International Emergency Nursing最新文献

{"title":"Determination of the relationship between competencies in disaster nursing management and perceived stress: The intermediary role of resilience","authors":"Gülnur Akkaya ,&nbsp;Yeliz Akkuş ,&nbsp;Ayşe Gül Parlak ,&nbsp;Yasemin Karacan","doi":"10.1016/j.ienj.2024.101530","DOIUrl":"10.1016/j.ienj.2024.101530","url":null,"abstract":"<div><h3>Background</h3><div>Türkiye encounters various natural disasters, foremost earthquakes, and, nurses’ resilience, ability to cope with stress and disaster competence play a significant role in disasters.</div></div><div><h3>Objective</h3><div>The objective of this study is to establish the intermediary role of resilience in the relation between nurses’ competencies in disaster management and perceived stress.</div></div><div><h3>Method</h3><div>The sampling of this descriptive and cross-sectional study included 240 nurses from across Türkiye. The socio-demographic characteristics questionnaire, Competencies for Disaster Nursing Management Questionnaire, Brief Resilience Scale, Perceived Stress Scale were utilized in order to collect data. Among the continuous variables of the research, Pearson correlation analysis, linear regression and hierarchical regression analyses regarding the intermediary effect were performed by using PROCESS Model.</div></div><div><h3>Findings</h3><div>The mean scale scores of nurses were detected to be “CDNMQ” 6.300 ± 2.771 (medium), “BRS” 18.463 ± 4.308 (medium), and “PS” 21.038 ± 6.759 (low), respectively. The relationship between CDNMQ and PS (path c; ß = −0.534) descends in case BRS is added to the model (path c’; ß = −0.429) (p &lt; 0.05). In light of this finding, BRS was determined to be a partial intervening variable between CDNMQ and PS.</div></div><div><h3>Conclusion</h3><div>In accordance with this study, it is recommended to plan studies to enhance disaster nursing competence, prioritize resilience, and reproduce this study in various nurse groups.</div></div>","PeriodicalId":48914,"journal":{"name":"International Emergency Nursing","volume":"78 ","pages":"Article 101530"},"PeriodicalIF":1.8,"publicationDate":"2024-11-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142702066","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 medical service nurses’ experiences and perspectives on a protocol change of pre-hospital preventive immobilization of spinal injuries after trauma: A qualitative study","authors":"Otto J. van de Breevaart ,&nbsp;Nancy E.E. Van Loey ,&nbsp;Luke P.H. Leenen ,&nbsp;Lisette Schoonhoven ,&nbsp;Wietske H.W. Ham","doi":"10.1016/j.ienj.2024.101533","DOIUrl":"10.1016/j.ienj.2024.101533","url":null,"abstract":"<div><h3>Objective</h3><div>In 2016, a selective preventive spinal immobilization protocol for emergency medical service (EMS) nurses was introduced in the Netherlands. This protocol leaves more room for autonomous decision-making in the pre-hospital phase regarding preventive spinal immobilization (PSI), compared to the previous strict protocol. In this study, we explored the experiences and perspectives of EMS nurses on decisionmaking about PSI after the change from a strict to a selective PSI protocol. Methods: We used a qualitative design with semi-structured face-to-face interviews. Thematic analysis was applied. The capability-opportunity-motivation-behavior-model was used to interpret the experiences and perspectives. Results: Thirteen EMS nurses from three emergency medical services were interviewed. Respondents appreciated autonomous decision-making as there was more room for patient-centered informed decision-making. However, autonomous decision-making required optimized knowledge and skills and elicited the need to receive feedback on their decision not to apply PSI. When nurses anticipated resistance to selective PSI from receiving hospitals, they were doubtful to apply it. Conclusion: Nurses appreciate the increased autonomy in decision-making, encouraging them to focus on patient-centered care. Increased autonomy also places higher demands on knowledge and skills, calling for training and feedback. Anticipated resistance to receiving hospitals based on mutual protocol discrepancies could lead to PSI application by EMS nurses while not deemed necessary. Recommendations: To enhance PSI procedures, optimizing the knowledge and skills of EMS nurses that facilitate on-scene decision-making may be indicated. A learning loop for feedback between the EMS nurses and the involved hospitals may add to their professional performance. More efforts are needed to create support for the changed Emergency Medical Services strategy in PSI to prevent unnecessary PSI and practice variation.</div></div>","PeriodicalId":48914,"journal":{"name":"International Emergency Nursing","volume":"78 ","pages":"Article 101533"},"PeriodicalIF":1.8,"publicationDate":"2024-11-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142696047","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Decreasing hemolysis rates through phlebotomy education","authors":"Mariolina Bartolomeo,&nbsp;Christina Tedesco,&nbsp;LuAnn Etcher","doi":"10.1016/j.ienj.2024.101534","DOIUrl":"10.1016/j.ienj.2024.101534","url":null,"abstract":"","PeriodicalId":48914,"journal":{"name":"International Emergency Nursing","volume":"78 ","pages":"Article 101534"},"PeriodicalIF":1.8,"publicationDate":"2024-11-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142688858","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":"What is the optimal outcome for evaluating the triage Systems? Insights from a prospective observational study","authors":"Arian Zaboli ,&nbsp;Francesco Brigo ,&nbsp;Serena Sibilio ,&nbsp;Gloria Brigiari ,&nbsp;Magdalena Massar ,&nbsp;Marta Parodi ,&nbsp;Michael Mian ,&nbsp;Norbert Pfeifer ,&nbsp;Gianni Turcato","doi":"10.1016/j.ienj.2024.101540","DOIUrl":"10.1016/j.ienj.2024.101540","url":null,"abstract":"<div><h3>Background</h3><div>Currently, there is no universally accepted gold standard outcome for assessing the effectiveness of the Triage Systems. This study aimed to comprehensively evaluate and compare various outcomes utilized in triage studies.</div></div><div><h3>Methods</h3><div>A prospective observational study was conducted at the Emergency Department (ED) of Merano Hospital from June 1 to December 31, 2023. We assessed the predictive capability of the Manchester Triage System (MTS) across multiple outcomes using areas under the receiver operating characteristic curve (AUROC), along with their corresponding 95% confidence intervals (95% CI), and frequency distributions.</div></div><div><h3>Results</h3><div>The MTS demonstrated strong performance concerning the most objective outcomes, such as mortality (at 72 h: AUROC 0.914; 95 %CI: 0.815–1; at 7 days: 0.845; 95 %CI: 0.729–0.965; at 30 days: 0.794; 95 %CI: 0.706–0.881), admission to the intensive care unit (0.831; 95 %CI: 0.763–0.899), and need for life-saving interventions (0.870; 95 %CI: 0.806–0.934). Additionally, outcomes such as urgency status and clinical priority, as judged by physicians, exhibited excellent performance and optimal frequency distribution.</div></div><div><h3>Conclusions</h3><div>The performance of the MTS varied significantly depending on the specific outcome under evaluation. Currently, no single outcome appears superior to others, nor does any seem poised to serve as a potential gold standard for the assessment of triage systems. It is advisable for dedicated working groups to convene and reach a consensus on the most effective outcomes for evaluating the performance of MTS and other triage systems. This should be accomplished through a systematic, standardized, and transparent approach, grounded in the best available evidence.</div></div>","PeriodicalId":48914,"journal":{"name":"International Emergency Nursing","volume":"78 ","pages":"Article 101540"},"PeriodicalIF":1.8,"publicationDate":"2024-11-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142683221","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 Multinational Association for Supportive Care in cancer criteria. An Evaluation and recommendations for the management of neutropenia in the emergency department","authors":"Anas Alsharawneh","doi":"10.1016/j.ienj.2024.101542","DOIUrl":"10.1016/j.ienj.2024.101542","url":null,"abstract":"<div><h3>Objectives</h3><div>We aimed to evaluate the reproducibility, accuracy, feasibility, and effect of the Multinational Association for Supportive Care in Cancer (MASCC) criteria on emergency clinical decisions, treatment, and health outcomes.</div></div><div><h3>Methods</h3><div>A retrospective cohort design was used.</div></div><div><h3>Results</h3><div>The MASCC score was better at correctly detecting the high urgency (70 % of patients with a high urgency were identified as high risk) than the low urgency (only 30 % of patients with a low urgency were identified as low risk). The examination of the MASCC score as a continuous variable could have been more valuable and indicated inferior validity. The likelihood ratios were far from good, which is better for ruling out the high urgency. The observed likelihood ratio of the MASCC range 17 to 20 provided no information for the goodness of the scale (equal to one). The results from multiple linear regression analyses identified that the MASCC original categorization (high vs. low risk) and the investigated new one (multiple ranges of MASCC score) were significantly associated with time to reassessment, time to be seen, time to decide on admission, boarding time until disposition, and length of stay. However, the original categorization nor the new one was predictive of the admission site. Still, both were significantly associated with hospital disposition (mortality) (<em>p</em> &lt; 0.05).</div></div><div><h3>Conclusion</h3><div>Even though the MASCC score determines the neutropenia treatment pathway, the sensitivity and specificity analysis identified that the scale did not perform well in detecting real clinical urgency.</div></div>","PeriodicalId":48914,"journal":{"name":"International Emergency Nursing","volume":"78 ","pages":"Article 101542"},"PeriodicalIF":1.8,"publicationDate":"2024-11-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142683219","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":"“It’s about making a difference”: Interplay of professional value formation and sense of coherence in newly graduated Finnish paramedics","authors":"Christoffer R Ericsson ,&nbsp;Veronica Lindström ,&nbsp;Ann Rudman ,&nbsp;Hilla Nordquist","doi":"10.1016/j.ienj.2024.101541","DOIUrl":"10.1016/j.ienj.2024.101541","url":null,"abstract":"","PeriodicalId":48914,"journal":{"name":"International Emergency Nursing","volume":"77 ","pages":"Article 101541"},"PeriodicalIF":1.8,"publicationDate":"2024-11-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142677518","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effect of rescue work training in nursing students with a novel device: A quasi-experimental study","authors":"Verónica V. Márquez Hernández ,&nbsp;José Miguel Garrido-Molina ,&nbsp;Antonio Javier Segura-Fornieles ,&nbsp;Mª Carmen Rodríguez-García ,&nbsp;Alba García-Viola","doi":"10.1016/j.ienj.2024.101544","DOIUrl":"10.1016/j.ienj.2024.101544","url":null,"abstract":"<div><h3>Aims</h3><div>The aim of this study was to analyze the effectiveness of an intervention for the training of nursing students in rescue work of a traumatized patient using the Snaid® device.</div></div><div><h3>Methods</h3><div>A quasi-experimental one group pretest–posttest study was carried out. A total of 107 nursing students participated. Data on self-efficacy, knowledge, ergonomics and skill were collected. The data were analyzed with SPSS version 29 statistical software.</div></div><div><h3>Results</h3><div>Statistically significant differences were found between mean self-efficacy score and time of measurement (U = 2090.500; Z = -8.377; p &lt; 0.001). Statistically significant differences were also found between the time of measurement and the knowledge score (U = 373.000; Z = -11.966; p &lt; 0.001). Considering the results on ergonomics, it was found that the mean score given after the intervention was 9.37 (SD = 1.02). Regarding intervention time, the mean time was 47.76 s (SD = 4.74). Finally, considering skill, the mean score was 8.78 (SD = 1.23).</div></div><div><h3>Conclusion</h3><div>The results of the present study indicate that participants obtained a high level of self-efficacy, knowledge, skill and ergonomics after training in the rescue work of a patient through the Snaid® device. This device may contribute to improve trauma patient care.</div></div>","PeriodicalId":48914,"journal":{"name":"International Emergency Nursing","volume":"77 ","pages":"Article 101544"},"PeriodicalIF":1.8,"publicationDate":"2024-11-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142677585","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":"Development of an evidence-based strategy to implement the HIRAID® emergency nursing framework in rural emergency departments using behaviour change theory","authors":"Belinda Kennedy ,&nbsp;Kate Curtis ,&nbsp;Sarah Kourouche ,&nbsp;Louise Casey ,&nbsp;Dorothy Hughes ,&nbsp;Andrea McCloughen","doi":"10.1016/j.ienj.2024.101538","DOIUrl":"10.1016/j.ienj.2024.101538","url":null,"abstract":"<div><h3>Introduction</h3><div>Emergency nurses are critical to emergency care delivery, particularly in rural areas with limited medical support. To support nurses, the validated emergency nursing framework, HIRAID®, was to be implemented. Implementing interventions in the emergency context is notoriously difficult and rural areas have added challenges with limited resources across large geographic areas. This study aims to develop an evidence-informed strategy to implement HIRAID® across a large rural/regional health district.</div></div><div><h3>Methods</h3><div>The behaviour change wheel and Theoretical Domains Framework were used in developing the implementation strategy. The theoretical domains, linked to barriers and enablers to implementing HIRAID®, were mapped to intervention functions. Associated Behaviour Change Techniques were considered to determine suitability to address barriers or enhance enablers, as well as suitability according to and the APEASE criteria.</div></div><div><h3>Results</h3><div>Seven intervention functions, such as modelling, education, and incentivisation, were deemed suitable for inclusion. The intervention functions were mapped to 20 BCTs and planned to be operationalised through 11 delivery modes, including a flexible education program, documentation templates, and support in the workplace.</div></div><div><h3>Conclusions</h3><div>This study determined the relevant BCTs and mechanisms of delivery to mediate change in behaviour and support uptake of the HIRAID® emergency nursing framework in a rural health district.</div></div>","PeriodicalId":48914,"journal":{"name":"International Emergency Nursing","volume":"77 ","pages":"Article 101538"},"PeriodicalIF":1.8,"publicationDate":"2024-11-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142639953","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The accuracy of triage classification using Emergency Severity Index","authors":"Krisada Suamchaiyaphum ,&nbsp;Allison R. Jones ,&nbsp;Shea Polancich","doi":"10.1016/j.ienj.2024.101537","DOIUrl":"10.1016/j.ienj.2024.101537","url":null,"abstract":"<div><h3>Introduction</h3><div>Accurate emergency triage is essential for timely and appropriate care based on patient acuity. We sought to evaluate triage accuracy among emergency department (ED) nurses and examine potential influencing factors.</div></div><div><h3>Methods</h3><div>We conducted an observational study using an electronic medical record chart review of 100 patients admitted at one of three EDs in a large academic medical system in the southern United States from December 1 to 7, 2021. Descriptive statistics were used to summarize the data. We compared the nurses’ initial assigned triage acuity level documented in the medical chart with triage acuity assigned using the Emergency Severity Index Version 4 handbook and assessed inter-rater agreement using Cohen’s kappa coefficient.</div></div><div><h3>Results</h3><div>Overall triage accuracy was 67%, with most patients (62%) triaged as ESI level 3; under- and over-triage occurred in 25% and 8% of cases, respectively. Cohen’s kappa coefficient was 0.437, indicating moderate interrater reliability between the triage nurses and the ESI handbook. Triage accuracy varied across ED locations and patient characteristics of sex (male: 55.6%, female: 72.3%), type of complaint (trauma: 57.1%, non-trauma: 69.4%), shift (day: 63.5%, night: 73.0%), and mode of arrival (ambulance: 80.8%, ambulatory: 65.2%, and private vehicle: 37.5%).</div></div><div><h3>Conclusion</h3><div>Triage inaccuracy may be attributed to a combination of nursing- and patient-specific factors. Further study of those factors associated with triage accuracy is warranted.</div></div>","PeriodicalId":48914,"journal":{"name":"International Emergency Nursing","volume":"77 ","pages":"Article 101537"},"PeriodicalIF":1.8,"publicationDate":"2024-11-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142630734","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":"Children with medical complexity in the emergency department: Parent experiences and information needs","authors":"Danielle Lysak ,&nbsp;Samina Ali ,&nbsp;Susan Neufeld ,&nbsp;Shannon Scott","doi":"10.1016/j.ienj.2024.101532","DOIUrl":"10.1016/j.ienj.2024.101532","url":null,"abstract":"<div><h3>Background</h3><div>Children with complex medical needs constitute a growing number of pediatric patients that utilize the emergency department, disproportionately more than children outside of this category. Our objective for this qualitative study was to explore information needs and experiences of parents accessing emergency health care for their child with medical complexity.</div></div><div><h3>Methods</h3><div>Qualitative description guided this study. Parent participants were recruited via purposive sampling and individually interviewed within a pediatric specialty clinic at a Canadian pediatric tertiary care center. Inductive content analysis organized interview data from parents.</div></div><div><h3>Results</h3><div>Nine, 60–90 min individual interviews were conducted with parents of a child with medical complexity; four content categories emerged: How the emergency department is different for children with medical complexity, parents as key care coordinators, emergency department experience and resilience, and communication and learning preferences.</div></div><div><h3>Conclusion</h3><div>These families openly shared their experience with pediatric emergency care. Strategies to support transfer of pertinent health information for children with complex medical needs are needed in the emergency department. Interviews with parents of children with complex medical needs provided key insights to inform and improve the care provided in the emergency department for this growing population of children.</div></div>","PeriodicalId":48914,"journal":{"name":"International Emergency Nursing","volume":"77 ","pages":"Article 101532"},"PeriodicalIF":1.8,"publicationDate":"2024-11-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142607154","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}