[Content Analysis of Chinese National Laws and Regulations on Emergencies from the Perspective of Disaster Nursing on the Basis of Crisis Life Cycle Theory]

Objective

To analyze Chinese national laws and regulations on emergencies from the perspective of nursing and on the basis of the crisis life cycle theory, to discuss the weaknesses in laws and regulations concerning emergencies, and to provide evidence for the definition of the scope of disaster nursing practice in China.

Methods

We selected emergency laws and regulations promulgated by the National People's Congress and its Standing Committee and the State Council as the subject matter of the study, constructing the analysis framework on the basis of the core competence of disaster nursing and crisis life cycle theory. Then, the 16 laws and regulations included in the study were analyzed with NVivo 12 software by the content analysis method.

Results

A total of 6 laws and regulations concerning earthquakes, 3 concerning infectious diseases, 2 concerning fire, 2 concerning food poisoning, 2 concerning emergencies, and 1 concerning flood were selected. A total of 24 food poisoning-related codes, 23 infectious disease codes, 22 emergency event codes, 22 earthquake codes, 21 fire codes, and 16 flood codes were obtained. In the key links of emergency preparedness, early prevention had the highest number of reference points, whereas collaborative response had the lowest number of reference points. In the key processes of emergency preparedness, aftermath management had the highest number of reference points, whereas social services and continuous operation had the lowest numbers of reference points.

Conclusion

Laws and regulations concerning emergencies are generally formulated on the basis of certain historical experience, with collaborative response, social services, and continuous operation being the weak links and processes. In the process of disaster nursing practice, we should effectively make up for the weaknesses in laws and regulations concerning emergencies by utilizing the positive aspects and the essence of the discipline.

Crisis Standards of Care

Nursing considerations during states of emergency.

[Regulated practices of fire and rescue service nurses]

Nurses in the fire and rescue service have been providing emergency care to people for more than twenty years. Their practice is regulated by national emergency nursing care protocols drawn up by the relevant learned societies. Numerous training programmes and more recently, the possible use of telemedicine, help to ensure the quality of the emergency care provided to patients or victims.

[Emergency nurse, a speciality whose name says it all?]

Proposal no. 10 in French Senate information report no. 685, drawn up by the Social Affairs Commission on hospital emergency departments, opens the debate regarding the creation of an emergency nursing speciality. Does this represent progress for the profession or an inadapted measure? The complex situation of emergency departments raises the need for methodological thinking on this subject.

[A senate report in favour of an emergency nursing speciality]

In July 2017, an information report written by three senators highlighted the difficulties encountered by emergency departments in France and attempted to pinpoint the causes. In addition, the recommendations of this report suggest reinforcing the nursing contribution within the multi-disciplinary emergency department team, by creating an emergency nurse speciality.

['See and Treat' in the Emergency Department: legal aspects and professional nursing responsibility]

The article aim to analyze the legal aspects of professional responsibility in the autonomous nursing care of a patient with a minor health problem treated in a See and Treat area of the Emergency Department through a literature review and an analyses of the Italian legislation about professional exercise. Recent studies have shown that the treatment of the emergency patients affected by minor health problems in separated areas of the A&E by skilled nurses proved to be effective in reducing time to medical examination and the overall time spent in the Emergency Department. Several studies have shown the positive effects of the Emergency Nurse Practitioner (ENP) in terms of reduction of time to medical examination with an increase in patient satisfaction, maintaining an adequate level of quality in the care of patients with minor health problems. The introduction of a See and Treat area, together with the institution of advanced post-triage protocols, represents a possible answer to the overcrowding of the Emergency Department. The aim is the reduction of waiting times and proper allocation of both material and professional resources. The "See and Treat" nurse represents an expert nurse, with an adequate level of competence, who acts in respect to the clinical protocols shared between physicians and nurses. The Italian legislation is not in contrast with the introduction of the See and Treat nurse, on the contrary it offers opportunities for further professional development.

Implementation of an advanced nursing directive for suspected appendicitis to empower pediatric emergency nurses

In response to a clinical safety review, we have implemented an AND to empower our pediatric emergency nurses to identify and initiate care directives for children with suspected appendicitis. Future quality assessment and research studies will focus on the accuracy of the AND in predicting which children will have imaging studies or an appendectomy as well as the impact of the AND on key pediatric ED flow measures.

Emergency care for young people who have used cocaine

Government figures suggest that there has been an increase in the number of young people using cocaine. Emergency and minor injury unit nurses are therefore increasingly likely to care for these people. This article describes the presenting symptoms and management of a patient who had an adverse reaction to cocaine, briefly examines the issues of 'adolescent consent' and discusses cocaine use among young people.

Australian nurses and child protection: practices and pitfalls

Most Australian states have child protection legislation mandating individuals and groups to notify suspected child abuse and neglect. Nurses are legally bound to report their suspicions of child abuse and neglect in a number of Australian states, with South Australia, New South Wales, Victoria and Tasmania specifically identifying nurses as mandated notifiers. While the unique role of nurses puts them in a valuable position to detect and report suspected child abuse, aspects of the role may lead to conflict in detecting and notifying child abuse and neglect. This paper addresses some key practice issues for Australian nurses as mandated notifiers. These issues include: knowledge and education about child protection; organisational influences on nurses' participation in child protection; concerns about consequences of suspecting and notifying; protecting the therapeutic relationship; and interaction with other professionals.

Patient group directions to enable hospital nurses to supply medicines

Sarah is a nurse specialist in accident and emergency (A&E) nursing. She is told by the consultant that as a nurse specialist she is able to supply various ointments and pain killers for patients who are only seen by the clinical nurse specialist in A&E. She feels that this is the equivalent of prescribing and considers that there should be a more formal procedure. What is the law?