Establishing enablers and barriers to implementing the HIRAID® emergency nursing framework in rural emergency departments

IF 2.1 4区医学 Q2 EMERGENCY MEDICINE

Australasian Emergency Care Pub Date : 2024-08-31 DOI:10.1016/j.auec.2024.08.002

Belinda Kennedy , Kate Curtis , Sarah Kourouche , Louise Casey , Dorothy Hughes , Vivienne Chapman , Margaret Fry

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引用次数: 0

Abstract

Background

Rural Australia has large geographic distances between emergency departments with variability of services and medical support. Emergency nurses must be appropriately skilled to assess and manage unpredictable and diverse presentations. HIRAID® is an evidence-based framework to support emergency nurses in assessment and care delivery. To inform implementation, the study aimed to identify the enablers and barriers to introducing HIRAID® in practice.

Methods

This embedded mixed methods study was conducted in 11 rural, regional emergency departments in Southern New South Wales, Australia. Respondents completed a 22-item survey, indicating their level of agreement on statements related to practice change, free text responses were optional. Quantitative data were analysed using descriptive statistics and qualitative data using content analysis. Results were identified as barriers or enablers, then integrated and mapped to the Theoretical Domains Framework.

Results

The survey was completed by 102 (54 %) nurses. Two enablers and four barriers to implementation were identified and mapped to 10 Theoretical Domains Framework domains. Key barriers were workplace limitations, such as time and resources, and knowledge of the HIRAID® intervention.

Conclusion

Barriers varied between facilities related to adequate support to implement and the impact on patient care. The results will inform a strategy to implement HIRAID®.

查看原文本刊更多论文

确定在农村急诊科实施 HIRAID® 急诊护理框架的有利因素和障碍。

背景：澳大利亚农村地区的急诊室之间相距甚远，服务和医疗支持也不尽相同。急诊护士必须具备适当的技能，以评估和处理不可预测的各种情况。HIRAID® 是一个以证据为基础的框架，用于支持急诊护士进行评估和提供护理。为了为实施提供信息，本研究旨在确定在实践中引入 HIRAID® 的有利因素和障碍：这项嵌入式混合方法研究在澳大利亚新南威尔士州南部的 11 个农村地区急诊科进行。受访者填写了一份包含 22 个项目的调查表，表明他们对与实践变革相关的陈述的同意程度，自由文本回答为可选项。定量数据采用描述性统计进行分析，定性数据采用内容分析进行分析。调查结果被确定为障碍或促进因素，然后与理论领域框架进行整合和映射：102 名护士（54%）完成了调查。结果：102 名护士（54%）完成了调查，确定了实施过程中的两个促进因素和四个障碍，并将其与理论领域框架的 10 个领域进行了映射。主要障碍是工作场所的限制，如时间和资源，以及对 HIRAID® 干预措施的了解：结论：不同机构在实施过程中遇到的障碍各不相同，这些障碍涉及到对实施的充分支持以及对患者护理的影响。这些结果将为 HIRAID® 的实施策略提供参考。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Australasian Emergency Care Nursing-Emergency Nursing

CiteScore

3.30

自引率

5.60%

发文量

审稿时长

37 days

期刊介绍： Australasian Emergency Care is an international peer-reviewed journal dedicated to supporting emergency nurses, physicians, paramedics and other professionals in advancing the science and practice of emergency care, wherever it is delivered. As the official journal of the College of Emergency Nursing Australasia (CENA), Australasian Emergency Care is a conduit for clinical, applied, and theoretical research and knowledge that advances the science and practice of emergency care in original, innovative and challenging ways. The journal serves as a leading voice for the emergency care community, reflecting its inter-professional diversity, and the importance of collaboration and shared decision-making to achieve quality patient outcomes. It is strongly focussed on advancing the patient experience and quality of care across the emergency care continuum, spanning the pre-hospital, hospital and post-hospital settings within Australasia and beyond.