Australasian Emergency Care最新文献_第2页

Emergency care experiences of patients known to palliative care services and their family: A qualitative interview study. 姑息治疗患者及其家属的急诊护理经验：一项质性访谈研究。

IF 2.1 4区医学

Australasian Emergency Care Pub Date : 2024-12-30 DOI: 10.1016/j.auec.2024.12.003

Reuben Sutton, Natalie Elizabeth Anderson, Merryn Gott

{"title":"Emergency care experiences of patients known to palliative care services and their family: A qualitative interview study.","authors":"Reuben Sutton, Natalie Elizabeth Anderson, Merryn Gott","doi":"10.1016/j.auec.2024.12.003","DOIUrl":"https://doi.org/10.1016/j.auec.2024.12.003","url":null,"abstract":"<p><strong>Background: </strong>With aging and comorbid populations and healthcare services under pressure, emergency department presentations related to palliative care needs are increasing. Little is known about patient and family experiences of care in this context. This study explores the emergency department care experiences of palliative patients and their family members.</p><p><strong>Methods: </strong>Semi-structured interviews with patients known to palliative care services who had presented to an urban emergency department within the study recruitment period. Six patients and five family members were interviewed. Reflexive thematic analysis methodology was underpinned by social constructivism.</p><p><strong>Findings: </strong>Participants often described misalignment between emergency care priorities and their own, which was sometimes associated with challenges, including dehumanisation. However, participants also shared stories of supported self-advocacy, associated with positive care experiences.</p><p><strong>Conclusion: </strong>This research identifies challenges patients and their family experience when accessing emergency department care. Symptom management, time, environment, and advocacy were impactful aspects of patient and family experience. There is a need to develop and support palliative care skills and knowledge within EDs, and adapt the environment to provide a safe space for sensitive communication and person-centred care.</p>","PeriodicalId":55979,"journal":{"name":"Australasian Emergency Care","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2024-12-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142911184","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}

引用次数: 0

RESCUE - Rapid, Effective, Safe Communication in Emergency Departments: A cross-sectional e-survey. 救援——急诊科快速、有效、安全的通信：一项横断面电子调查。

IF 2.1 4区医学

Australasian Emergency Care Pub Date : 2024-12-27 DOI: 10.1016/j.auec.2024.12.002

Amy Freeman-Sanderson, Nicola Clayton, Margaret Fry, Rebecca Sullivan, Bronwyn Hemsley

{"title":"RESCUE - Rapid, Effective, Safe Communication in Emergency Departments: A cross-sectional e-survey.","authors":"Amy Freeman-Sanderson, Nicola Clayton, Margaret Fry, Rebecca Sullivan, Bronwyn Hemsley","doi":"10.1016/j.auec.2024.12.002","DOIUrl":"https://doi.org/10.1016/j.auec.2024.12.002","url":null,"abstract":"<p><strong>Background: </strong>Effective staff-to-staff and patient-provider communication in the Emergency Department (ED) is essential for safe, quality care. Routine wearing of Personal-Protective-Equipment (PPE) has introduced new challenges to communication. We aimed to understand the perspectives of ED staff about communicating while wearing PPE, and to identify factors contributing to communication success, breakdown, and repair.</p><p><strong>Methods: </strong>Study design was a descriptive cross-sectional online survey with convenience sampling. Categorical data were analysed using descriptive statistics and qualitative data analysed using content thematic analysis.</p><p><strong>Results: </strong>Across nursing, medical and allied health, 78 staff responded with mean age= 38.8 years and mean ED clinical experience= 8.8 years). Respondents reported PPE impacted communication with patients/family members (81 %) and staff (61 %), with almost three-quarters of patient interactions rated as \"somewhat difficult\" or \"extremely difficult\". Content themes were: (i) impacts of mask-wearing on communication, (ii) impacts of mask-wearing on patient care quality and safety, and (iii) strategies for repairing communication breakdown. Health impacts of communicating in PPE (50 %) included voice fatigue, skin irritation, and throat dryness.</p><p><strong>Conclusion: </strong>ED staff perceived that wearing PPE impacted communication and compromised safe and efficient quality care delivery. Staff reported using increased voice volume, repetition, gestures, increased proximity, and emphasised facial movements to enhance their communication.</p>","PeriodicalId":55979,"journal":{"name":"Australasian Emergency Care","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2024-12-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142900684","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}

引用次数: 0

Maintenance of normothermia in the out-of-hospital setting: A pilot comparative crossover study of a foil blanket versus self-warming blanket. 院外环境中正常体温的维持：铝箔毯与自温毯的试点比较交叉研究。

IF 2.1 4区医学

Australasian Emergency Care Pub Date : 2024-12-17 DOI: 10.1016/j.auec.2024.12.001

Kathleen M O'Leary, Rebecca Henderson, Joanne N Caldwell Odgers, Benjamin N Meadley

{"title":"Maintenance of normothermia in the out-of-hospital setting: A pilot comparative crossover study of a foil blanket versus self-warming blanket.","authors":"Kathleen M O'Leary, Rebecca Henderson, Joanne N Caldwell Odgers, Benjamin N Meadley","doi":"10.1016/j.auec.2024.12.001","DOIUrl":"https://doi.org/10.1016/j.auec.2024.12.001","url":null,"abstract":"<p><strong>Introduction: </strong>Hypothermia can increase mortality in certain patients. Paramedics apply cotton and foil \"space\" blankets for warming, yet their effectiveness remains uncertain. This pilot study aimed to evaluate combining cotton blankets with a self-warming blanket versus a combination of cotton blankets and a foil blanket in an out-of-hospital simulation.</p><p><strong>Methods: </strong>Eight participants were allocated to warming with either two cotton blankets and one foil blanket, or two cotton blankets and one self-warming blanket, with the alternate method applied in a subsequent session. Participants were cooled using an ice-vest and fan until shivering onset, after which the warming method was applied. Simulation involved transitioning through three environments: baseline (22 °C), cooling/warming (16 °C), and \"ambulance\" (27 °C). Core temperature was monitored via oesophageal probe, skin temperature via thermistors (recorded every minute), and tympanic temperature and thermal sensation and comfort were recorded five minutely.</p><p><strong>Results: </strong>There were minor differences in thermal sensation. For the primary outcome there was no significant difference between blanket methods (core: foil 36.98 ± 0.08 °C vs. self-warming 36.95 ± 0.10 °C, P > 0.05).</p><p><strong>Conclusion: </strong>The combination of cotton and self-warming blankets did not exhibit superiority compared to cotton and foil blankets in out-of-hospital simulation. Future research should explore alternative warming methodologies to optimise normothermia maintenance.</p>","PeriodicalId":55979,"journal":{"name":"Australasian Emergency Care","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2024-12-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142856911","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}

引用次数: 0

First Nations women's experiences of out-of-hospital childbirth: Insights for enhancing paramedic practice - A scoping review. 第一民族妇女院外分娩的经验：加强护理实践的见解-范围审查。

IF 2.1 4区医学

Australasian Emergency Care Pub Date : 2024-12-09 DOI: 10.1016/j.auec.2024.11.002

Arwen Wilkinson, Haley Findlay, Jayne Lawrence, Linda Deravin

{"title":"First Nations women's experiences of out-of-hospital childbirth: Insights for enhancing paramedic practice - A scoping review.","authors":"Arwen Wilkinson, Haley Findlay, Jayne Lawrence, Linda Deravin","doi":"10.1016/j.auec.2024.11.002","DOIUrl":"https://doi.org/10.1016/j.auec.2024.11.002","url":null,"abstract":"<p><strong>Background: </strong>Birthing on Country principles in Australia have seen a revitalisation in midwifery care over the last decade with it being seen as a metaphor for the best start to life for First Nations peoples. This scoping review aimed to explore the extent of evidence of Australian First Nations women's experiences of out-of-hospital childbirth and the alignment with Birthing on Country principles to inform paramedic practice.</p><p><strong>Methods: </strong>Four databases were searched including MEDLINE, CINAHL, EBSCOhost Health and Scopus utilising the Joanna Briggs Institute (JBI) methodology for Scoping Reviews. Inclusion and exclusion criteria were identified. All articles were reviewed in a two stage process.</p><p><strong>Results: </strong>Fifty two papers were yielded with 6 meeting the inclusion criteria. Using reflective thematic analysis four key themes were generated; Birthing on Country and identity, inequitable access to healthcare, trusting relationships and medicalisation of birth.</p><p><strong>Conclusions: </strong>There is a large gap in the literature surrounding delivery of care by paramedics to First Nations women birthing out-of-hospital in Australia. This review proposes supports and actions required to implement Birthing on Country principles into paramedicine. Further, standard maternity care has been found to be insufficient for First Nations women due to a lack of culturally safe care.</p>","PeriodicalId":55979,"journal":{"name":"Australasian Emergency Care","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2024-12-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142808741","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}

引用次数: 0

The experiences of trans (binary and non-binary) people accessing emergency department care in Australia: A grounded theory study. 跨性别（二元和非二元）人在澳大利亚急诊科就诊的经历：一项有根据的理论研究。

IF 2.1 4区医学

Australasian Emergency Care Pub Date : 2024-12-04 DOI: 10.1016/j.auec.2024.11.001

Jake A Muller, Elizabeth M Forster, Katina Corones-Watkins, Belinda Chaplin

{"title":"The experiences of trans (binary and non-binary) people accessing emergency department care in Australia: A grounded theory study.","authors":"Jake A Muller, Elizabeth M Forster, Katina Corones-Watkins, Belinda Chaplin","doi":"10.1016/j.auec.2024.11.001","DOIUrl":"https://doi.org/10.1016/j.auec.2024.11.001","url":null,"abstract":"<p><strong>Background: </strong>This study aimed to explore the experiences of trans (binary and non-binary) people accessing emergency department care in Australia.</p><p><strong>Method: </strong>This qualitative descriptive study utilised a grounded theory approach. Seven people who identified as trans were recruited through social media and trans support groups. Individuals participated in an in-depth narrative interview. Interview transcriptions were analysed using a constant comparative approach.</p><p><strong>Results: </strong>Following thematic analysis, four key themes were identified: 1. identity; 2. clinical care; 3. communication; and 4. perceptions of health professional education, beliefs and experience in caring for trans people.</p><p><strong>Conclusion: </strong>This study is the first in Australia to explore the experiences of trans people utilising emergency department services. The findings of this study are similar to international data whereby the delivery of gender affirming care in emergency departments is inconsistent, health professionals are perceived as poorly educated and gender identity is inadequately recognised.</p>","PeriodicalId":55979,"journal":{"name":"Australasian Emergency Care","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2024-12-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142781961","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}

引用次数: 0

Gender bias in text-to-image generative artificial intelligence depiction of Australian paramedics and first responders. 澳大利亚护理人员和急救人员的文本到图像生成人工智能描述中的性别偏见。

IF 2.1 4区医学

Australasian Emergency Care Pub Date : 2024-12-02 DOI: 10.1016/j.auec.2024.11.003

Geoffrey Currie, Johnathan Hewis, Phillip Ebbs

{"title":"Gender bias in text-to-image generative artificial intelligence depiction of Australian paramedics and first responders.","authors":"Geoffrey Currie, Johnathan Hewis, Phillip Ebbs","doi":"10.1016/j.auec.2024.11.003","DOIUrl":"https://doi.org/10.1016/j.auec.2024.11.003","url":null,"abstract":"<p><strong>Introduction: </strong>In Australia, almost 50 % of paramedics are female yet they remain under-represented in stereotypical depictions of the profession. The potentially transformative value of generative artificial intelligence (AI) may be limited by stereotypical errors, misrepresentations and bias. Increasing use of text-to-image generative AI, like DALL-E 3, could reinforce gender and ethnicity biases and, therefore, is important to objectively evaluate.</p><p><strong>Method: </strong>In March 2024, DALL-E 3 was utilised via GPT-4 to generate a series of individual and group images of Australian paramedics, ambulance officers, police officers and firefighters. In total, 82 images were produced including 60 individual-character images, and 22 multiple-character group images. All 326 depicted characters were independently analysed by three reviewers for apparent gender, age, skin tone and ethnicity.</p><p><strong>Results: </strong>Among first responders, 90.8 % (N = 296) were depicted as male, 90.5 % (N = 295) as Caucasian, 95.7 % (N = 312) as a light skin tone, and 94.8 % (N = 309) as under 55 years of age. For paramedics and police the gender distribution was a statistically significant variation from that of actual Australian workforce data (all p < 0.001). Among the images of individual paramedics and ambulance officers (N = 32), DALL-E 3 depicted 100 % as male, 100 % as Caucasian and 100 % with light skin tone.</p><p><strong>Conclusion: </strong>Gender and ethnicity bias is a significant limitation for text-to-image generative AI using DALL-E 3 among Australian first responders. Generated images have a disproportionately high misrepresentation of males, Caucasians and light skin tones that are not representative of the diversity of paramedics in Australia today.</p>","PeriodicalId":55979,"journal":{"name":"Australasian Emergency Care","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2024-12-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142774990","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}

引用次数: 0

The Clinical Frailty Scale offers little utility as part of a prediction model for community-dwelling older fallers at risk of re-presenting to the emergency department. 临床虚弱量表作为预测模型的一部分，对社区居住的老年老年人再次出现在急诊科的风险没有多大用处。

IF 2.1 4区医学

Australasian Emergency Care Pub Date : 2024-12-02 DOI: 10.1016/j.auec.2024.11.004

Loren Barton, Mark Nelson, Kirsten Strudwick, Corey Scholes

{"title":"The Clinical Frailty Scale offers little utility as part of a prediction model for community-dwelling older fallers at risk of re-presenting to the emergency department.","authors":"Loren Barton, Mark Nelson, Kirsten Strudwick, Corey Scholes","doi":"10.1016/j.auec.2024.11.004","DOIUrl":"https://doi.org/10.1016/j.auec.2024.11.004","url":null,"abstract":"<p><strong>Background: </strong>There is no published literature on the predictive ability of the Clinical Frailty Scale (CFS) for falls risk specific to the Emergency Department (ED) population. This study aims to develop a prognostic model to determine the predictive ability of the CFS for ED falls' re-presentation in community-dwelling older people.</p><p><strong>Methods: </strong>A retrospective observational cohort study was completed from July 2019 to July 2022 on community dwelling people aged 75 years and over who presented to the ED with an extrinsic fall and had a CFS score recorded. The primary outcome was fall-related re-presentation to ED; the secondary outcome was mortality. A flexible parametric survival model was applied with time to falls re-presentation, and post-estimation, used to predict the probability of another fall re-presentation within 6 months. Calibration was assessed and a decision support curve generated.</p><p><strong>Results: </strong>The model demonstrated reasonable calibration-in-the-large (Slope = 0.999) and fit between CFS and probability of fall re-presentation. The CFS model displayed negligible discriminant ability (C-statistic = 0.534) for identifying older people at risk of falls-related ED re-presentations within 6 months of index presentation.</p><p><strong>Conclusions: </strong>The CFS cannot be used to prognosticate an individual's risk of ED re-presentation within 6 months of an index extrinsic fall.</p>","PeriodicalId":55979,"journal":{"name":"Australasian Emergency Care","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2024-12-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142774992","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}

引用次数: 0

'It's only a matter of time' - Lessons learnt and recommendations from COVID-19 to inform emergency nursing for future pandemics: An integrated literature review. 这只是时间问题"--从 COVID-19 中汲取的经验教训和建议，为未来大流行病的应急护理提供参考：综合文献综述。

IF 2.1 4区医学

Australasian Emergency Care Pub Date : 2024-11-26 DOI: 10.1016/j.auec.2024.10.004

Megan R Simic, Joanne E Porter, Blake Peck, Christopher Mesagno

{"title":"'It's only a matter of time' - Lessons learnt and recommendations from COVID-19 to inform emergency nursing for future pandemics: An integrated literature review.","authors":"Megan R Simic, Joanne E Porter, Blake Peck, Christopher Mesagno","doi":"10.1016/j.auec.2024.10.004","DOIUrl":"https://doi.org/10.1016/j.auec.2024.10.004","url":null,"abstract":"<p><strong>Purpose: </strong>In the recovery phase of COVID-19 disaster management, Emergency Department (ED) nurses are attempting to return to normal workforce operations, despite significant impacts on personal and professional lives. This review aims to examine and synthesise current literature for the learnings and recommendations from the lived experiences of ED nurses during the COVID-19 pandemic.</p><p><strong>Procedures: </strong>Electronic databases CINAHL Complete, Web of Science, Scopus (Elsevier) and PubMed were utilised using a 5-year timeframe that aligned with COVID-19 in Australia. Final date of accepted papers was 28th February 2024. A JBI Mixed Methods Convergent Integrated Approach was used.</p><p><strong>Findings: </strong>A total of 15 studies were included in the final review, representing seven countries of origin and included 649 ED nurses. Seven major themes related to learnings and recommendations were generated from data synthesis including (1) professional identity, (2) wellbeing support, (3) camaraderie, (4) effective communication, (5) working conditions and professional boundaries, (6) education and training, and (7) external support.</p><p><strong>Conclusion: </strong>With the likelihood of future epidemic and pandemic events globally, it is vital to explore and collate evidence on the learnings and recommendations from ED during the COVID-19 pandemic to continue to build a sustainable, resilient, and supported workforce.</p>","PeriodicalId":55979,"journal":{"name":"Australasian Emergency Care","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2024-11-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142741534","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}

引用次数: 0

Managing non-traumatic musculoskeletal conditions presenting to emergency departments: Do patient profiles vary between a physiotherapy-led 'Diversion' pathway and routine care? 处理急诊科就诊的非创伤性肌肉骨骼疾病：以物理治疗为主导的 "分流 "路径和常规护理之间的患者情况是否存在差异？

IF 2.1 4区医学

Australasian Emergency Care Pub Date : 2024-11-21 DOI: 10.1016/j.auec.2024.08.001

Robert Waller , Mathew McLaughlin , Sarah King , Jessica Lai , Reuben Holt , Pippa Flanagan , Ivan Lin , Karen Richards , Piers Truter

{"title":"Managing non-traumatic musculoskeletal conditions presenting to emergency departments: Do patient profiles vary between a physiotherapy-led 'Diversion' pathway and routine care?","authors":"Robert Waller , Mathew McLaughlin , Sarah King , Jessica Lai , Reuben Holt , Pippa Flanagan , Ivan Lin , Karen Richards , Piers Truter","doi":"10.1016/j.auec.2024.08.001","DOIUrl":"10.1016/j.auec.2024.08.001","url":null,"abstract":"<div><h3>Background</h3><div>Low urgency, non-traumatic musculoskeletal presentations are common in emergency departments. Although care is safe, it is expensive, and low priority. Pathways diverting these patients from emergency departments to physiotherapy care may improve hospital outcomes. Identifying the suitable patient profile for these pathways is important.</div></div><div><h3>Methods</h3><div>A mixed prospective and retrospective, descriptive, cross-sectional study investigated adults aged 18–65 presenting to two emergency departments. Suitable patients were diverted directly to a physiotherapy outpatient diversion pathway. Three groups were compared, diverted patients, patients suitable but not diverted, and patients unsuitable for diversion.</div></div><div><h3>Results</h3><div>Diverted patients were aged 43 (median, inter-quartile range 34–53.5) years, triaged as low-urgency, self-referred, self-transported, and had few concerning features of serious pathology. Diverted patients had a 113-minute shorter emergency stay at 79 (median) minutes compared to suitable but not diverted patients, and both groups had a similar profile. Most (93.4 %) diverted patients were discharged within 4- hours, compared to suitable but not diverted patients (72.9 %). Key factors preventing diversion were concern for serious pathology or diversion capacity restraints.</div></div><div><h3>Conclusion</h3><div>A group of patients with non-traumatic musculoskeletal conditions who can be safely diverted to physiotherapy outpatients are described. Diversion impact was high quality care and improved emergency department metrics.</div></div>","PeriodicalId":55979,"journal":{"name":"Australasian Emergency Care","volume":"28 1","pages":"Pages 24-30"},"PeriodicalIF":2.1,"publicationDate":"2024-11-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142689724","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}

引用次数: 0

Barriers and enablers to nurse-initiated care in emergency departments: An embedded mixed methods survey study 急诊科护士主动护理的障碍和促进因素：一项嵌入式混合方法调查研究。

IF 2.1 4区医学

Australasian Emergency Care Pub Date : 2024-11-04 DOI: 10.1016/j.auec.2024.10.003

Julie Gawthorne , Kate Curtis , Margaret Fry , Andrea Mccloughen , Judith Fethney

{"title":"Barriers and enablers to nurse-initiated care in emergency departments: An embedded mixed methods survey study","authors":"Julie Gawthorne , Kate Curtis , Margaret Fry , Andrea Mccloughen , Judith Fethney","doi":"10.1016/j.auec.2024.10.003","DOIUrl":"10.1016/j.auec.2024.10.003","url":null,"abstract":"<div><h3>Background</h3><div>Increased demand, wait times and length of stay have seen many emergency departments implement nurse-initiated protocols In New South Wales, Australia, 74 nurse-initiated protocols have been developed for implementation. The aim of this paper is to identify the barriers and enablers to nurses’ use of these protocols to inform and maximise future implementation.</div></div><div><h3>Methods</h3><div>Data were collected via surveys informed by the theoretical domains' framework and the Practice Environment Scale of the Nursing Work Index (PES-NWI). Descriptive statistics summarised quantitative data and content analysis was performed on qualitative data. Results were integrated and classified as barriers or enablers to nurses’ use of protocols.</div></div><div><h3>Results</h3><div>The nurses’ response rate was 82 % (n = 76) and doctors 72 % (n = 34) Six categories were generated; one barrier (lack of resources), three enablers (patient and organisational benefits, nurses’ motivation, nurses’ desire to develop their practice) and two were both a barrier and enabler ( nurse confidence and the work environment).</div></div><div><h3>Conclusion</h3><div>Emergency nurses are highly motivated to use nurse-initiated protocols to positively impact patient outcomes. However, a lack of resources, time, access to education and confidence are barriers to use that need to be addressed when designing implementation.</div></div>","PeriodicalId":55979,"journal":{"name":"Australasian Emergency Care","volume":"28 1","pages":"Pages 12-23"},"PeriodicalIF":2.1,"publicationDate":"2024-11-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142585196","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}

引用次数: 0