Authors: Emma Philp and Deepankar Datta
Both of us are looking forward to being at ICEM 2023, the 22nd International Conference on Emergency Medicine, which is taking place in Amsterdam this month.
Emma is one of our Advanced Nurse Practitioners at St John's Hospital Emergency Department. She’s a lynchpin in the staffing of our department, and is currently in the process of credentialing as an RCEM ACP. Locally she’s a beacon for what an ANP can achieve.
I’m glad we had a successful poster submission for ICEM 2023: there’s a few benefits to this. It’s highlighted the role of Emma in our department and has convinced our bosses to sponsor Emma to go. It raises the profile of the ANP role, and ANP training, locally. And it gives Emma experience of doing research and going to conferences. So wins all round.
On a personal basis, it's been years since I've been to a conference, so I'm looking forward to learning lots and catching up with fellow emergency medicine specialists from around the world.
We wanted to write a bit more about our poster, “Women’s experiences and perspectives during early pregnancy miscarriage in the emergency department: a literature review”, than can be displayed at ICEM – and this is a shout out to the beneficial technology of QR codes.
If you want access to an electronic version of the poster, click the image below:
So here’s Emma’s thoughts on the work:
The topic for this literature review was chosen after I reflected on some of the clinical cases I had seen in the ED. One particularly memorable patient who presented with mild abdominal cramping and some PV bleeding in early pregnancy waited 2hrs to be seen by a care provider. When she was reviewed she was noted to have a biscuit tin with her. This biscuit tin contained the products she had passed which could be easily identified. However no one had noted the significance of the biscuit tin, and she had sat in the busy waiting room for 2 hours with this on the seat beside her. The emotions this patient must have been feeling were hugely significant, however we failed to recognise this. I felt there was room for improvements in the care we deliver to this patient group, and so the need for this topic review.
The initial search for studies to be included in this extended literature review involved a search of MEDLINE, CINAHL and PYSCHINFO databases which produced 13,707 published articles. These were narrowed down to 6 articles using strict inclusion and exclusion criteria which can be seen in the PRISMA chart below.
The CASP (Critical Appraisal Skills Programme 2018) tool Qualitative Checklist was chosen to appraise the 6 studies to evaluate the quality and value of the published research. Of the 6 studies, 2 were deemed high quality and the remaining 4 were good quality. None of the studies were considered to score low/weak and therefore all 6 studies were included in the literature review.
The diagram below is a summary of the themes identified within the literature, which I summarised into four key areas:
1. the ED environment
2. poor communication and psycho-social care
3. lack of follow-up care
4. lack of information
Literature Review
Thanks again for looking at the poster and reading further into what was done. If you have any questions, please don’t hesitate to get in touch with Emma or myself.
Thanks
Thanks to all our colleagues at St John's ED as well as our wider colleagues within Edinburgh Emergency Medicine and NHS Lothian. Specific thanks to AL for helping supervise the research; RA (the boss!) for supporting Emma for doing this work; the wider NHSL team for being supportive of Emma’s ANP role; AS, MM and BW for proof-reading; and DM for helping to get this blog posted.