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Introduction: Emergency department usage for non-urgent care has been identified as an issue worldwide. Many health professionals have an opinion as to why parents seek care for their children at an emergency department. In Australia, although it is known that there is increasing usage of paediatric emergency departments for non-urgent care; there is a paucity of research on the reasons for this high usage. Aim: This study aims to provide a better understanding of the motivations and actions of parents of children with non-urgent injury or illness who attend the emergency department (PED) at a tertiary paediatric hospital seeking care. Method: This study was designed as a cross sectional descriptive survey to ascertain information fiom parents about their care-giving and care-seeking behaviours prior to presenting with their child to the paediatric emergency department (PED) for professional assessment and treatment. Demographic characteristics were compared with those of the general population to ensure representativeness. Results: A total of 355 parents were surveyed in the three-month period between May and July 2005. This represented 8% of the parents/carers who had presented to the PED for nonurgent (Australian Triage Score Category 4 and 5) care of their child. Just over half of the children presenting were male (185 (53%)) with an overall mean age of 5.45 years (*SD 4.25). The factors the study identified as seminal as to why parents sought care for their child at the paediatric emergency department are that parents rated their child's condition as moderate to very serious (242 (68%)) and that two thirds of parents (234 (66%)) had sought advice prior to attending PED. Other pertinent factors identified were that 54% of children attended with an injury (137) presented promptly to PED (i-e. within four hours of injury) whereas of those presenting with illness (88 (41.3%)) presented within two to seven days of the onset of the illness. The majority of children attended with an illness (213 (60%)) and of these, 98% had medication administered prior to presentation to PED. The presenting child was most likely to be the youngest sibling. Conclusions: The results of the study highlight the accuracy of 'parental triage', that is that parents assess their child's health, and generally engage in appropriate care-giving and careseeking behaviours before presenting to paediatric PED. This study highlights the deficiencies in current primary care services available to families and the perception that not all cases deemed as non-urgent by the emergency department are able to be dealt with in a primary care setting. In recognising that presentation is multifactorial, an issue that needs to be addressed is that there will always be non-urgent presentations at the paediatric emergency department and service delivery and W i g models need further development to address the increasing paediatric requirements for care. In identifying these multiple factors, this study will provide a solid base for future planning within paediatric hospitals, the emergency department setting and in provision of care in the community.

Concussions are brain injuries--also called mild traumatic brain injuries--that affect the function of the brain temporarily or permanently. The purpose of this doctoral project was to develop an education module for staff at an urgent care center to address the lack of knowledge and low level of comfort regarding the care for patients with a head trauma. This project introduced and educated the clinical staff on an evidence-based protocol for the treatment and management of a patient with a concussion. The Rosswurm and Larrabee model for evidence-based change was used as a foundation for refining the practice question, gathering evidence, and translation of the protocol into the clinical setting. The Dreyfus model of the 5 stages of skill acquisition was used to measure the learners' level of achievement. A pretest and posttest were conducted to determine whether there was a gain in knowledge and confidence as a result of the project. There were 6 participants: 3 nonclinical staff and 3 nurses. Overall, there was a statistically significant improvement in confidence based on the Wilcoxon sign ranks test (z = -2.201; p = .028); however, a statistically significant increase in knowledge was not apparent, even though the scores did improve. All staff members were able to apply the practice guideline and make sound judgments using case studies. This project resulted in the translation of evidenced-based care into the urgent care setting, enhanced the confidence of the nursing staff, and has the potential to bring about positive social change by improving the quality of care that will be provided to patients with head injuries.

Introduction to the issue and the importance of the topic: Emergency Department (ED) is a new type of the health care service and these departments are organized in a different way in the Czech Republic so far. However, ED is an integral part of the acute care system, and the Emergency Deaprtment is capable to ensure the continuity of care between the field and the hospital despite of the increasing atomization of medical disciplines. In recent years, it is a model that is able to deal with all acute conditions of all severity, 24 hours a day, with an adequate level of safety for patients, because they can be briefly observed at the observation unit of the ED. Goal of the thesis and methodology: The main goal of the diploma thesis is a comprehensive analysis of the existing Emergency Departments in the Czech Republic. The first partial goal was to find out the disposition and organization of Emergency Departments in details, how many acute beds for emergency care are available and how is the work regime organized. The second partial goal was to find out staffing of the Emergency Departments. Whether a specialised emergency physician is continually present and whether there ais enough qualified non-medical medical staff. The third partial goal was the intention to find out how are Emergency...

Background: Involuntary exposure to secondhand smoke (SHSe) is an important cause of morbidity in children who present to the pediatric emergency department (PED) and urgent care (UC). SHSe interventions delivered in the PED and UC would benefit both the smoker and child, but there have been no large trials testing the efficacy of such interventions. The Healthy Families program is the first randomized controlled trial to test whether a screening, brief intervention, and referral to treatment (SBIRT) intervention delivered in the PED and UC will be effective in decreasing SHSe in children and increasing cessation in smokers. Methods/design: This trial uses a randomized, two-group design in which caregiver-smokers of children 0-17 years old are recruited from the PED and UC. Eligible caregiver-smokers are randomized to either the: 1) SBIRT Condition with face-to-face, tailored counseling that focuses on the child's illness, the importance of reducing child SHSe, caregiver smoking cessation, and the option to receive nicotine replacement therapy; or 2) Healthy Habits Control Condition which includes face-to-face, tailored attention control "5-2-1-0" counseling that focuses on improving the child's health. Dyadic assessments are conducted in-person at baseline, and via email, phone, or in-person at 6-weeks and 6-months. The primary outcomes are biochemically-verified, 7-day point prevalence and prolonged smoking abstinence. Secondary outcomes are cigarettes smoked per week, 24 h quit attempts, and biochemically validated child SHSe at each time point. The costs of this intervention will also be analyzed. Discussion: This study will test an innovative, multilevel intervention designed to reduce child SHSe and increase smoking cessation in caregivers. If effective and routinely used, this SBIRT model could reach at least one million smokers a year in the U.S., resulting in significant reductions in caregivers' tobacco use, SHSe-related pediatric illness, and healthcare costs in this population of children.

Introduction of the problematic: A burnout syndrome is largely presents among paramedics and has a negative impact on both work performance and life quality. The aim of this thesis was to analyse the incidence of burnout syndrome among male paramedics working in emergency care and to find out the effect the syndrome on their sexuality. The research was conducted by an internet survey. Methodology: Research was conceived as quantitative. Research was conducted paramedics working in emergency care by an internet survey that was in progress from 1.2.2019 to 30.4.2019 within facebook group ,,Ošetřovna od ošetřovatelství.info. The research group was consisted of 124 male paramedics working in emergency care. The measure of burnout syndrome was investigated using the Czech version of Shiron-Melamed burnout measure scale (SMBM questionnaire), the sexual life of respondents was examined using the questionnaire Sexual functions of man) in the extended Kroměříž's version (SFM/K). Results: Three of the five hypotheses were confirmed completely, two hypotheses were confirmed partially. The burnout syndrome has been shown to affect the need for sexual activity, the frequency of tries of sexual intercourse and the frequency of satisfying sexual intercourse, the sense of success in sexual life and also the...

Healthcare industry owners who have unsatisfactory customer care services may experience a financial risk and create dissatisfied patients. The purpose of this case study was to explore customer care strategies that managers of urgent care businesses used to improve customer care services and patient satisfaction. The target population consisted of 1 urgent care manager from 3 separate urgent care clinics with the highest customer satisfaction ratings in Alabama. The urgent care managers were knowledgeable about effective customer care strategies that improved customer care services and patient satisfaction. Customer loyalty theory with emphases on customer behavior, customer attitude, repeat patronage, and loyalty was the conceptual framework for the study. Semistructured interviews and patient survey forms were the data sources. Data were analyzed using thematic analysis which identified similar codes, patterns, and themes. The 3 primary themes that emerged from thematic analysis were patient-focused care, social media outreach, and employee engagement. The implications of this study for positive social change include the potential to enhance the quality of healthcare experiences, which may empower individuals to seek medical care. The patients might become trusting of healthcare providers and become collaborators in responding to medical care requests by medical staff to improve their quality of life.

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Injuries in children have been undoubtedly a threat for all parents, healthcare professionals and the children themselves for many years, but the children often do not have the possibility to even realize this threat. Just in moment too fast, they enter the turmoil of prehospital care and become patients, victims of their own play or due to the lack of attention of others, or even victims of adults. Burns or the so called thermal injuries are very common mechanisms of injuries in children. In our diploma thesis, we decided to focus on thermal injuries from the viewpoint of those who are the first to come in contact with the patients, and who must evaluate the given trauma and initiate treatment based on the evaluation. In particular, this applies to the personnel of emergency medical services, and also to the graduates of the Faculty of Health and Social Studies, University of South Bohemia in České Budějovice (USB FHSS). These persons should also be the ones to be aware of how burn injuries are evaluated in children - given among others that many of them are often found in the position of healthcare personnel at children´s camps or nurse at offices of general practitioners for children and adolescents. The following hypothesis was formulated based on consultations with the professional public (MUDr. Robert Zajíček, Burn Medicine Department, University Hospital Královské Vinohrady): ?Education of healthcare personnel of emergency medical services and USB FHSS graduates is inadequate, being a potential source of errors in the provision of prehospital care?. Based on this hypothesis, objectives of the diploma thesis were set as follows: Objective 1: Determine the knowledge status and practical skills in respect of evaluating 6 essential burn factors amnog emergency medical service personnel and USB FHSS graduates. Objective 2: Develop an educational material on prehospital care in children with burns.

Patient perceptions of health care quality are critical to a health care service provider's long-term success because of the significant influence perceptions have on customer satisfaction and consequently organization financial performance. Patient satisfaction affects not only the outcome of the health care process such as patient compliance with physician advice and treatment, but also patient retention and favorable word-of-mouth. Accordingly, it is a critical strategy for health care organizations to provide quality service and address patient satisfaction. The urgent care (UC) industry is an integral part of the health care system in the United States that has been experiencing a rapid growth. UC provides a wide range of medical services for a large group of patients and now serves an increasing population. UC is becoming popular because of the convenient locations, extended hours, walk-in policy, short waiting times, and accessibility. A closer examination of the current health care research, however, indicates that there is a paucity of research on urgent care providers. Confronted with the emergence of the urgent care industry and the increasing demand for urgent care, it is necessary to understand how patients perceive urgent care providers and what influences patient satisfaction and retention. This dissertation addresses four areas relevant to the above mentioned issues: (1) development of an instrument to measure perceived service quality in the urgent care industry; (2) identification of the determinants of patient satisfaction and behavioral intentions; (3) empirical examination of the relationships among perceived service quality, patient satisfaction and behavioral intentions; and (4) comparison of the perceived service quality across several primary urgent care providers, such as urgent care centers, hospital emergency departments, and primary care physicians' offices. To validate this new instrument and examine the hypothesized relationships proposed in this study, an electronic web based survey was designed and administered to college students. Both exploratory and confirmatory factor analysis were employed to assess the reliability and validity of the developed instrument. The contextualized relationships were evaluated using structural equation modeling. The results of this research could potentially contribute to urgent care management and quality improvement.