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Adv Emerg Nurs J. 2019 Jul/Sep;41(3):261-270. doi: 10.1097/TME.0000000000000256.

Improving the Care of Individuals With Sickle Cell Disease in the Emergency Department Using a Quality Improvement Framework: The Emergency Department Sickle Cell Assessment of Needs and Strengths (ED-SCANS).

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School of Nursing, Duke University, Durham, North Carolina (Drs Brennan-Cook and Tanabe and Ms Bonnabeau); and Emergency Department, Duke University Health Systems, Durham, North Carolina (Ms Harris-Bloom).


Sickle cell disease (SCD) is a severe chronic disease that leads to premature mortality caused by serious complications of the disease such as acute chest syndrome, stroke, and sepsis. Patients presenting to the emergency department (ED) with pain due to vaso-occlusive crisis (VOC) are at a higher risk for complications, making it imperative that emergency nurses, nurse practitioners, and physicians are knowledgeable about SCD and understand the other associated complications besides VOC. Because of the complexity of disease and misperceptions about SCD among ED nurses, physicians, and nurse practitioners, a quality improvement (QI) framework for treatment of adults with SCD in EDs was developed. The Emergency Department Sickle Cell Assessment of Needs and Strengths (ED-SCANS) is a research-based QI framework consisting of 7 distinct algorithms that serve to guide all ED team members in assessment and management of the complexity of care that patients with SCD require.

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