Australasian Emergency Care最新文献

{"title":"Determinants of work stress among emergency department nurses in Sleman, Yogyakarta, Indonesia.","authors":"Happy Indah Kusumawati, Suis Galischawati, Sri Warsini, Bayu Fandhi Achmad, Nurul Aida Fatma, Nazhifah Salsabila Tiyani, Dewi Nirmalasari, Eko Budi Santoso","doi":"10.1016/j.auec.2024.06.002","DOIUrl":"https://doi.org/10.1016/j.auec.2024.06.002","url":null,"abstract":"<p><strong>Background: </strong>The nursing field is the fourth most stressful occupation in the health sector. Emergency department nurses often face crises and unpredictable situations that can negatively affect their quality of life and the quality of care. This study aimed to investigate the determinants of work stress among ED nurses in Sleman, Yogyakarta, Indonesia.</p><p><strong>Methods: </strong>A descriptive cross-sectional study was conducted. Participants (n = 122) were emergency nurses recruited through convenience sampling from four EDs in Sleman District, Yogyakarta, Indonesia. Data were gathered using an online self-administered survey consisting of the workload, self-efficacy, and work stress questionnaires. Hierarchical linear regression analysis with the entry method was used to examine the main determinants of work stress.</p><p><strong>Results: </strong>The average work stress (38.29 ± 8), workload (30.83 ± 9.21), and self-efficacy (32.47 ± 3.61) scores were at a moderate level. Hierarchical linear regression showed that workplace, being a head nurse, and workload were the main determinants that contributed to 25.4 % of work stress among ED nurses.</p><p><strong>Conclusions: </strong>The study results confirm that having a high workload, working in a private hospital, and being a head nurse are the main determinants of work stress among ED nurses in Sleman, Indonesia.</p>","PeriodicalId":55979,"journal":{"name":"Australasian Emergency Care","volume":null,"pages":null},"PeriodicalIF":2.1,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141494409","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 experiences of patients not conveyed after evaluation by emergency medical services in Southwest Finland - A qualitative survey study.","authors":"Anne Kuoppala, Eetu Skaffari, Timo Iirola, Hilla Nordquist","doi":"10.1016/j.auec.2024.05.001","DOIUrl":"https://doi.org/10.1016/j.auec.2024.05.001","url":null,"abstract":"<p><strong>Background: </strong>The amount of non-critical Emergency Medical Services missions has been increasing. After examination and treatment, paramedics can decide, based on guidelines, not to convey the patient to a healthcare facility. This study aimed to investigate patients' experiences in non-conveyance situations in Southwest Finland. Our research questions were: 1) Which patient concerns were not addressed? 2) What key actions improved patient comfort? and 3) What possible enhancements could make the patient experience more positive?</p><p><strong>Methods: </strong>This was a qualitative survey study. In March 2023, all the patients who met the inclusion criteria (N = 1017) received a survey via mail. The data from three open-ended questions were analyzed using inductive content analysis.</p><p><strong>Results: </strong>The response rate was 22.2 % (n = 226). The unaddressed patient concerns were related to inadequate immediate care and guidance and non-clinical factors causing concern. Key actions for improved patient comfort were related to immediate treatment and guidance, as well as non-clinical factors that impact the patient experience. More thorough treatment processes and more attentive encounters would have enhanced the patient experience.</p><p><strong>Conclusions: </strong>Predominantly, patients reported having received excellent services. Utilizing paramedics' soft skills and keeping the patient as the central focus is key to improving the non-conveyance process and experience.</p>","PeriodicalId":55979,"journal":{"name":"Australasian Emergency Care","volume":null,"pages":null},"PeriodicalIF":1.8,"publicationDate":"2024-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141094750","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 paramedic personality profiles and the relationship with burnout and employment retention: A scoping review.","authors":"Chloe Betts, Alannah Stoneley, Tara Picker","doi":"10.1016/j.auec.2024.04.003","DOIUrl":"https://doi.org/10.1016/j.auec.2024.04.003","url":null,"abstract":"<p><strong>Background: </strong>Paramedics play a pivotal role in delivering emergency medical care, contributing to excellence in the prehospital environment and ensuring a seamless continuum of healthcare. Achieving this objective is subject to various factors. This review aims to explore, the relationship between paramedic personality profiles and key factors including stress, burnout and employment retention or attrition.</p><p><strong>Methods: </strong>The JBI approach was used to perform a scoping review. Key words including paramedic* , ambulance* , personalit* , retention OR attrition and burnout OR stress were inserted into the search engines OVID, CINAHL Plus, Scopus, Web of Science Core Collection, Psychology ProQuest, and Nursing ProQuest. Titles and abstracts of 226 results were screened and inclusion and exclusion criteria applied. Full texts of the remaining 18 results were screened to inform the results.</p><p><strong>Results: </strong>Three themes emerged relevant to the objective including the correlation of neuroticism with stress and burnout, personality types and mental illness with the ability to cope during stressful situations and finally resilience and burnout with the intention to quit.</p><p><strong>Conclusion: </strong>Further research should be completed into specific personality characteristics, including neuroticism, perfectionism, and excitability to facilitate the development of strategies aimed at improving the health and wellbeing of paramedics and EMT workers internationally.</p>","PeriodicalId":55979,"journal":{"name":"Australasian Emergency Care","volume":null,"pages":null},"PeriodicalIF":1.8,"publicationDate":"2024-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141079624","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":"Vital signs monitoring in Australasian emergency departments: Development of a consensus statement from ACEM and CENA","authors":"","doi":"10.1016/j.auec.2024.04.001","DOIUrl":"10.1016/j.auec.2024.04.001","url":null,"abstract":"<div><h3>Background</h3><p>Emergency Department (ED) care is provided for a diverse range of patients, clinical acuity and conditions. This diversity often calls for different vital signs monitoring requirements. Requirements often change depending on the circumstances that patients experience during episodes of ED care.</p></div><div><h3>Aim</h3><p>To describe expert consensus on vital signs monitoring during ED care in the Australasian setting to inform the content of a joint Australasian College for Emergency Medicine (ACEM) and College of Emergency Nursing Australasia (CENA) position statement on vital signs monitoring in the ED.</p></div><div><h3>Method</h3><p>A 4-hour online nominal group technique workshop with follow up surveys.</p></div><div><h3>Results</h3><p>Twelve expert ED nurses and doctors from adult, paediatric and mixed metropolitan and regional ED and research facilities spanning four Australian states participated in the workshop and follow up surveys. Consensus building generated 14 statements about vital signs monitoring in ED. Good consensus was reached on whether vital signs should be assessed for 15 of 19 circumstances that patients may experience.</p></div><div><h3>Conclusion</h3><p>This study informed the creation of a joint position statement on vital signs monitoring in the Australasian ED setting, endorsed by CENA and ACEM. Empirical evidence is needed for optimal, safe and achievable policy on this fundamental practice.</p></div>","PeriodicalId":55979,"journal":{"name":"Australasian Emergency Care","volume":null,"pages":null},"PeriodicalIF":2.1,"publicationDate":"2024-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2588994X24000228/pdfft?md5=67da3fa112be55f99e1df1c1253cea70&pid=1-s2.0-S2588994X24000228-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141077294","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 significance of paramedic communication during women’s birth experiences: A scoping review","authors":"","doi":"10.1016/j.auec.2024.04.002","DOIUrl":"10.1016/j.auec.2024.04.002","url":null,"abstract":"<div><h3>Background</h3><p>Internationally, over one-third of women experience birth trauma, leading to adverse mental health outcomes. Poor communication with healthcare professionals is a primary contributing factor. Paramedics attend various clinical presentations, including childbirth, yet their potential impact on women's birth experiences has been largely overlooked.</p></div><div><h3>Methods</h3><p>A systematic literature search was conducted following the Joanna Briggs Institute methodological framework. The search identified 1015 potentially suitable articles, and 5 articles met the inclusion criteria. Data was analysed using reflexive thematic analysis from a feminist standpoint.</p></div><div><h3>Results</h3><p>Three themes were generated: 1. <em>First Impressions Count:</em> paramedic demeanour impacted the woman's sense of safety and perception of paramedic clinical competence. 2. <em>Choice as a Pathway to Control:</em> when paramedics involved women in decision-making, it led to empowerment, while non-involvement led to women becoming passive participants. 3. <em>Exposed, Violated and Disempowered:</em> some paramedics disrespected and abused women, treating them solely as objects for the purpose of producing a baby.</p></div><div><h3>Conclusions</h3><p>This review highlights the influence of paramedic communication on women's birth experiences. While some paramedics communicated respectfully, other paramedics were the perpetrators of Obstetric Violence. Future research should inform paramedic education and improve outcomes for birthing women.</p></div>","PeriodicalId":55979,"journal":{"name":"Australasian Emergency Care","volume":null,"pages":null},"PeriodicalIF":2.1,"publicationDate":"2024-05-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2588994X2400023X/pdfft?md5=db073b87497e7113f51febc56284a211&pid=1-s2.0-S2588994X2400023X-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140909617","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":"Designing a standardised emergency nurse career pathway for use across rural, regional and metropolitan New South Wales, Australia: A consensus process","authors":"","doi":"10.1016/j.auec.2024.03.002","DOIUrl":"10.1016/j.auec.2024.03.002","url":null,"abstract":"<div><h3>Background</h3><p>Emergency nurses are the first clinicians to see patients in the ED; their practice is fundamental to patient safety. To reduce clinical variation and increase the safety and quality of emergency nursing care, we developed a standardised consensus-based emergency nurse career pathway for use across Australian rural, regional, and metropolitan New South Wales (NSW) emergency departments.</p></div><div><h3>Methods</h3><p>An analysis of career pathways from six health services, the College for Emergency Nursing Australasia, and NSW Ministry of Health was conducted. Using a consensus process, a 15-member expert panel developed the pathway and determined the education needs for pathway progression over six face-to-face meetings from May to August 2023.</p></div><div><h3>Results</h3><p>An eight-step pathway outlining nurse progression through models of care related to different ED clinical areas with a minimum 172 h protected face-to-face and 8 h online education is required to progress from novice to expert. Progression corresponds with increasing levels of complexity, decision making and clinical skills, aligned with Benner’s novice to expert theory.</p></div><div><h3>Conclusion</h3><p>A standardised career pathway with minimum 180 h would enable a consistent approach to emergency nursing training and enable nurses to work to their full scope of practice. This will facilitate transferability of emergency nursing skills across jurisdictions.</p></div>","PeriodicalId":55979,"journal":{"name":"Australasian Emergency Care","volume":null,"pages":null},"PeriodicalIF":2.1,"publicationDate":"2024-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2588994X24000216/pdfft?md5=e0c8d48c3b9fe6c4a23c2c615672ad6f&pid=1-s2.0-S2588994X24000216-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140308013","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":"Exploring clinicians' insertion experience with a new peripheral intravenous catheter in the emergency department","authors":"","doi":"10.1016/j.auec.2024.03.001","DOIUrl":"10.1016/j.auec.2024.03.001","url":null,"abstract":"<div><h3>Background</h3><p>Hospitals frequently introduce new medical devices. However, the process of clinicians adapting to these new vascular access devices has not been well explored. The study aims to explore clinicians’ experience with the insertion of a new guidewire peripheral intravenous catheter (PIVC) introduced in the emergency department (ED) setting.</p></div><div><h3>Methods</h3><p>The study was conducted at two EDs in Queensland, Australia, utilising a qualitative explorative approach. Interviews were conducted with guidewire PIVC inserters, including ED doctors and nurses, and field notes were recorded by research nurses during insertions. Data analysis was performed using inductive content analysis, from which themes emerged.</p></div><div><h3>Results</h3><p>The study compiled interviews from 10 participants and field notes from 191 observation episodes. Five key themes emerged, including <em>diverse experience, barriers related to the learning process, factors influencing insertion success, and recommendations to enhance clinicians’ acceptance</em>. These themes suggest that the key to successful adoption by clinicians lies in designing user-friendly devices that align with familiar insertion techniques, facilitating a smooth transfer of learning.</p></div><div><h3>Conclusion</h3><p>Clinician adaptation to new devices is vital for optimal patient care. Emergency nurses and doctors prefer simplicity, safety, and familiarity when it comes to new devices. Providing comprehensive device training with diverse training resources, hands-on sessions, and continuous expert support, is likely to enhance clinician acceptance and the successful adoption of new devices in ED settings.</p></div>","PeriodicalId":55979,"journal":{"name":"Australasian Emergency Care","volume":null,"pages":null},"PeriodicalIF":2.1,"publicationDate":"2024-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2588994X24000204/pdfft?md5=cde8ee19968cdda69f5abf2c22331e64&pid=1-s2.0-S2588994X24000204-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140137461","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":"Characteristics and outcomes of emergency department presentations brought in by police with and without an emergency examination authority: A state-wide cohort study","authors":"","doi":"10.1016/j.auec.2024.02.001","DOIUrl":"10.1016/j.auec.2024.02.001","url":null,"abstract":"<div><h3>Background</h3><p>The aim of this study was to describe and compare the demographic characteristics, clinical characteristics and patient and health service outcomes of emergency department (ED) presentations brought in by police with and without an emergency examination authority.</p></div><div><h3>Methods</h3><p>A retrospective cohort study of adult (≥ 18 years old) presentations brought in by police to EDs in Queensland, Australia from 01 January 2018 to 31 December 2020. Routinely collected ED data were used to describe and compare the demographic characteristics, clinical characteristics, and outcomes of people brought in by police with and without an emergency examination authority.</p></div><div><h3>Results</h3><p>A total of 42 502 adult ED presentations were brought in by police over the three-year period, of which 22 981 (44.7%) had an emergency examination authority. Compared with presentations brought in by police without an emergency examination authority, those brought in by police with an emergency examination authority had a higher proportion of presentations for mental health problems, were from major cities, and were allocated more urgent Australasian Triage Scale categories. Presentations brought in by police with an emergency examination authority were less likely to be seen within their Australasian Triage Scale timeframe and experienced a longer length of stay than those brought in by police without an emergency examination authority whether admitted (217 mins vs. 186 mins, p &lt; 0.001) or discharged (212 mins vs. 97 mins, p &lt; 0.001).</p></div><div><h3>Conclusions</h3><p>The characteristics and outcomes of people brought in by police with emergency examination authorities differed to those brought in by police without emergency examination authorities. Further research is required to enhance understanding of this relatively unexplored group of people and foster interagency collaborations.</p></div>","PeriodicalId":55979,"journal":{"name":"Australasian Emergency Care","volume":null,"pages":null},"PeriodicalIF":2.1,"publicationDate":"2024-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2588994X24000198/pdfft?md5=39ae159359cc04058606980029e0be31&pid=1-s2.0-S2588994X24000198-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140095219","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":"Providing end of life care in the emergency department: A hermeneutic phenomenological study","authors":"","doi":"10.1016/j.auec.2024.01.002","DOIUrl":"10.1016/j.auec.2024.01.002","url":null,"abstract":"<div><h3>Background</h3><p>Registered nurses report the experience of delivering end of life care in emergency departments as challenging. The study aim was to understand what it is like to be a registered nurse providing end of life care to an older person in the emergency department.</p></div><div><h3>Methods</h3><p>A hermeneutic phenomenological study was conducted in 2021, using semi-structured interviews with seven registered nurses across two hospital emergency departments in Queensland, Australia. Thematic analysis of participants’ narratives was undertaken.</p></div><div><h3>Findings</h3><p>Seven registered nurses were interviewed; six of whom were women. Participant’s experience working in the emergency department setting ranged from 2.5–20 years. Two themes were developed through analysis: (i) Presenting the patient as a dying person; and (ii) Mentalising death in the context of the emergency department.</p></div><div><h3>Conclusions</h3><p>Nurses providing end of life care in the emergency department draw upon their personal and aesthetic knowing to present the dying patient as a person. The way death is mentalised suggests the need to develop empirical knowing about ageing and supportive medical care and ethical knowing to assist with the transition from resuscitation to end of life care. Shared clinical reflection on death in the emergency department, facilitated by experts in ageing and end of life care is recommended.</p></div>","PeriodicalId":55979,"journal":{"name":"Australasian Emergency Care","volume":null,"pages":null},"PeriodicalIF":2.1,"publicationDate":"2024-02-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2588994X24000022/pdfft?md5=232c2a40be81379115e2c51c5de6b8b0&pid=1-s2.0-S2588994X24000022-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139663843","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 experiences of trans (binary and non-binary) patients accessing care in the emergency department: An integrative review","authors":"","doi":"10.1016/j.auec.2024.01.003","DOIUrl":"10.1016/j.auec.2024.01.003","url":null,"abstract":"<div><p>Accessing care in the Emergency Department is often fraught with stress and heightened emotions due to illness or injury, and the complexity of navigating an often busy and overwhelming healthcare setting. For people who identify as trans (binary and non-binary), accessing Emergency Department care is often associated with additional stress or avoided due to fears of discrimination, or previous negative experiences (1). The aim of this integrative review was to identify and review the literature relating to the experiences of trans (binary and non-binary) people accessing Emergency Department care, to guide practice and future research. A structured search process was used to identify 11 articles published between January 2013 and November 2023. These articles were appraised using the mixed methods appraisal tool (MMAT) (2) and included in this review. Utilising the methodology outlined by Whittemore &amp; Knafl (3), a constant comparison analytic approach identified five key themes; <em>1. emergency department context; 2. interactions with staff and language; 3. health professional knowledge; 4. advocacy;</em> and <em>5. disclosing trans status.</em> This review identified a perceived lack of competence for healthcare providers to deliver gender affirming healthcare in the Emergency Department due to perceptions of inadequate healthcare provider knowledge, and structural barriers founded on cisgender processes.</p></div>","PeriodicalId":55979,"journal":{"name":"Australasian Emergency Care","volume":null,"pages":null},"PeriodicalIF":2.1,"publicationDate":"2024-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2588994X24000046/pdfft?md5=24bd4e5fc294d367baec4c210dd38ae4&pid=1-s2.0-S2588994X24000046-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139656402","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}