveness of the proposed guideline after the end of pilot study and the end of implementation of guideline. The effectiveness of the proposed innovation is determined by change of core temperature as + 1.1 °C/hr and at least 90% reduction in shivering and thermal discomfort which are reported in the reviewed articles. The guideline is considered as clinical effective when similar outcome is obtained.
published_or_final_version
Nursing Studies
Master
Master of Nursing
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38

Davison, John. "Multifactorial assessment and intervention in cognitively intact older recurrent fallers attending an accident & emergency department." Thesis, University of Newcastle Upon Tyne, 2005. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.424016.

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39

Leung, Po-shan Melissa. "The prevalence of domestic violence among the female Chinese population in the accident and emergency department." Hong Kong : University of Hong Kong, 2002. http://sunzi.lib.hku.hk/hkuto/record.jsp?B25910383.

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40

Harrison, John Christopher. "An examination of the attitudes of Accident & Emergency clinicians toward children who deliberately self-harm." Thesis, Liverpool John Moores University, 2005. http://researchonline.ljmu.ac.uk/5842/.

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Recent years have seen an increase in self-harm behaviours amongst children and young people. In tandem, the amount of research on the phenomenon has also grown. However, despite the evident importance of care staff attitudes in the treatment of those who self-harm, an examination of the literature indicated a limited number of studies on how clinicians view such behaviour in the young. The aim of this thesis was to examine the attitudes of health care staff toward child self-harm. Within the study, it is argued that factors pertaining to both patients (age, gender and rate of admission) and care staff (role and clinical experience), will influence how an incidence of child self-harm is viewed. To answer the question, both quantitative and qualitative methods were employed. Within the former, a questionnaire was developed that contained hypothetical case vignettes of child self-harm. Once constructed, the instrument was distributed to the care staff of four Accident and Emergency departments, each of which treated self-harming children. Examination of the completed questionnaires (n = 152), showed significant differences in both staff and patient variables, confirming that attitudes toward child self-harm should not be viewed as a single entity but rather as constituent parts of a whole phenomena, each worthy of examination in its own right. In order to explore these issues in more detail, a series of focus groups were undertaken amongst care staff. Use was made of a Foucauldian discourse analysis framework devised by Kendall and Wickham (1999). This revealed intrinsic differences in the way clinicians view self-harm in children and the constituent parts therein. Comparison of both experienced and inexperienced nurses and physicians produceda raft of reasonsw hy child self-harm elicited responsesp articular to each group, ranging from personal experiences to the use of medical jargon. In conclusion, this thesis has explored a particular aspect of the self-harm spectrum, touching on topics that appear to have been neglected by the literature. The dissemination of its results to a wider audience, it is hoped, will generate debate aroundt his sensitiveto pic andt husi ncreasea n understandinogf the needso f those clinicians who deal with such vulnerable patients.
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41

Vassilacopoulos, George. "Aspects of information management and resource allocation in hospitals with special reference to Accident and Emergency." Thesis, Royal Holloway, University of London, 1985. http://repository.royalholloway.ac.uk/items/25499417-0afb-49ea-b48d-8d21ff56e843/1/.

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The management and control process in an Accident and Emergency (A/E) department of a District General Hospital is investigated and the functional relationship between the A/E department and the inpatient hospital service is discussed. Attention is focused on resource allocation and methods are proposed towards reconciling levels of service and resource utilisation. Within the framework of control problems inside the A/E department, a computerised patient record system has been designed and implemented, on an experimental basis, to allow easy access to patient-related information for performance evaluation. Established statistical techniques are employed to demonstrate how such information can be utilised in medium-term management activities in the A/E department and to provide a sound basis for defining areas where specific problems arise. A method is developed, which uses patient data to the extent that they are routinely available through the patient record system, for allocating physicians to weekly shifts in a way which takes account of the fixed number of physician hours per week; of physician preferences with regard to shifts; and of the patient assessment of the service provided. With regard to the role of the A/E department as an essential link between the community at large and the hospital service, a simulation model is developed for determining the number of beds in hospital inpatient departments on the basis of expected demand and according to a pre-specified set of measures of hospital efficiency. The measures used are the rapid admission of emergency patients; high occupancy rates; and short lengths of waiting lists. A further study on bed capacity planning concerns the contemplated development of an observation ward in the A/E department. Owing to the increased uncertainty in planning for prospective units, approximation is accepted for the sake of procedural simplicity and an analytic infinite server queueing model is employed to evaluate various numbers of beds for the unit interms of the average occupancy rates and of hourly and daily service levels.
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42

Sebela, Refilwe Precious Stephina. "The experiences of emergency medical care practitioners (EMCP) after exposure to fatal motor vehicle accident scenes." Diss., University of Pretoria, 2016. http://hdl.handle.net/2263/60421.

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Although many international sources in literature describe the stress experienced by emergency workers, very few actually evaluate the experiences of emergency medical care practitioners and the care that is offered, and whether it is beneficial to and supportive of an optimal level of health. The researcher initiated this study with the specific goal of exploring the experiences of Emergency Medical Care Practitioners after exposure to fatal motor vehicle accident scenes. The research will constitute an initial exploration of possible factors related to the daily work exposure of EMCPs and will thus explore and describe the situation broadly. By exploring the experiences of these EMCPs it is hoped that insight may be gained into factors influencing their experiences and behaviour and the attainment of successful working environments. The information that was gathered has been incorporated into the writing of recommendations for Emergency Medical Service towards the improvement of EMCPs. The objectives of the study are: ? to describe the field of practice of EMCPs, their constant exposure to trauma and the phenomenon of fatal motor vehicle accident scenes; ? to explore the experiences of EMCPs of fatal motor vehicle accident scenes; ? to determine EMCPs' experience of their constant exposure to trauma and its effect on their daily functioning; ? to explore the experiences and awareness of EMCPs of current EAP services; and to formulate recommendations for EAP support services to EMCPs regarding their exposure to trauma and specifically to fatal motor vehicle accident scenes. A qualitative approach guided the research process of gathering detailed data that is rich in context, in which nine one-on-one semi-structured interviews were held with Emergency Medical Care Practitioners. This study was conducted in an Emergency Services station in Gauteng, South Africa. The bio-psychosocial approach was used in this study as an appropriate theoretical framework. This approach views health and wellness as the result of the interaction of biological, psychological and social factors, hence all three components should be taken into consideration when the illness, or rather the holistic wellness, of an individual is assessed. In this study, the case study design was used, specifically the collective case study, in order to study various participants. The unit of analysis comprised all EMCPs in the field of the Emergency Medical Care Division in the City of Tshwane Metropolitan Municipality who had experienced being on the scene of a fatal motor vehicle accident. Non-probability volunteer sampling was specifically employed, which meant that participants chose whether they wished to participate in the study or not, so as not to feel obliged or coerced. It was found to be the best method to use, as participants were known to one another and encouraged one another to become involved in the study. The researcher made use of semi-structured one-on-one interviews which were voice recorded in order to gain a detailed picture of the participants' experiences after being exposed to fatal motor vehicle accident scenes. The interviews were transcribed and subsequently analysed using the steps set out by Creswell (2004:155). Trustworthiness was considered a primary means to ensure rigour in qualitative research without any concomitant sacrifice of relevance. The researcher employed the constructs of credibility and dependability in order to ensure trustworthiness in this research. Trustworthiness is established when findings reflect as closely as possible the meanings described by the participants. Member checking and peer debriefing were the strategies that the researcher used to support the argument that the researcher's findings are worth paying attention to. Compliance with ethical principles was crucial to the researcher. Before the research commenced, letters of approval were obtained from the Ethics Committee of the Faculty of Humanities, University of Pretoria and the City of Tshwane: Research and Innovation. Ethical principles governing the manner in which the research was conducted were also observed, as the study involved human subjects and the researcher aimed to protect the participants. The following ethical considerations were relevant to this study: no harm to participants, informed consent, voluntary participation, confidentiality, debriefing and release or publication of findings.
Mini Dissertation (MSW)--University of Pretoria, 2016.
Social Work and Criminology
MSW
Unrestricted
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43

Benger, Jonathan Richard. "The SECT(A&E) project : standards, effectiveness and costs of telemedicine in accident and emergency." Thesis, University of Bristol, 2002. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.251122.

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44

Henriksson, Tomas. "Driver Assistance Systemswith focus onAutomatic Emergency Brake." Thesis, KTH, Fordonsdynamik, 2011. http://urn.kb.se/resolve?urn=urn:nbn:se:kth:diva-121306.

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This thesis work aims at performing a survey of those technologies generally called DriverAssistance Systems (DAS). This thesis work focuses on gathering information in terms ofaccident statistics, sensors and functions and analyzing this information and shall thruaccessible information match functions with accidents, functions with sensors etc.This analysis, based on accidents in United States and Sweden during the period 1998 – 2002and two truck accident studies, shows that of all accidents with fatalities or sever injuriesinvolving a heavy truck almost half are the result of a frontal impact. About one fourth of theaccidents are caused by side impact, whereas single vehicle and rear impact collisions causesaround 14 % each. Of these, about one fourth is collision with unprotected (motorcycles,mopeds, bicycles, and pedestrians) whereas around 60 % are collision with other vehicles.More than 90 % of all accidents are partly the result of driver error and about 75 % aredirectly the result of driver error. Hence there exist a great opportunity to reduce the numberof accidents by introducing DAS.In this work, an analysis of DAS shows that six of the systems discussed today have thepotential to prevent 40 – 50 % of these accidents, whereas 20 – 40 % are estimated to actuallyhaving the chance to be prevented.One of these DAS, automatic emergency brake (AEB), has been analyzed in more detail.Decision models for an emergency brake capable to mitigate rear-end accidents has beendesigned and evaluated. The results show that this model has high capabilities to mitigatecollisions.
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45

Brebner, Eileen Margaret. "Clinical telemedicine : the development and introduction of an accident and emergency teleconsultation service for North East Scotland." Thesis, University of Aberdeen, 2004. http://digitool.abdn.ac.uk/R?func=search-advanced-go&find_code1=WSN&request1=AAIU185574.

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Introduction: A joint grant application, lead by the University of Aberdeen and the National Health Service Grampian, was successful in securing £1.1million pounds from the Scottish Executive, Health Department. The grant funding was for the establishment of a national pilot telemedicine network in Scotland. The purpose of the network was to provide an accident and emergency teleconstruction service to community hospitals based in the northeast of Scotland. The establishment of this service allowed several academic studies to be completed. Aims of the thesis: to conduct a systematic review of peer reviewed publications describing the use of accident and emergency teleconsultations for primary care. The review examines technical feasibility, clinical effectiveness, cost effectiveness and user satisfaction; To develop, deliver and evaluate a training course for telemedicine users involved in accident and emergency teleconsultations; To introduce and evaluate an accident and emergency teleconsultation service; To produce guidelines for the introduction of future clinical telemedicine services. Systematic Review: Thirty one papers were selected for review. The results indicated that accident and emergency teleconsultations were technically feasible, clinically effective and produced a high degree of user satisfaction. There was a lack of evidence to demonstrate that these teleconsultations were cost effective. Training: Before establishing a telemedicine service the following steps were identified as being important: identifying the required training competencies; Delivering a "hands on" training programme based on the required training competencies; Reinforcing the training programme with an instruction booklet; Ensuring that trainees have at least weekly practice; Measuring the level of user competence. Evaluation: The present study suggests that: A telemedicine service must be needs driven; The workload must be sufficient to maintain the skill and confidence levels of the staff who use the service; There must be a commitment, at the main centre, to service provision; Telemedicine 'champions' should be identified and encouraged; Clear telemedicine protocols must be produced and distributed; Both the equipment and the communication infrastructure must be reliable; The equipment must be 'user-friendly'; Training must be given to establish and maintain user competence; The staffing and training implications of treating patients locally instead of sending them to the main centre must be addressed; The service must be objectively evaluated. Guidelines: Based on the information provided by the study, a series of guidelines have been produced. These guidelines are suitable for use by any individual or group in seeking to implement a clinical telemedicine service.
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46

Lo, Shui-sang, and 盧瑞生. "Explaining the policy change in accident and emergency services in public hospitals in Hong Kong: an applicationof John W. Kingdon model." Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 2009. http://hub.hku.hk/bib/B46759050.

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47

Blackshaw, Alison. "An investigation to determine the social and psychological characteristics of people who frequently attend accident and emergency services." Thesis, Lancaster University, 2002. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.413830.

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48

Walsh, Mike. "A study of the use made by the general public of a large urban accident and emergency department." Thesis, University of the West of England, Bristol, 1993. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.386101.

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49

Dale, Jeremy. "Primary care in accident and emergency departments : the cost effectiveness and applicability of a new model of care." Thesis, London School of Hygiene and Tropical Medicine (University of London), 1998. http://researchonline.lshtm.ac.uk/682264/.

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The thesis describes the development, research and evaluation of the applicability of a new model of care that involves GPs being employed on a sessional basis in A&E departments to treat patients attending with primary care needs. The main aim of the study was to research its cost and clinical effectiveness. A multi-faceted approach was taken to include consideration of patients' needs and preferences, professional concerns, organisational and structural issues within the health service, and planning and policy issues. Clinical, sociological, epidemiological, and economic perspectives are drawn upon, reflecting the context of the service development and to provide a firm base for discussion about the generalisability and applicability of the findings. The first two chapters provide a detailed review of the epidemiological, sociological, clinical, and organisational literature relating to the primary care/A&E interface. The incentives and disincentives that may act to increase or reduce demand and supply are explored, in addition to issues relating to the 'appropriateness' of demand, the organisational culture of A&E departments, and strategies used to curtail or cope with demand. The demand for primary care at A&E departments appears to cross national boundaries and hence, literature from other countries (particularly the USA) is included and its applicability to the UK considered. Relevant literature relating to the quality of A&E care, patient satisfaction, and the costing of care is also discussed. The main study was a prospective controlled trial that was conducted at King's College Hospital. This compared process variables, clinical outcome and costs of 'primary care' consultations performed by senior house officers (SHOs), registrars, and general practitioners working three-hour sessions in A&E. A new system of nurse triage was implemented to allow the prospective identification of patients presenting with primary care needs. A total of 27 SHOs, three registrars and one senior registrar were included, and the patient sample comprised 1702 patients seen by GPs, 2382 by SHOs, and 557 by registrars or the senior registrar. GPs were found to practice considerably less interventionist care than A&E medical staff, and the resource implications were substantial. The findings are discussed critically, and their applicability is considered drawing on empirical data from recent evaluations of A&E Primary Care Service developments in other parts of London. The policy and service implications of the study are considered and further research needs identified.
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Gray, Jason. "The nursing activities and interventions important when caring for children in Accident and Emergency (A&E) Departments." Thesis, King's College London (University of London), 2017. https://kclpure.kcl.ac.uk/portal/en/theses/the-nursing-activities-and-interventions-important-when-caring-for-children-in-accident-and-emergency-ae-departments(929c1fb5-9675-4096-a1e0-54fa0a576929).html.

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The aim of this study was to investigate the activities and interventions important when caring for children in A&E Departments. Background: Approximately three million children attend A&E Departments in the UK each year. However, there is an imbalance between those services provided by children’s A&E Departments and mixed A&E Departments resulting in most children having to attend the latter that are staffed primarily by non-paediatric specialists. Mixed A&E Departments focus primarily on the care of adult patients, with nurses less experienced in caring for acutely unwell or injured children. Furthermore, training and education pertaining to the care of children in A&E has yet to be formalised nationally which is not helped by the lack of evidence about what activities and interventions are important when caring for children in A&E Departments. Method: A sequential mixed method study comprising a three round Delphi survey followed by semi-structured interviews with service users and providers were conducted between July 2012 and June 2013. The purpose of using mixed methods was to identify views from clinicians and parents regarding the activities and interventions important when caring for children in A&E Departments, along with the factors that may enable or inhibit their undertaking. Results: Twenty-six activities and interventions were identified by the Delphi panelists creating an inventory that could be utilised to support the training and education of nurses working in both mixed and children’s A&E Departments. The study identified variable practice among RNs when assessing children in A&E Departments. Communication was considered the most important nursing activity among parents and was in contrast to RNs that reported the assessment and observation as the activities of most importance. Both RNs and parents shared equal experiences of the factors that enable and inhibit the undertaking of activities and interventions such as family centred care, the availability of a skilled nursing workforce and provision of a suitable environment for children that has facilities tailored to their specific needs. Conclusion: The findings of this research study illustrate that there is variable practice among RNs caring for children in A&E Departments that is not helped by an absence of training and education with respect to children’s A&E nursing. The study provides an inventory of activities and interventions to equip managers and clinicians with information that can be used for the training and education of nurses. Further, understanding the experiences of nurses and parents will strengthen the argument for family centred care to be adopted more favorably within A&E Departments, alongside commitment to providing a skilled nursing workforce and an environment that caters specifically for children and their families. Finally, understanding the enabling and inhibiting factors will aid clinicians when developing services for children and give them confidence when doing so.
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