Barriers and enablers to nurse-initiated care in emergency departments: An embedded mixed methods survey study.

IF 2.1 4区医学 Q2 EMERGENCY MEDICINE

Australasian Emergency Care Pub Date : 2024-11-04 DOI:10.1016/j.auec.2024.10.003

Julie Gawthorne, Kate Curtis, Margaret Fry, Andrea Mccloughen, Judith Fethney

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引用次数: 0

Abstract

Background: Increased demand, wait times and length of stay have seen many emergency departments implement nurse-initiated protocols In New South Wales, Australia, 74 nurse-initiated protocols have been developed for implementation. The aim of this paper is to identify the barriers and enablers to nurses' use of these protocols to inform and maximise future implementation.

Methods: Data were collected via surveys informed by the theoretical domains' framework and the Practice Environment Scale of the Nursing Work Index (PES-NWI). Descriptive statistics summarised quantitative data and content analysis was performed on qualitative data. Results were integrated and classified as barriers or enablers to nurses' use of protocols.

Results: The nurses' response rate was 82 % (n = 76) and doctors 72 % (n = 34) Six categories were generated; one barrier (lack of resources), three enablers (patient and organisational benefits, nurses' motivation, nurses' desire to develop their practice) and two were both a barrier and enabler ( nurse confidence and the work environment).

Conclusion: Emergency nurses are highly motivated to use nurse-initiated protocols to positively impact patient outcomes. However, a lack of resources, time, access to education and confidence are barriers to use that need to be addressed when designing implementation.

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急诊科护士主动护理的障碍和促进因素：一项嵌入式混合方法调查研究。

背景：需求、等待时间和住院时间的增加使得许多急诊科实施了由护士发起的协议。本文旨在确定护士使用这些协议的障碍和促进因素，为今后的实施提供信息并使其最大化：方法：根据理论领域框架和护理工作指数实践环境量表（PES-NWI）通过调查收集数据。对定量数据进行了描述性统计，对定性数据进行了内容分析。对结果进行了整合，并将其归类为护士使用规程的障碍或促进因素：结果：护士的回复率为 82%（n = 76），医生的回复率为 72%（n = 34）。共产生了六个类别：一个障碍（缺乏资源）、三个促进因素（患者和组织利益、护士的积极性、护士发展实践的愿望）和两个既是障碍又是促进因素的类别（护士的信心和工作环境）：结论：急诊科护士有很高的积极性使用护士发起的协议来积极影响患者的治疗效果。然而，缺乏资源、时间、接受教育的机会和信心是使用的障碍，需要在设计实施方案时加以解决。

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.