International Emergency Nursing最新文献

{"title":"Factors associated with disposition of patients transferred to an emergency department in a district hospital in Botswana","authors":"Tebogo T. Mamalelala ,&nbsp;William Holzemer ,&nbsp;Mabona E. Maleho ,&nbsp;Ditebogo J. Mokone","doi":"10.1016/j.ienj.2025.101624","DOIUrl":"10.1016/j.ienj.2025.101624","url":null,"abstract":"<div><h3>Background</h3><div>The Emergency Department (ED) at the district hospital or primary hospital serves as a point of entry for patients with various medical needs from health posts and community clinics. A delayed or inaccurate disposition can result in a transfer to a lower level of care and a possible return to the health system. The study aimed to investigate the factors associated with disposition of patients from district hospital ED.</div></div><div><h3>Methods</h3><div>A retrospective descriptive study using 1,565 triage charts and admitting medical records was conducted for the period June through December 2020. A binomial logistic regression investigated patient and facility factors related to patient disposition. The moderated mediation model evaluated the effect of patients’ urgency on the disposition of the patients from the ED.</div></div><div><h3>Results</h3><div>Referring facility, HIV status, patient-level of acuity, length of stay in the ED, and the waiting time for the doctor were predictors of the disposition of the patients from the ED (p = 0000). Waiting time for a doctor’s consultation is positively and significantly associated with length of stay in the ED (p &lt; 0.001).</div></div><div><h3>Conclusion</h3><div>The findings highlight the need for an efficient triage system, as delays in care can adversely affect patient outcomes. Addressing challenges related to prolonged length of stay (LOS) and doctors waiting time are also essential for optimizing patient flow. Enhancing triage processes and conducting further research are crucial for improving emergency care efficiency and safety.</div></div>","PeriodicalId":48914,"journal":{"name":"International Emergency Nursing","volume":"81 ","pages":"Article 101624"},"PeriodicalIF":1.8,"publicationDate":"2025-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144154537","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Telehealth Referral to Improve Outcomes (TRIO) Intervention for Asymptomatic Hypertension in the Emergency Department: A Randomized Pilot Feasibility Study","authors":"K. Souffront ,&nbsp;C. Shubeck ,&nbsp;G.T. Loo ,&nbsp;L.D. Richardson","doi":"10.1016/j.ienj.2025.101622","DOIUrl":"10.1016/j.ienj.2025.101622","url":null,"abstract":"","PeriodicalId":48914,"journal":{"name":"International Emergency Nursing","volume":"81 ","pages":"Article 101622"},"PeriodicalIF":1.8,"publicationDate":"2025-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144154679","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Strengthening healthcare readiness: Lessons from frontline nurses in a South African tertiary hospital for future pandemic preparedness","authors":"Sue Anne Bell ,&nbsp;Jennifer B. Inloes ,&nbsp;Petra Brysiewicz","doi":"10.1016/j.ienj.2025.101620","DOIUrl":"10.1016/j.ienj.2025.101620","url":null,"abstract":"<div><h3>Background</h3><div>The World Health Organization and the International Council of Nurses both support nurses’ involvement in health policymaking, including readiness planning for public health emergencies. South Africa’s frontline nurses often have limited involvement in healthcare policymaking, even though nurses comprise 56% of the country’s total public healthcare workforce and 87% of its skilled health professionals. This has implications for the quality and safety of nursing care provided during past and anticipated future pandemic events.</div></div><div><h3>Objective</h3><div>This purpose of this study was to evaluate frontline healthcare professionals’ perspectives on pandemic preparedness in South Africa to inform policy improvements.</div></div><div><h3>Methods</h3><div>Four focus groups with registered nurses (n = 11) and semi-structured interviews with disaster committee members (n = 4) were conducted. A review of existing disaster policies contextualized the findings, which were analyzed using qualitative content analysis guided by a health policy framework.</div></div><div><h3>Results</h3><div>Four key categories emerged that described barriers to working in a disaster context: working outside of role and scope, insufficient staffing, mental health impacts, and lack of training for disasters and pandemics, all of which contribute to challenges in pandemic preparedness.</div></div><div><h3>Conclusions</h3><div>Despite being the majority of the health workforce, South African nurses often lack influence in disaster planning. This study highlights how systemic challenges in a resource-limited hospital setting—such as chronic staffing shortages, insufficient inclusion of nurses in disaster policy development, and lack of tailored mental health support—compromised pandemic preparedness. Interventions such as peer-led mental health support, bedside microteaching, and nurse-informed policies could strengthen future pandemic readiness. These findings offer practical, scalable solutions for similar low-resource settings and underscore the importance of involving frontline nurses in disaster policymaking.</div></div>","PeriodicalId":48914,"journal":{"name":"International Emergency Nursing","volume":"80 ","pages":"Article 101620"},"PeriodicalIF":1.8,"publicationDate":"2025-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144105600","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The relationship between intervention and transport times in pre-hospital emergency medical services and resuscitation success","authors":"Akın Turan,&nbsp;Ali Ekşi,&nbsp;Süreyya Gümüşsoy,&nbsp;Batuhan Tay,&nbsp;Elif Çamarası Bilgin","doi":"10.1016/j.ienj.2025.101623","DOIUrl":"10.1016/j.ienj.2025.101623","url":null,"abstract":"<div><h3>Objective</h3><div>This study aimed to evaluate the relationship between pre-hospital emergency medical services’ intervention and transport times at the scene of cardiac arrest cases and resuscitation success.</div></div><div><h3>Method</h3><div>The study retrospectively analyzed six years of data from the Çanakkale Provincial Ambulance Service Chief Physician’s office between January 1, 2018, and December 31, 2023. Descriptive statistical methods were employed in the data analysis. The normality of the data distribution was tested, and for quantitative data comparison, an independent <em>t</em>-test was used for normally distributed data, while the Mann-Whitney <em>U</em> test was used for non-normally distributed data. A p-value of &lt;0.05 was considered statistically significant.</div></div><div><h3>Results</h3><div>In the study, 2,940 cases involving resuscitation in pre-hospital emergency medical services were evaluated. The EMS teams provided an average of 18.12 min of on-scene intervention for cardiac arrest cases, while the average duration of intervention during transport from the scene to the hospital was 11.23 min. Of these cases, 6.3 % (n = 186) involved witnessed sudden cardiac arrest. The rate of successful resuscitation was 21.5 % in witnessed sudden cardiac arrest cases, whereas it was 12.7 % in unwitnessed cases. No statistically significant difference was found between successful resuscitation outcomes and the durations of on-scene intervention or transport to the hospital (p &gt; 0.05).</div></div><div><h3>Conclusion</h3><div>In witnessed cardiac arrest cases receiving pre-hospital emergency medical services, the intervention and transport times generally did not show a significant difference compared to other cases, and interventions are typically completed within 20 min. This duration is also considered a threshold for good neurological recovery in cases of successful resuscitation. Further studies are needed to make clear recommendations regarding optimal time values for intervention in cardiac arrest cases at the scene.</div></div>","PeriodicalId":48914,"journal":{"name":"International Emergency Nursing","volume":"80 ","pages":"Article 101623"},"PeriodicalIF":1.8,"publicationDate":"2025-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144116292","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Construction of emergency competency models for nurses in emerging high-consequence infectious disease outbreaks: Behavioural event interview approach","authors":"Shanshan Liu ,&nbsp;Yijing Li ,&nbsp;Chunfen Zhou ,&nbsp;Jing Zhao ,&nbsp;Juan Guo ,&nbsp;Li Luo ,&nbsp;Yan Jiang","doi":"10.1016/j.ienj.2025.101621","DOIUrl":"10.1016/j.ienj.2025.101621","url":null,"abstract":"<div><h3>Background</h3><div>Emerging high-consequence infectious disease outbreaks (EHCIDs) have significantly impacted healthcare systems worldwide. Nurses specialising in outbreak response nurses play an important role in the prevention and control of EHCIDs. However, the specific competencies required for these nurses remain undefined. This study aims to develop a competency model for nurses involved in managing EHCIDs, providing a foundation for the training and organisation of specialised nurse response teams.</div></div><div><h3>Methods</h3><div>We recruited a geographically stratified sample of nurses from tertiary hospitals in four representative regions of China (Eastern, Western, Northern, Southern) for this cross-sectional study, conducted from April 2021 to April 2023. Using the validated Behavioural Event Interview (BEI) methodology, we conducted qualitative research with 40 nurses from hospitals designated for COVID-19 treatment. Participants were asked to describe three successful scenarios and three challenging experiences they encountered during recent pandemic responses with semi-structured interviews. We analysed the qualitative data using an iterative constant comparison method, employing a three-phase coding process (open, axial, selective) facilitated by NVivo 12.0 software. This analysis culminated in an evidence-based competency model. To ensure the model’s reliability and validity, we performed categorical consistency checks and synchronous cross-validity testing‌.</div></div><div><h3>Results</h3><div>The study included 20 excellent nurses and 20 average nurses. We developed a tailored nursing competency model comprising 20 total competencies, categorised into core (6 competencies), critical (7 competencies), and foundational (7 competencies). Inter-coder reliability was robust, with Cohen’s κ ranging from 0.741 to 0.830, and an overall agreement of 0.773. Significant differences in competency scores (p &lt; 0.05) were noted between high-performing and adequately-performing nurses, particularly in core and critical competencies.</div></div><div><h3>Conclusions</h3><div>The competency model for outbreak response nursing is scientifically robust and practically applicable. It is particularly crucial for effective nursing management in the face of sudden and uncertain infectious disease outbreaks.</div></div>","PeriodicalId":48914,"journal":{"name":"International Emergency Nursing","volume":"80 ","pages":"Article 101621"},"PeriodicalIF":1.8,"publicationDate":"2025-05-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144089157","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Nursing staff’s perceptions of and reasons for missed nursing care in patients with traumatic injuries","authors":"Andrea Lundin ,&nbsp;Maria Unbeck ,&nbsp;Ann- Christine Andersson ,&nbsp;Anders Enocson ,&nbsp;Lena M. Berg","doi":"10.1016/j.ienj.2025.101616","DOIUrl":"10.1016/j.ienj.2025.101616","url":null,"abstract":"<div><h3>Introduction</h3><div>Trauma causes nearly six million deaths annually and is the leading cause of death in the working-age population. Systematic, multidisciplinary, team-based initial care is vital. Trauma nursing addresses complex physical and psychological needs, enhancing patient outcomes and preventing complications. However, acute care settings have challenges, such as heavy workloads and high patient-to-nurse ratios.</div></div><div><h3>Aim</h3><div>This study aimed to explore nursing staff́s perceptions of reasons for missed nursing care for patients with traumatic injuries.</div></div><div><h3>Methods</h3><div>Four semi-structured group interviews were conducted with 22 registered and assistant nurses caring for trauma patients in a level one trauma center. The data were analyzed using thematic analysis and an inductive approach.</div></div><div><h3>Results</h3><div>The main findings revealed that complex organizational challenges hinder consistent nursing care. Factors such as patient characteristics and team composition necessitate prioritizing medical interventions over nursing care, leading to feelings of inadequacy among nurses when they are unable to provide timely care.</div></div><div><h3>Conclusion</h3><div>Our findings indicate that essential nursing care is frequently overlooked in the trauma ward, often taking a backseat to medical interventions. This trend arises from the intricate dynamics of patient characteristics, team composition, and the organizational environment.</div></div>","PeriodicalId":48914,"journal":{"name":"International Emergency Nursing","volume":"80 ","pages":"Article 101616"},"PeriodicalIF":1.8,"publicationDate":"2025-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143943550","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The experiences of patients and family members after being discharged at scene following an emergency ambulance attendance. A rapid evidence review","authors":"Sarah Doran ,&nbsp;Marishona Ortega ,&nbsp;Gregory Adam Whitley","doi":"10.1016/j.ienj.2025.101618","DOIUrl":"10.1016/j.ienj.2025.101618","url":null,"abstract":"<div><h3>Introduction</h3><div>A large proportion of emergency calls to the ambulance service are non-life-threatening, resulting in some patients being discharged by paramedics at the scene. Negative patient and family member experiences during a clinical encounter may have lasting effects. We aimed to explore the experiences of patients and family members who were discharged on scene after ambulance attendance.</div></div><div><h3>Methods</h3><div>A rapid evidence review was conducted. MEDLINE and CINAHL Complete databases were searched simultaneously for all articles published before the 15th March 2024. Study screening and data extraction was performed. The included studies were critically appraised, and a thematic synthesis was conducted.</div></div><div><h3>Results</h3><div>Five papers representing patients and family members from Australia, Sweden, Finland, and Denmark were included. Patients and family members experienced: fear and uncertainty at transitional points; reassurance from sharing responsibility; relief from a normal physical assessment; confidence from informative worsening advice; being listened to and validated; reliance on each other; and empowerment through being involved in decision making.</div></div><div><h3>Conclusion</h3><div>Patients and family members have varied experiences when being discharged at scene. The limited number of available studies highlights the need for further research to be conducted internationally.</div></div>","PeriodicalId":48914,"journal":{"name":"International Emergency Nursing","volume":"80 ","pages":"Article 101618"},"PeriodicalIF":1.8,"publicationDate":"2025-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143943639","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Addressing documentation deficiencies in emergency department records: Implications for fall risk assessment and holistic care in older adults","authors":"Sara Bergström ,&nbsp;Kristina Rosengren ,&nbsp;Catarina Wallengren ,&nbsp;Ramona Schenell ,&nbsp;Hanna Falk Erhag","doi":"10.1016/j.ienj.2025.101617","DOIUrl":"10.1016/j.ienj.2025.101617","url":null,"abstract":"<div><h3>Background</h3><div>Falls are a substantial threat to public health globally and the leading cause of unintentional injury and death among individuals aged 65 years and older. This study aimed to review the medical records of older patients in an ED after an accidental fall to summarize their documented care process and identify factors associated with hospitalization or discharge to home.</div></div><div><h3>Methods</h3><div>A retrospective review of medical records (n = 778) was conducted at a university hospital emergency department (ED) in Sweden. Descriptive statistics were used to report patient characteristics and differences in proportions based on information sources, the patient’s inability to state the reason for the fall, and health- care interventions.</div></div><div><h3>Results</h3><div>The medical records documentation of all professionals focused on medical conditions but lacked information on social background, screening, and status in the ED. Being discharged after a fall accident (55%) was more common than being hospitalized (45%), and most hospitalizations were attributed to medical reasons. There were differences in documentation between hospitalized and discharged. Overall, the medical records of the hospitalized group had more information of patient’s social situations and walking aids than the discharged group.</div></div><div><h3>Conclusion</h3><div>The results highlight deficiencies in documenting critical patient information within ED medical records. These gaps in medical records hinder the effective assessment and management of fall risk in older adults. Therefore, implementing person-centered care (PCC) with a holistic approach along with fall prevention is essential.</div></div>","PeriodicalId":48914,"journal":{"name":"International Emergency Nursing","volume":"80 ","pages":"Article 101617"},"PeriodicalIF":1.8,"publicationDate":"2025-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143943549","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Emergency Department overnight deflection of low acuity patients: A 6-month evaluation of a quality improvement project","authors":"Rob Fenwick ,&nbsp;Nina Bassett ,&nbsp;Charlotte Revell-Jones ,&nbsp;Rachel Bowen ,&nbsp;Lindsey Bloor ,&nbsp;Robin Roop","doi":"10.1016/j.ienj.2025.101619","DOIUrl":"10.1016/j.ienj.2025.101619","url":null,"abstract":"<div><h3>Background and problem statement</h3><div>Emergency care services in the United Kingdom (UK) are currently under unprecedented pressure which has resulted in long patient delays. Alternative approaches are therefore required to improve patient experience.</div></div><div><h3>Project Aims</h3><div>Deflection is the process where patients with low acuity presentations are offered the option of returning to an appointment. This project aimed to reduce the Length Of Stay (LOS) by introducing deflection into our Emergency Department (ED).</div></div><div><h3>Methods</h3><div>Patients with suitable conditions were identified and their predicted ED-LOS was recorded which was then compared to their actual ED-LOS when they returned along with a satisfaction score.</div></div><div><h3>Results</h3><div>147 overnight patients were deflected in a 6-month period (1.8%). The mean reduction in the predicted patient ED LOS was 5 h (300 min). The patient reported satisfaction was 4.79 out of 5.</div></div><div><h3>Discussion</h3><div>Whilst only suitable for a subset of patients presenting overnight to our ED, deflection empowered the nursing team to be able to offer alternatives to waiting.</div></div><div><h3>Conclusion</h3><div>Within our ED, overnight deflection of patients with low acuity conditions has reduced the overall LOS and improved the experience for suitable patients. This may additionally benefit the wider ED system by reducing congestion in waiting areas and the need for nursing care whilst patients wait.</div></div>","PeriodicalId":48914,"journal":{"name":"International Emergency Nursing","volume":"80 ","pages":"Article 101619"},"PeriodicalIF":1.8,"publicationDate":"2025-05-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143936058","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The effect of the vein imaging device used in peripheral intravenous catheterization on the initial vascular access of the procedure in patients admitted to the children’s emergency department: A randomized controlled trial","authors":"Duygu Karaarslan ,&nbsp;Dilek Ergin ,&nbsp;Alkan Bal ,&nbsp;Abdulkadir Utar","doi":"10.1016/j.ienj.2025.101613","DOIUrl":"10.1016/j.ienj.2025.101613","url":null,"abstract":"<div><h3>Introduction</h3><div>The intravenous cannulation of children in emergency can be extremely challenging. This study was aimed at investigating the effect of the vein-imaging device used in peripheral intravenous catheterization on the success of the procedure in patients who presented to the children’s emergency department.</div></div><div><h3>Methods</h3><div>In this randomized controlled study, 70 6- to 12-year-old children who presented to the emergency department were enrolled in the study. Then, they were randomly assigned to the vein imaging group (experimental group, n = 35) and to the standard group (control group, n = 35). The primary outcome measure was the success of the first attempt. Secondary outcome measures were the number of intravenous attempts and time allocated to the peripheral intravenous catheter placement.</div></div><div><h3>Results</h3><div>Seventy children completed the study. Of them, 35 were girls and 35 were boys. The total time for the attempts per patient were shorter in the vein imaging group than it was in the standard group (29.48 ± 10.21 vs 35.00 ± 24.65). There was a significant difference between the children in the vein imaging device and standard groups in terms of the mean difficult intravenous access scores during the procedure (p &lt; 0.05). The children in the vein imaging device group obtained higher mean scores than did the children in the standard group.</div></div><div><h3>Discussion</h3><div>The use of new AccuVein AV500 technology assisted with peripheral intravenous catheterization access in children improves the first time success rate. Improved visualization of veins also reduced the number of attempts and the time required for the placement.</div></div>","PeriodicalId":48914,"journal":{"name":"International Emergency Nursing","volume":"80 ","pages":"Article 101613"},"PeriodicalIF":1.8,"publicationDate":"2025-05-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143927715","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}