Journal of Emergency Nursing最新文献

{"title":"Street Nursing 101: Caring for the Homeless Population.","authors":"Luis Gino Guzman, Jill R Hobbs","doi":"10.1016/j.jen.2026.03.011","DOIUrl":"https://doi.org/10.1016/j.jen.2026.03.011","url":null,"abstract":"<p><strong>Introduction: </strong>Homelessness presents significant public health challenges, contributing to higher rates of chronic illness, mental health conditions, and overutilization of emergency departments. This project implemented the Street Nursing 101 educational program to enhance nurses' competence and improve care for homeless patients in the emergency department.</p><p><strong>Methods: </strong>A quantitative approach, guided by the Iowa Model of Evidence-Based Practice, supported the implementation of an online training program centered on homelessness care. Nurse competence was assessed using the PROFFNurse SAS II, modified HCAHPS surveys for patient experience, and hospital data for emergency department visit trends.</p><p><strong>Results: </strong>Nurse competence mean scores improved from 5 to 8.0, reflecting increased confidence. Perceived training needs dropped from a mean of 8.25 to 4, indicating nurses felt more prepared without requiring immediate additional training. Patient feedback showed a slight decline in reports of \"Always\" courteous and respectful care, but a significant reduction in \"Never\" listened-to complaints. Ratings for communication, discharge planning, and aftercare education improved, while non-emergent emergency department visits by homeless patients decreased by 4.6% (from 304 to 290).</p><p><strong>Discussion: </strong>This initiative successfully improved nurse competence, patient feedback experience, and non-emergent visits. By addressing communication gaps, discharge support, and nurse preparedness, Street Nursing 101 provides a replicable model to reduce health care disparities and enhance care delivery for homeless populations in emergency department settings.</p>","PeriodicalId":51082,"journal":{"name":"Journal of Emergency Nursing","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147845754","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":"Triage Competency and Qualifications","authors":"Jean A. Proehl MN, RN, CEN, CPEN, TCRN, FAEN, FAAN","doi":"10.1016/j.jen.2025.11.011","DOIUrl":"10.1016/j.jen.2025.11.011","url":null,"abstract":"","PeriodicalId":51082,"journal":{"name":"Journal of Emergency Nursing","volume":"52 3","pages":"Pages 542-546"},"PeriodicalIF":2.3,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147755441","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":"Making Room for Public Health in Emergency Nursing","authors":"Madeleine Whalen MSN/MPH, RN, CEN, NPD-BC,&nbsp;Ebony Toussaint RN-MSN, MPH, PhD","doi":"10.1016/j.jen.2025.10.016","DOIUrl":"10.1016/j.jen.2025.10.016","url":null,"abstract":"","PeriodicalId":51082,"journal":{"name":"Journal of Emergency Nursing","volume":"52 3","pages":"Pages 593-598"},"PeriodicalIF":2.3,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147755447","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":"Effectiveness of a Tutoring Program for the Development of Competencies in Novice Nurses in a Hospital Emergency Service: Longitudinal Quasi-Experimental Study","authors":"Marta Manero-Solanas PhD(c), MSc, RN,&nbsp;Noelia Navamuel-Castillo PhD(c), MSc, RN,&nbsp;Nieves López-Ibort PhD, MSc, RN,&nbsp;Ana Gascón-Catalán MD, PhD","doi":"10.1016/j.jen.2025.09.006","DOIUrl":"10.1016/j.jen.2025.09.006","url":null,"abstract":"<div><h3>Introduction</h3><div>This study aimed to measure the effectiveness of a tutoring program designed for the development of competencies in novice nurses in a hospital emergency service. The development of nursing competencies is essential to ensure patient safety and quality care. Health care systems should implement programs that enhance competency and facilitate the professional transition of new nurses to ensure safe clinical environments.</div></div><div><h3>Methods</h3><div>A quasi-experimental, longitudinal, and prospective study was conducted in the emergency department of a tertiary hospital in Spain between 2023 and 2024. Newly hired nurses (n = 63) were allocated to an experimental group, which received a structured tutoring program led by a single tutor, and to a control group. Competency levels were evaluated by the tutor using validated rubrics. Data were analyzed with descriptive and inferential statistics, with significance set at <em>P</em>&lt;.05.</div></div><div><h3>Results</h3><div>The experimental group demonstrated significant improvements in all evaluated competencies compared with the control group (<em>P</em>&lt;.05). Gains were maintained at 6 months, supporting the program’s sustained effectiveness.</div></div><div><h3>Discussion</h3><div>The findings of this study have important implications for health care settings, showing that the development of a tutoring program within hospitals is an effective measure for the competency and professional development of nurses.</div></div>","PeriodicalId":51082,"journal":{"name":"Journal of Emergency Nursing","volume":"52 3","pages":"Pages 778-792"},"PeriodicalIF":2.3,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145551544","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 Nursing Assessment in a Patient With a Hand Arteriovenous Fistula Caused by a Fishbone: A Case Report","authors":"Shangeetha Tarmalinggam MBBS,&nbsp;Firdati Mohd Said MBBS, MS (Ortho),&nbsp;Manohar Arumugam MBBS, MS (Ortho)","doi":"10.1016/j.jen.2025.11.017","DOIUrl":"10.1016/j.jen.2025.11.017","url":null,"abstract":"<div><div>Traumatic arteriovenous fistulas, accounting for most cases (approximately 82%-98%), are typically the consequence of penetrating injuries. The ulnar and radial arteries are the most common sites of occurrence, whereas incidents at the distal radial and ulnar arteries are rare. This emphasizes the critical role of systematic clinical reasoning when evaluating patients with unclear or atypical presentations. Emergency nurses play a vital role in recognizing red flags, escalating care, and advocating for further investigation when standard treatments fail. A previously healthy 55-year-old woman presented with a pulsating and painful swelling on the volar aspect of her right hand, which gradually increased in size after a puncture injury from a fishbone. Emergency nurses should recognize that such presentations require immediate vascular assessment, given that the pulsatile nature and progressive enlargement are key clinical indicators that distinguish arteriovenous fistulas from simple soft tissue injuries. On clinical assessment, a pulsatile mass was noted. Duplex ultrasound, along with angiography, confirmed the presence of an arteriovenous fistula. Differential diagnoses, such as pseudoaneurysm or soft tissue hematoma, were considered but ruled out based on imaging and flow characteristics. A successful embolization procedure was performed to treat the arteriovenous fistulas in her right hand, yielding a positive outcome.</div><div>For emergency nurses, this case emphasizes the importance of thorough neurovascular assessment in all penetrating hand injuries, regardless of apparent severity. Early recognition of pulsatile masses, assessment of distal perfusion, and prompt escalation to vascular specialists are crucial nursing interventions. The diagnosis of arteriovenous fistulas should not be underestimated, given that they can potentially lead to serious complications such as infection, aneurysm, stenosis, congestive heart failure, steal syndrome, ischemic neuropathy, and thrombosis. Emergency nurses play a pivotal role in early detection through systematic assessment and patient education about warning signs, ultimately preventing progression to life-threatening complications through timely intervention.</div></div>","PeriodicalId":51082,"journal":{"name":"Journal of Emergency Nursing","volume":"52 3","pages":"Pages 613-621"},"PeriodicalIF":2.3,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145812328","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":"Implementation of “STAMP” at Triage to Prevent Workplace Violence in the Emergency Department: A Quality Improvement Project","authors":"Stephanie O’Bryon DNP, RN, NEA-BC,&nbsp;Jason Stopyra MD, MS,&nbsp;Jennifer Wardwell BSN, RN,&nbsp;Chris Gates MSN, RN, CEN, NEA-BC,&nbsp;Kathy Barnard MSN, RN, CEN,&nbsp;Brandee Khoshnevis MSN, BSBA, RN, CEN, TCRN,&nbsp;Lindsay T. Munn PhD, RN","doi":"10.1016/j.jen.2025.10.007","DOIUrl":"10.1016/j.jen.2025.10.007","url":null,"abstract":"<div><h3>Introduction</h3><div>Workplace violence (WPV) is a significant concern in healthcare settings, especially in the Emergency Department (ED). Early identification of patients at risk for violent behavior is critical to WPV prevention and staff safety. The STAMP tool—Staring, Tone, Anxiety, Mumbling, and Pacing—is uniquely designed for the ED and guides clinicians in assessing behavioral cues associated with potential for violence. This project aimed to decrease staff injuries by implementing the STAMP tool at triage.</div></div><div><h3>Methods</h3><div>The STAMP tool was piloted in the triage of three urban emergency departments in the Southeastern U.S. Project outcomes included WPV-related staff injuries, tracked for two years before and after STAMP implementation. Additional measures included usability and satisfaction evaluated through surveys and focus group interviews with triage nurses, along with documentation rates of STAMP. Descriptive statistics and independent t-tests were used to analyze the data.</div></div><div><h3>Results</h3><div>Implementation of the STAMP tool was associated with a significant reduction in WPV-related staff injuries (t(46) = 4.45, p &lt; .001, CI 0.66–1.76). The average usability score for STAMP was 81.5 (SD ± 12.3), with 65% of triage nurses rating usability above average (n = 13/20). 90% of nurses (n = 18/20) found the tool helpful, and 65% (n = 13/20) reported feeling safer at work following implementation. Documentation rates for STAMP surpassed 90% by Week 9 and averaged 88.97% throughout the two-year study period.</div></div><div><h3>Discussion</h3><div>The STAMP tool is an easily adopted and sustainable tool for early detection and prevention of WPV in the ED. With effective implementation into the triage workflow, STAMP is associated with significant harm reduction, improved communication, high usability, and consistent documentation, supporting its potential for effective prevention of WPV in the ED.</div></div>","PeriodicalId":51082,"journal":{"name":"Journal of Emergency Nursing","volume":"52 3","pages":"Pages 695-705"},"PeriodicalIF":2.3,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145649979","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":"Reduction of Triage Nurse Fatigue Through the Implementation of an Evidence-Based Rotational Protocol","authors":"Chris Roden DNP, MSN, AGACNP-BC, CRNP, RNFA,&nbsp;Somali Nguyen DNP, AGACNP-BC, CRNP,&nbsp;Heidi Martin DNP, RN,&nbsp;Hiboombe Haamankuli DNP, MSN, ACNP-BC,&nbsp;Adam Kinsaul DNP, MSN, ACNP-BC, RNFA,&nbsp;Sabrina Kopf DNP, ACNP-BC, CRNP","doi":"10.1016/j.jen.2025.11.004","DOIUrl":"10.1016/j.jen.2025.11.004","url":null,"abstract":"<div><h3>Introduction</h3><div>Emergency triage nurses frequently experience significant fatigue owing to long shifts, high patient volumes, and rapid decision-making demands. This chronic fatigue not only affects nurses’ health and job satisfaction but also compromises patient care through increased risk of errors. This quality improvement project aimed to assess and address triage nurse fatigue by implementing a reduced shift length protocol at a single academic medical center.</div></div><div><h3>Methods</h3><div>Using the focus, analyze, develop, and execute model, this project compared fatigue levels during traditional 12-hour triage shifts with reduced 6-hour shifts. A Qualtrics-based pre- and postsurveys using the Samn-Perelli fatigue scale assessed self-reported fatigue levels among emergency triage nurses at 6- and 12-hour intervals. Surveys also captured demographic data including gender (man/woman), experience, education, and ethnicity. Preintervention data were collected over 34 days, followed by the implementation of a 6-hour rotational shift model.</div></div><div><h3>Results</h3><div>Data analysis from 66 responses over 68 days revealed a statistically significant reduction in fatigue after the intervention. The average fatigue level decreased from 4.58 at the 12-hour mark before the intervention to 3.21 after the intervention (<em>P</em> = .02), representing a 29.91% overall reduction. Experienced nurses reported lower fatigue scores than less experienced peers, whereas nurses with bachelor’s degrees demonstrated lower fatigue than those with associate degrees.</div></div><div><h3>Discussion</h3><div>The implementation of shorter, 6-hour triage shifts effectively reduced fatigue among emergency triage nurses, highlighting a feasible strategy to improve nurse well-being, job retention, and patient care quality. Further projects should evaluate long-term outcomes and explore additional strategies to address nurse fatigue comprehensively.</div></div>","PeriodicalId":51082,"journal":{"name":"Journal of Emergency Nursing","volume":"52 3","pages":"Pages 649-654"},"PeriodicalIF":2.3,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145991762","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":"Reflections on Attitudes Toward Family Presence During Resuscitation: Enhancing Generalizability and Incorporating Family Perspectives in Iranian Emergency Care","authors":"Göknur Yıldız MD","doi":"10.1016/j.jen.2025.10.009","DOIUrl":"10.1016/j.jen.2025.10.009","url":null,"abstract":"","PeriodicalId":51082,"journal":{"name":"Journal of Emergency Nursing","volume":"52 3","pages":"Pages 537-538"},"PeriodicalIF":2.3,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147755446","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":"A Nurse-Led Split Flow Model for Operational Improvement","authors":"Alexandra Germani DNP, RN, FNP-C,&nbsp;Kristi Mobus MPH,&nbsp;Patricia Russell MSN, RN, CEN","doi":"10.1016/j.jen.2025.11.002","DOIUrl":"10.1016/j.jen.2025.11.002","url":null,"abstract":"<div><h3>Background</h3><div>Emergency departments often face overcrowding that delays care and compromises patient safety. This quality improvement initiative implemented a nurse-led split flow model to improve throughput for Emergency Severity Index level 3 patients in a high-volume emergency department.</div></div><div><h3>Methods</h3><div>Guided by principles of continuous improvement and system leadership, a multidisciplinary team restructured emrgency department operations using vertical and horizontal zoning, role redefinition, and space reallocation. Leadership facilitated change management through staged pilot testing and feedback incorporation over 6 months.</div></div><div><h3>Results</h3><div>Implementation reduced door-to-provider times, enhanced patient satisfaction, and improved operational throughput. Leadership-driven decisions resulted in permanent layout changes and formal role expansion.</div></div><div><h3>Conclusion</h3><div>Strategic leadership by emergency nurses enabled sustained improvements in emergency department flow and capacity. The project demonstrates how nurse-led quality improvement initiatives can drive high-impact systems change.</div></div>","PeriodicalId":51082,"journal":{"name":"Journal of Emergency Nursing","volume":"52 3","pages":"Pages 573-582"},"PeriodicalIF":2.3,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147755450","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 Power of Positive Self-Affirmation","authors":"Michael Dustin Bass DNP, MHA, RN, CEN, NEA-BC","doi":"10.1016/j.jen.2026.03.002","DOIUrl":"10.1016/j.jen.2026.03.002","url":null,"abstract":"","PeriodicalId":51082,"journal":{"name":"Journal of Emergency Nursing","volume":"52 3","pages":"Pages 535-536"},"PeriodicalIF":2.3,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147755807","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}