International Emergency Nursing最新文献

{"title":"Enhancing triage accuracy: The influence of nursing education on risk prediction","authors":"Arian Zaboli ,&nbsp;Serena Sibilio ,&nbsp;Magdalena Massar ,&nbsp;Gloria Brigiari ,&nbsp;Gabriele Magnarelli ,&nbsp;Marta Parodi ,&nbsp;Michael Mian ,&nbsp;Norbert Pfeifer ,&nbsp;Francesco Brigo ,&nbsp;Gianni Turcato","doi":"10.1016/j.ienj.2024.101486","DOIUrl":"10.1016/j.ienj.2024.101486","url":null,"abstract":"<div><h3>Aim</h3><p>This study aimed to compare the performance in risk prediction of various outcomes between specially trained triage nurses and the Manchester Triage System (MTS).</p></div><div><h3>Design</h3><p>Prospective observational study.</p></div><div><h3>Methods</h3><p>The study was conducted from June 1st to December 31st, 2023, at the Emergency Department of Merano Hospital. Triage nurses underwent continuous training through dedicated courses and daily audits. We compared the risk stratification performed by expert nurses with that of MTS on various outcomes such as mortality, hospitalisation, and urgency defined by the physicians. Comparisons were made using the Areas Under the Receiver Operating Characteristic curve (AUROC).</p></div><div><h3>Results</h3><p>The agreement in code classification between the MTS and the expert nurse was very low. The AUROC curve analysis showed that the expert nurse outperformed the MTS in all outcomes. The triage nurse’s experience led to statistically significant better stratification in admission rates, ICU admissions, and all outcomes based on the physician’s assessment.</p></div><div><h3>Conclusions</h3><p>The continuous training of nurses enables them to achieve better risk prediction compared to standardized triage systems like MTS, emphasizing the utility and necessity of implementing continuous training pathways for these highly specialised personnel.</p></div>","PeriodicalId":48914,"journal":{"name":"International Emergency Nursing","volume":"75 ","pages":"Article 101486"},"PeriodicalIF":1.8,"publicationDate":"2024-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141471816","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":"Exploring clinicians’ knowledge and attitudes toward the care needs of complex adult users of an Emergency Department: A descriptive mixed methods study","authors":"Vicki Binnie ,&nbsp;Amy N.B. Johnston","doi":"10.1016/j.ienj.2024.101481","DOIUrl":"10.1016/j.ienj.2024.101481","url":null,"abstract":"<div><h3>Background</h3><p>Adults who frequently present (FPAs) to emergency departments (EDs) often have a history of adverse childhood experiences (ACEs) and related adult health sequelae. Implications for ED care of this group remains poorly understood. This study explored clinicians’ knowledge and attitudes toward the care needs of FPAs who have an ACEs history, providing preliminary evidence to inform further research and interventions.</p></div><div><h3>Methods</h3><p>A purposive sample of ED clinicians completed an investigator developed mixed-methods survey. Descriptive statistics and content analysis were applied.</p></div><div><h3>Results</h3><p>Forty-three ED clinicians completed the survey. Most perceived that ACEs were common among FPAs and influenced their ED presentations. Clinicians were more aware of the psychosocial impacts of ACEs than the risks to physical health. While most clinicians agreed that FPAs should be asked about ACEs for management planning, most never asked, describing multiple barriers to doing so. Consumer’s healthcare needs were often described as unmet by clinicians who desired additional support to provide care for this group.</p></div><div><h3>Conclusions</h3><p>This study highlights clinicians’ perceptions of gaps in healthcare for this patient group and introduces requirements for appropriate knowledge and resources to partner with consumers to provide patient-centred and trauma-informed health care responses.</p></div>","PeriodicalId":48914,"journal":{"name":"International Emergency Nursing","volume":"75 ","pages":"Article 101481"},"PeriodicalIF":1.8,"publicationDate":"2024-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1755599X24000764/pdfft?md5=645a1d9c7e9342007aecb0545b7d7173&pid=1-s2.0-S1755599X24000764-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141471817","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":"What can be done about workplace wellbeing in emergency departments? ‘There’s no petrol for this Ferrari’","authors":"Jennifer Davids ,&nbsp;Nicole Bohlken ,&nbsp;Martin Brown ,&nbsp;Margaret Murphy","doi":"10.1016/j.ienj.2024.101487","DOIUrl":"10.1016/j.ienj.2024.101487","url":null,"abstract":"<div><p>Workplace wellbeing encompasses all aspects of working life. Peak health organisations recognise that poor workplace wellbeing is costly, both to individuals and to the organisation, and the value in promoting healthy workplaces. Workplace wellbeing improves when its barriers are acknowledged and addressed, and protective factors are promoted.</p><p>The Emergency Department (ED) is a place of intense and challenging activity, exacerbated by high workloads and overcrowding. This impacts negatively on patient care, staff safety and wellbeing.</p><p>We held focus groups across four EDs to discuss barriers and enablers to wellbeing and found four core themes: Workplace Satisfaction; Barriers to Wellbeing; Organisational Culture that Prioritises Staff Wellbeing; Self-care and Self Compassion. From this, and existing literature, we collaboratively developed a contextualised staff wellbeing framework titled: ‘Staff Wellbeing Good Practice Framework: From Surviving to Thriving, How to Protect your Wellbeing in the Emergency Department’ that emphasises their values of Competence, Connection and Control.</p></div>","PeriodicalId":48914,"journal":{"name":"International Emergency Nursing","volume":"75 ","pages":"Article 101487"},"PeriodicalIF":1.8,"publicationDate":"2024-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141471822","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":"Factors associated with mental health representations to the emergency department within six months","authors":"Shanley Chong ,&nbsp;Helen M Achat ,&nbsp;Joanne M Stubbs ,&nbsp;Margaret Murphy","doi":"10.1016/j.ienj.2024.101480","DOIUrl":"10.1016/j.ienj.2024.101480","url":null,"abstract":"<div><h3>Background/objective</h3><p>ED representation places a tremendous drain on resources with mental health (MH) representation among the most common. This study aimed to identify patient and clinical factors associated with 28-day and six-month ED MH representation of an index MH ED presentation.</p></div><div><h3>Method</h3><p>All MH related ED presentations from 1 January 2017 to 30 June 2019 were extracted from routinely collected administrative data. Cox regression and multinomial logistic regression models tested associations between patient characteristics and risk of representation.</p></div><div><h3>Results</h3><p>For the 8,010 patients, 28-day and six-month representations were 8 % and 16 % respectively. Self-identifying with a MH problem at index presentation (28-day hazard ratio (HR) = 1.48, 95 % CI = 1.19–1.84; six-month HR = 1.52, 95 % CI = 1.29–1.78), leaving ED before completing treatment (28-day HR = 4.13, 95 % CI = 3.36–5.08; six-month HR = 2.52, 95 % CI = 2.12–2.99), no private health insurance (six-month HR = 1.34, 95 % CI = 1.08–1.66), and hospital admission within one year prior to index (six month MH-related admission vs non-MH, HR = 1.59, 95 % CI = 1.19–2.13) were associated with increased risk of representation. Being uninsured was associated with frequent six-month representation among adults aged 16–39 years (OR = 3.16, 95 %CI = 1.59–6.25).</p></div><div><h3>Conclusion</h3><p>Self-identifying with a MH problem, leaving ED prematurely, being uninsured and prior hospitalisation are areas for in-depth investigation for improved understanding of unplanned representations.</p></div>","PeriodicalId":48914,"journal":{"name":"International Emergency Nursing","volume":"75 ","pages":"Article 101480"},"PeriodicalIF":1.8,"publicationDate":"2024-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141471818","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":"Corrigendum to “Nurses’ lived experience of providing hospice care in the emergency department in mainland China: A qualitative study” [Int. Emerg. Nurs. 75 (2024) 101464]","authors":"","doi":"10.1016/j.ienj.2024.101485","DOIUrl":"10.1016/j.ienj.2024.101485","url":null,"abstract":"","PeriodicalId":48914,"journal":{"name":"International Emergency Nursing","volume":"75 ","pages":"Article 101485"},"PeriodicalIF":1.8,"publicationDate":"2024-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1755599X24000806/pdfft?md5=d5a7451f5054aa65582543237db6474c&pid=1-s2.0-S1755599X24000806-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141471840","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":"Telenursing as a tool in emergencies and disasters: A systematic review","authors":"Noemi Aspas Sebastià ,&nbsp;Olga Navarro Martínez","doi":"10.1016/j.ienj.2024.101478","DOIUrl":"10.1016/j.ienj.2024.101478","url":null,"abstract":"<div><p>Telenursing as a tool in emergencies and disasters: a systematic review.</p></div><div><h3>Background</h3><p>Telenursing is an innovative strategy that allows nurses to care for patients in various situations with the help of technology. The aim of this systematic review is to analyse the current situation of telenursing in emergencies and disasters by means of a systematic review of the scientific literature.</p></div><div><h3>Methods</h3><p>A systematic review of the scientific literature was carried out following the PRISMA methodology. A systematic search was conducted using the CINAHL, Pubmed and Cochrane Library databases. Study selection and risk of bias were performed independently by pair of authors.</p></div><div><h3>Results</h3><p>A total of 14 publications were selected. The results of the study focus on two main themes; on the one hand, the benefits offered by telenursing in the field of emergency and disaster situations and, on the other hand, the perspective of professionals who use it or who are likely to do so.</p></div><div><h3>Conclusions</h3><p>Telenursing brings benefits to the emergency department, such as improved clinical outcomes, fewer unnecessary visits to the department, enhanced nursing autonomy and reduced healthcare costs. Nurses have a positive attitude towards the use of this technology; however, more training and equipment are required to increase its effectiveness.</p></div>","PeriodicalId":48914,"journal":{"name":"International Emergency Nursing","volume":"75 ","pages":"Article 101478"},"PeriodicalIF":1.8,"publicationDate":"2024-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141471821","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":"Comparison of the correlation between moral sensitivity and clinical competence in emergency and intensive care nurses: A cross-sectional-correlation study","authors":"Maedeh Pourhossein Alamdari ,&nbsp;Nayyereh Raiesdana ,&nbsp;Monir Nobahar ,&nbsp;Mohammad Bagher Yavari","doi":"10.1016/j.ienj.2024.101483","DOIUrl":"10.1016/j.ienj.2024.101483","url":null,"abstract":"<div><h3>Introduction</h3><p>Nurses’ sensitivity to moral issues, especially in emergency and intensive care units is essential for providing complex nursing care. Therefore, the present study aimed to determine the correlation between moral sensitivity and clinical competence in emergency and intensive care nurses.</p></div><div><h3>Methods</h3><p>The present multi-center cross-sectional correlational study was conducted in 2022 on 180 nurses in five emergency departments and four intensive care units of general hospitals affiliated to Semnan University of Medical sciences. The study tools include a demographic questionnaire, 25 item Lutzen Moral Sensitivity Questionnaire (MSQ), and a standardized Competency Inventory for Registered Nurses (CIRN). Data were analyzed by mean, standard deviation and MANOVA, Pearson’s correlation coefficient test.</p></div><div><h3>Results</h3><p>The two groups did not have significant differences in demographic characteristics (p &lt; 0.05). Majority of two emergency department nurses (83.9%) and Intensive care nurses (81.8%) had a moderate level of moral sensitivity. Also, clinical competence of majority of emergency department nurses (73.3%) and Intensive care nurses (75.8%) were in moderate level. There was significant positive relationship between moral sensitivity with Clinical competence in emergency department nurses (p ≤ 0.01, r = 0.61). No significant relationship was observed between moral sensitivity and the clinical competence of intensive care nurses (p &gt; 0.05, r = 0.15).</p></div><div><h3>Conclusions</h3><p>There is need for improving the level of knowledge of nurses about moral principles and increasing moral sensitivity which can expand the components of clinical competence, especially in intensive care units.</p></div>","PeriodicalId":48914,"journal":{"name":"International Emergency Nursing","volume":"75 ","pages":"Article 101483"},"PeriodicalIF":1.8,"publicationDate":"2024-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141471842","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’ moral judgements during emergency department triage – A prospective mixed multicenter study","authors":"Benjamin Pilleron ,&nbsp;Delphine Douillet ,&nbsp;Yoakim Furon ,&nbsp;Carole Haubertin ,&nbsp;Elsa Parot-Schinkel ,&nbsp;Bruno Vielle ,&nbsp;Pierre-Marie Roy ,&nbsp;Laurent Poiroux","doi":"10.1016/j.ienj.2024.101479","DOIUrl":"10.1016/j.ienj.2024.101479","url":null,"abstract":"<div><h3>Introduction</h3><p>In EDs, triage ensures that patients whose condition requires immediate care are prioritized while reducing overcrowding. Previous studies have described the manifestation of caregivers’ moral judgements of patients in EDs. The equal treatment of patients in clinical practice presents a major issue. Studying the impact of prejudice on clinical practice in the ED setting provides an opportunity to rethink clinical tools, organizations and future training needs. Our study sought to describe the moral judgements expressed by triage nurses during admission interviews in emergency departments and to assess their impact on patient management.</p></div><div><h3>Methods</h3><p>An exploratory sequential mixed-method study was performed. The study was conducted between January 1, 2018, and February 18, 2018, in the EDs of three French hospitals. Five hundred and three patients and 79 triage nurses participated in the study. Audio recordings, observations and written handover reports made by nurses during admission triage interviews were analyzed with a view to discerning whether moral judgements were expressed in them. We studied the impact of moral judgements on patient management in the emergency department.</p></div><div><h3>Results</h3><p>Abstract Moral judgements were made in 70% of the triage situations studied (n=351/503). They could be classified in seven categories. Patients were more likely to be subjected to moral judgements if they were over 75 years old, visibly disabled or if they had visible signs of alcohol intoxication. Being subjected to moral judgement was associated with differential treatment, including assignment of a triage score that differed from the theoretical triage score.</p></div><div><h3>Conclusion</h3><p>More than two thirds of patients admitted to EDs were triaged using moral criteria. Patients who were morally judged at the admission interview were more likely to be treated differently.</p></div>","PeriodicalId":48914,"journal":{"name":"International Emergency Nursing","volume":"75 ","pages":"Article 101479"},"PeriodicalIF":1.8,"publicationDate":"2024-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141471820","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":"When is a fracture not just a fracture? Exploring emergency nurses' knowledge of osteoporosis in the West of Ireland","authors":"Norrie Tierney ,&nbsp;Bernard McCarthy ,&nbsp;Naomi Davies","doi":"10.1016/j.ienj.2024.101482","DOIUrl":"10.1016/j.ienj.2024.101482","url":null,"abstract":"<div><h3>Background</h3><p>Osteoporosis and fragility fractures are set to rise with the global ageing population. Prevalence will continue to significantly impact people’s quality of life and healthcare expenditure. Emergency nurses are ideally placed to highlight the importance of screening, and treatment, to the public. For emergency nurses to impart information to patients it is essential they have accurate, evidence-based knowledge. This study aims to determine if emergency nurses’ knowledge of osteoporosis is sufficient to educate the public.</p></div><div><h3>Method</h3><p>A cross sectional descriptive design of 210 emergency nurses using the ‘Osteoporosis Knowledge Questionnaire’ (OKQ) was administered in four hospitals in the West of Ireland. Data was analysed using SPSS v28.</p></div><div><h3>Results</h3><p>A 66 % response rate was achieved. The mean score on the OKQ was 12.13 out of a possible 22. This suggests emergency nurses’ knowledge of osteoporosis is substandard. Level of education has the greatest impact on participants (p = 0.005). Results indicated that emergency nurses acknowledge their responsibility regarding health promotion but lack the knowledge to undertake the role.</p></div><div><h3>Conclusion</h3><p>Emergency nurses play a pivotal role in reducing osteoporosis and fragility fractures, by disseminating information to patients on prevention and management. This study highlighted that educational initiatives are required to address the deficiencies amongst emergency nurses’ understanding of osteoporosis. Enhancing knowledge will inevitably lead to increased public awareness in tackling this global health crisis.</p></div>","PeriodicalId":48914,"journal":{"name":"International Emergency Nursing","volume":"75 ","pages":"Article 101482"},"PeriodicalIF":1.8,"publicationDate":"2024-06-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1755599X24000776/pdfft?md5=42e368f3d6b9d34f7a2729030b359a2c&pid=1-s2.0-S1755599X24000776-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141443637","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":"Using primary healthcare facilities and patients’ expectations about triage system: Patients’ perspective from multisite Jordanian hospitals","authors":"Mohammad Minwer Alnaeem ,&nbsp;Asma Islaih ,&nbsp;Shaher H. Hamaideh ,&nbsp;Abdulqadir J. Nashwan","doi":"10.1016/j.ienj.2024.101476","DOIUrl":"https://doi.org/10.1016/j.ienj.2024.101476","url":null,"abstract":"<div><h3>Background</h3><p>Using primary healthcare facilities can decrease the tension and workload in emergency departments (EDs). This study aim to examine the patient’s use of primary healthcare facilities before EDs visits and their expectations about the triage.</p></div><div><h3>Methods</h3><p>A cross-sectional design was utilized in at various EDs in different hospitals. A convenience sample of 726 patients were enrolled and completed a self-administrated questionnaire.</p></div><div><h3>Results</h3><p>The mean age of the participants was 38.1 (<em>SD</em> = 12.9). Most participants (68.2 %) did not have primary care physicians and did not want to know how long other patients waited (61.4 %). There are significant relationships between participants’ desired to know how long other patients have been waiting and their age (<em>X²</em> = 4.02, P &lt; .05), education level (<em>X²</em> = 13.5, P &lt; .001), and current job (<em>X²</em> = 9.90, p &lt; .05). Also, periodic updates from EDs staff about the delays were significantly related to participants’ age (<em>X²</em> = 3.29), current job (<em>X²</em> = 28.4), marital status (<em>X²</em> = 8.93), and residency place (<em>X²</em> = 9.94).</p></div><div><h3>Conclusion</h3><p>Educating patients about the triage system and the importance of using primary healthcare facilities is recommended to reduce ED waiting times and overload.</p></div>","PeriodicalId":48914,"journal":{"name":"International Emergency Nursing","volume":"75 ","pages":"Article 101476"},"PeriodicalIF":1.8,"publicationDate":"2024-06-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1755599X24000715/pdfft?md5=1703ad7f79cd87e2a43cc5a49f24b3a6&pid=1-s2.0-S1755599X24000715-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141429186","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}