International Emergency Nursing最新文献

{"title":"South African emergency nurses' perceptions and experiences of workplace violence: A qualitative study.","authors":"Khutso Brian Maimela, Alhassan Sibdow Abukari, Emmanuel Kwame Korsah, Shelley Schmollgruber","doi":"10.1016/j.ienj.2025.101694","DOIUrl":"https://doi.org/10.1016/j.ienj.2025.101694","url":null,"abstract":"<p><strong>Background: </strong>Workplace violence (WPV) is a persistent challengein emergency departments (EDs), exacerbated by complex sociocultural dynamics, institutional shortcomings, and insufficient support systems. Emergency healthcare providers in South Africa work in high-pressure environments, frequently encountering aggression from patients and families who misunderstand the nature of emergency care.</p><p><strong>Aim: </strong>To explore nurses' perceptions and experiences of workplace violence in the emergency departments in South Africa.</p><p><strong>Methods: </strong>This study used a qualitative descriptive design. Five semi-structured focus group discussions with 20 emergency nurses in South Africa. Data were analysed using thematic analysis. The study followed the COREQ guidelines.</p><p><strong>Findings: </strong>Three themes emerged: contributors to violence, barriers to reporting workplace violence, and environmental and institutional challenges. Contributors to violence were frequently fuelled by public misconceptions about emergency care procedures, particularly unrealistic triage expectations and staff confrontational behaviours. Barriers to reporting were evidenced by unclear reporting protocols, fear of retaliation or futility, and a culture of managerial indifference. The identified environmental and institutional challenges included insufficient security presence, hazardous physical environments, and a lack of structured support mechanisms.</p><p><strong>Conclusion: </strong>In South African EDs, WPV is exacerbated by socio-cultural misunderstandings, managerial complacency, and structural weaknesses. Addressing these issues will necessitate comprehensive strategies, such as improved institutional leadership, formalised reporting systems, and proactive safety interventions.</p>","PeriodicalId":48914,"journal":{"name":"International Emergency Nursing","volume":"83 ","pages":"101694"},"PeriodicalIF":1.8,"publicationDate":"2025-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145253299","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":"Paramedic nursing students' experiences of clinical placement in an ambulance where the teacher is another clinical supervisor - A qualitative study.","authors":"Kaisa Seppänen, Antti Tanninen, Anu Venesoja","doi":"10.1016/j.ienj.2025.101698","DOIUrl":"https://doi.org/10.1016/j.ienj.2025.101698","url":null,"abstract":"<p><strong>Background: </strong>Clinical placements are crucial for paramedic nursing students' and other healthcare students' learning. However, students' experiences of guidance in placements vary. Our aim was to describe paramedic nursing students' experiences of clinical placement in an ambulance where the teacher was another supervisor.</p><p><strong>Methods: </strong>This descriptive qualitative study used purposeful sampling to interview 22 paramedic nursing students who completed their ambulance clinical placement with teacher supervision between April and December 2023. Data were analyzed using inductive content analysis.</p><p><strong>Findings: </strong>One main category \"Paramedic nursing students' professional growth\", and two generic categories \"Teachers' supervising competence\" and \"Student-centered view\" were generated. Students highlighted low threshold to ask questions, different perspective on supervising, and experiences of being safe, as well as time spent on ambulance tasks, learning discussions, learning experiences, and a targeted weekly schedule in a clinical placement where the teacher was their supervisor.</p><p><strong>Conclusion: </strong>Embedding pedagogically trained teachers as clinical supervisors in ambulance placements enhances paramedic students' professional growth by fostering a safe, structured, and student-centered learning environment. Familiar teacher-student relationships, low thresholds for questions, and reflective learning discussions contribute to meaningful supervision and highlight the need for pedagogical competence in ambulance settings.</p>","PeriodicalId":48914,"journal":{"name":"International Emergency Nursing","volume":"83 ","pages":"101698"},"PeriodicalIF":1.8,"publicationDate":"2025-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145253350","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":"Nurses' perspectives on providing analgesia in the Italian prehospital emergency setting: A phenomenological study.","authors":"Francesca Sandroni, Martina Pia Pugliese, Silvia Magagna, Stefano Sebastiani, Boaz Gedaliahu Samolsky Dekel, Guglielmo Imbriaco","doi":"10.1016/j.ienj.2025.101696","DOIUrl":"https://doi.org/10.1016/j.ienj.2025.101696","url":null,"abstract":"<p><strong>Background: </strong>Effective pain management is a fundamental aspect of prehospital emergency care. However, numerous barriers, including inconsistent protocols, limited pharmacological options, and documentation gaps, hinder optimal pain relief. Emergency medical services (EMS) nurses play a crucial role in assessing and managing pain, yet their perspectives on prehospital analgesia remain underexplored.</p><p><strong>Objective: </strong>This study aims to explore the experiences and perceptions of Italian EMS nurses regarding prehospital pain management, identifying key challenges and potential improvements.</p><p><strong>Methods: </strong>A qualitative study was conducted using an interpretative phenomenological approach. Semi-structured interviews were performed with 14 EMS nurses from various Italian regions. Data was analyzed through thematic analysis, identifying recurring themes related to pain assessment, treatment, and documentation.</p><p><strong>Results: </strong>Five main themes emerged: (1) variability in analgesia protocols and pharmacological options, (2) inconsistent pain assessment and documentation, (3) challenges in pain management related to specific patient populations or environmental and logistical factors, (4) nurses' personal experiences shaping their approach to pain management, and (5) interprofessional collaboration challenges. While nurses emphasized the importance of systematic pain evaluation, barriers such as legal restrictions, inconsistent protocols, and limited pharmacological options were frequently reported.</p><p><strong>Conclusion: </strong>Prehospital pain management by EMS nurses in Italy faces significant challenges. Expanding protocol-approved pharmacological options, improving documentation practices, and enhancing training for pain management in vulnerable populations could improve care. A standardized, evidence-based national framework is needed to optimize pain relief and ensure equitable patient outcomes.</p>","PeriodicalId":48914,"journal":{"name":"International Emergency Nursing","volume":"83 ","pages":"101696"},"PeriodicalIF":1.8,"publicationDate":"2025-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145245568","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 nurses' experiences of caring for critically ill patients requiring intensive care in the emergency department.","authors":"Duygu Akbaş Uysal, Ebru Ekiz","doi":"10.1016/j.ienj.2025.101697","DOIUrl":"https://doi.org/10.1016/j.ienj.2025.101697","url":null,"abstract":"<p><strong>Background: </strong>Emergency departments' red zones are complex clinical environments requiring both emergency interventions and intensive care-level services, representing a critical area of focus in this special issue on emergency critical care. Nurses working in these settings face multifaceted challenges, including role ambiguity, time constraints, and limited resources. However, few studies have explored these experiences through theoretical models.</p><p><strong>Objective: </strong>This study aims to provide an in-depth exploration of nurses' experiences delivering intensive care-level care to critically ill patients in the red zones of emergency departments, within a theoretical framework.</p><p><strong>Method: </strong>Using a phenomenological qualitative approach, semi-structured interviews were conducted with 21 emergency nurses from various regions in Turkey. Data were analyzed using Braun and Clarke's six-step thematic analysis, and findings were conceptually interpreted through Meleis's Transition Theory and Tanner's Clinical Judgment Model.</p><p><strong>Findings: </strong>Four main themes and eleven subthemes emerged, including challenges in clinical judgment, role incompatibilities, and systemic shortages. Guided by Meleis's framework, findings indicate that adherence to intensive care standards and clinical education enhances competence, confidence, and reflective practice, informing nursing practice and policy.</p><p><strong>Conclusion: </strong>Nurses in emergency department red zones face multifaceted challenges, including the demands of multitasking, complexities in decision-making, and structural limitations in providing care for critically ill patients. The study emphasizes that clinical judgment is shaped not only by individual competencies but also by the availability of systemic support. These results underscore the necessity of establishing clear clinical guidelines, implementing structured team-based care models, and developing practice-oriented training programs to facilitate nurses' transition between emergency and intensive care settings.</p>","PeriodicalId":48914,"journal":{"name":"International Emergency Nursing","volume":"83 ","pages":"101697"},"PeriodicalIF":1.8,"publicationDate":"2025-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145245614","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":"Adaptation and validation of the critical care family needs inventory - Emergency department (CCFNI-ED) in Indonesian emergency care settings.","authors":"Rafi Achmad Rukhama, Raditya Bagus Septian, Desy Listyaningrum","doi":"10.1016/j.ienj.2025.101695","DOIUrl":"https://doi.org/10.1016/j.ienj.2025.101695","url":null,"abstract":"<p><strong>Objectives: </strong>This study aimed to assess the validity, reliability, and cultural adaptation of the Critical Care Family Needs Inventory - Emergency Department (CCFNI-ED) into the Indonesian language.</p><p><strong>Methods: </strong>The study was conducted in three phases, including the translation and cultural adaptation process, content and face validation by six emergency nursing experts, and construct validity and reliability testing through a cross-sectional survey of 120 family members of patients in three emergency departments in Indonesia. Data analysis included the item-level content validity index (I-CVI), Cronbach's alpha, item-total correlation, and exploratory factor analysis (EFA).</p><p><strong>Results: </strong>The results showed a total Cronbach's alpha value of 0.931, with all subscales having values greater than 0.70. The I-CVI value for all items was 1, indicating excellent content validity. EFA yielded six factors from 24 items, explaining 64.7 % of the total variance, with all items showing loadings ≥ 0.50 and communalities > 0.50. The correlations between subscales were significant (p < 0.01), with the strongest relationship observed between participation and communication (r = 0.720).</p><p><strong>Conclusions: </strong>The CCFNI-ED instrument is valid and reliable for assessing family needs in patient care within emergency settings. This can enhance the quality of family-centered services in emergency departments.</p>","PeriodicalId":48914,"journal":{"name":"International Emergency Nursing","volume":"83 ","pages":"101695"},"PeriodicalIF":1.8,"publicationDate":"2025-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145239845","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":"Nasal high flow therapy in the emergency department - A prospective study.","authors":"Esra Türe","doi":"10.1016/j.ienj.2025.101699","DOIUrl":"https://doi.org/10.1016/j.ienj.2025.101699","url":null,"abstract":"","PeriodicalId":48914,"journal":{"name":"International Emergency Nursing","volume":"83 ","pages":"101699"},"PeriodicalIF":1.8,"publicationDate":"2025-10-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145233998","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":"Artificial intelligence for improved decision-making in diabetic emergency survival: A cross-sectional study","authors":"Lintang Arum Nikentari ,&nbsp;Heri Kristianto ,&nbsp;Laily Yuliatun ,&nbsp;Ali Haedar ,&nbsp;Paulus Lucky Tirma Irawan","doi":"10.1016/j.ienj.2025.101700","DOIUrl":"10.1016/j.ienj.2025.101700","url":null,"abstract":"<div><h3>Aims</h3><div>This study aims to develop and validate an artificial intelligence -driven survival prediction model using the Random Forest algorithm to support clinical decision-making in diabetic emergency cases. The model is designed to assist emergency nurses in triage prioritization and resource allocation to improve patient outcomes.</div></div><div><h3>Methods</h3><div>A retrospective cross-sectional study was conducted using medical records of 1,047 diabetic emergency patients treated at regional hospital in Indonesia, from 2019 to 2024. Key clinical variables, including age, gender, blood glucose levels, Glasgow Coma Scale, triage classification, and insulin use, were analyzed. Logistic regression identified significant survival predictors, and random forest model was developed for survival prediction. Model performance was evaluated using accuracy, sensitivity, specificity, and the area under the receiver operating characteristic AUC (Area Under Curve).</div></div><div><h3>Results</h3><div>The random forest model identified GCS and triage classification as the most significant predictors of survival. Patients with higher GCS scores and immediate triage classification (P1) had a greater likelihood of survival. The model demonstrated high predictive performance, achieving an accuracy of 94.9 %, sensitivity of 95.6 %, specificity of 93.7 %, and an AUC of 0.96.</div></div><div><h3>Conclusion</h3><div>The AI-based random forest model demonstrated excellent predictive accuracy, supporting its integration into emergency nursing workflows. Implementing AI-driven decision-support systems in emergency departments may enhance triage accuracy, to improve survival outcomes in diabetic emergencies, future studies should focus on external validation and the integration of additional clinical parameters to further refine model performance.</div></div>","PeriodicalId":48914,"journal":{"name":"International Emergency Nursing","volume":"83 ","pages":"Article 101700"},"PeriodicalIF":1.8,"publicationDate":"2025-10-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145220937","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 nurses and the care of people who have self-harmed: A meta-ethnography","authors":"Luke Molloy ,&nbsp;Hadwan Aldahmashi ,&nbsp;Tammy Tran Merrick ,&nbsp;Kelly Lewer ,&nbsp;Faisal Khalaf Alanazi ,&nbsp;Louise Doyle ,&nbsp;Brian Keogh ,&nbsp;Timothy Wand","doi":"10.1016/j.ienj.2025.101682","DOIUrl":"10.1016/j.ienj.2025.101682","url":null,"abstract":"<div><h3>Background</h3><div>Self-harm is a significant public health issue and a key focus of health policies globally. Emergency departments (EDs) often see self-harm cases, with emergency nurses playing a crucial role. However, care is inconsistent and substandard due to a lack of evidence-based practices and mixed attitudes among nurses.</div></div><div><h3>Objective</h3><div>To understand the social context of emergency nurses’ practice with self-harm patients by synthesising qualitative research findings.</div></div><div><h3>Method</h3><div>Noblit and Hare’s <em>meta</em>-ethnography method was used to synthesise qualitative studies. Three databases (PsychINFO, CINAHL, and MEDLINE) were searched for relevant studies over the period October 2013 to July 2025. Five studies with rich qualitative data were included.</div></div><div><h3>Results</h3><div>Nurses often feel discomfort and uncertainty when caring for self-harm patients due to a lack of knowledge and confidence. Emotional responses like frustration and anger can negatively impact care quality. Service barriers, including time constraints, lack of privacy, and inadequate guidelines, further hinder optimal care. However, with experience and education, nurses develop greater comfort and skills. The presence of mental health specialists in EDs enhances nurses’ confidence and care quality. Focused education and training are crucial for changing attitudes and improving care for self-harm patients.</div></div><div><h3>Conclusion</h3><div>The <em>meta</em>-ethnography highlights the need for improved education and training for ED nurses in mental health care. Enhancing the physical environment of EDs and fostering a culture of shared responsibility for mental health care can improve service users’ outcomes and professional satisfaction for nurses.</div></div>","PeriodicalId":48914,"journal":{"name":"International Emergency Nursing","volume":"83 ","pages":"Article 101682"},"PeriodicalIF":1.8,"publicationDate":"2025-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145220938","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":"Trauma assessment within people who identify as LGBTQ+","authors":"Patrice Wade-Olson ,&nbsp;Jeremiah Wade-Olson","doi":"10.1016/j.ienj.2025.101687","DOIUrl":"10.1016/j.ienj.2025.101687","url":null,"abstract":"<div><h3>Objective</h3><div>Assess the prevalence of childhood and adulthood trauma in people who identify as LGBTQ+ as compared to people who identify as cisgender heterosexual.</div></div><div><h3>Background</h3><div>Trauma can have disastrous impacts on health. Much of the current trauma research is focused on childhood trauma and persons who identify as <em>cis</em>-gender heterosexuals. There is limited research regarding lifetime prevalence of trauma within people who identify as LGBTQ+.</div></div><div><h3>Method</h3><div>This study design is a survey and a quantitative, non-probability based, convenience sampling method was used to measures lifetime prevalence of trauma and discrimination in study participants. The survey was a combination of three validated instruments [<span><span>[1]</span></span>, <span><span>[2]</span></span>, <span><span>[3]</span></span>]. One hundred and fifty-five participants were enrolled across three community health primary care clinics within the United States and 141 surveys were analyzed.</div></div><div><h3>Results</h3><div>Participants who identified as LGBTQ+ had higher values of trauma across all measures as compared to participants who were cisgender heterosexual. African American respondents had higher trauma scores on two of the three trauma measures.</div></div><div><h3>Conclusion</h3><div>The widespread prevalence of trauma within the general population and the LGBTQ+ community suggests that the utilization of a trauma informed approach by emergency nurses can help to improve the health care experiences of people who identify as LGBTQ+ and prevent retraumatization. A trauma informed approach is recommended for persons who have experienced trauma.</div></div>","PeriodicalId":48914,"journal":{"name":"International Emergency Nursing","volume":"83 ","pages":"Article 101687"},"PeriodicalIF":1.8,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145214180","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":"Using virtual reality to enhance procedure-related experiences in adult emergency departments: A qualitative study","authors":"Hui (Grace) Xu ,&nbsp;Jed Duff ,&nbsp;Vicki Binnie","doi":"10.1016/j.ienj.2025.101692","DOIUrl":"10.1016/j.ienj.2025.101692","url":null,"abstract":"<div><h3>Introduction</h3><div>Needle phobia is a common issue affecting many patients in emergency departments (EDs), including adults. Virtual reality (VR) has rapidly advanced in recent years and is increasingly used in patient care. However, there is limited research exploring the subjective experiences of VR users in this context.</div></div><div><h3>Aim</h3><div>This study aims to explore the experiences of both patients and clinicians during painful needle-related procedures, as well as identify the barriers and facilitators associated with the use of VR to manage these procedures in ED.</div></div><div><h3>Design</h3><div>An exploratory qualitative study.</div></div><div><h3>Method</h3><div>The study was conducted in one adult ED in Australia in 2024. VR was used as an intervention to help manage needle phobia among adult patients with moderate or high anxiety levels. Semi-structured interviews were conducted with ten patients and seven ED clinicians. Thematic analysis was employed to analyse the data.</div></div><div><h3>Findings</h3><div>Overall, participants reported positive experiences with the innovative technology. Four themes developed from patient interviews included <em>Communication with clinicians; The influence of current and past experiences</em>; <em>The VR experience</em>; and <em>Considerations for VR implementation.</em> Three themes emerged from Clinician interviews including: <em>Communication with patients</em>; <em>The VR experience;</em> and <em>Considerations for VR implementation.</em></div></div><div><h3>Conclusion</h3><div>This study offers valuable preliminary insight into VR experiences from both patient and clinician perspectives in the ED setting.</div></div><div><h3>Implications</h3><div>Clinicians and researchers should consider the identified barriers, facilitators, and potential solutions when incorporating VR interventions into their clinical practice and research.</div></div>","PeriodicalId":48914,"journal":{"name":"International Emergency Nursing","volume":"83 ","pages":"Article 101692"},"PeriodicalIF":1.8,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145214238","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}