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Purpose: To understand how emergency nurses develop resilience in the context of workplace violence. Design: This study employed grounded theory methodology. Thirty nurses from three hospital emergency departments in Taiwan were interviewed between August and December 2018. Methods: Semistructured interviews were used to collect data. Interviews were audio‐recorded and transcribed verbatim. Findings: The process through which emergency nurses who had experienced workplace violence developed resilience took place in three stages: the release of emotions after the assault; the interpretation of conflicting thoughts and actions; and the establishment of strategies to cope with workplace violence in the future. The core theme was the motivating role of professional commitment to emergency patient care. Conclusions: The results of this study can inform the development of support systems to enhance the resilience of nurses experiencing workplace violence by alerting healthcare administrators and governing institutions to their needs. Clinical Relevance: Emergency nurses viewed professional growth and professional commitment as an invisible motivator in the development of resilience following an encounter with workplace violence. [ABSTRACT FROM AUTHOR]

Aims and objectives: To examine underlying factor structure of the Critical Care Family Needs Inventory—Emergency Department across three countries to identify similarities and differences. Background: Understanding family needs assists nurses to provide family‐centred care to deliver optimal outcomes for critically ill patients and their families in Emergency Departments. Design: Retrospective secondary analyses of data collected in three cross‐sectional surveys. Methods: Convenience samples involved recruitment of family members accompanying a critically ill relative into four Emergency Departments in Australia (2), South Africa (1) and Taiwan (1). Item‐matched raw data from 374 responses to 40 items from the surveys were collated and analysed using confirmatory factor analysis methods. Reporting adhered to an adapted STROBE checklist. Results: The factor structure of the 40‐item Critical Care Family Needs Inventory—Emergency Department differed between countries. Analyses of the Australian data revealed a four‐factor solution comprised of 18 items across four categories of family need (support, communication, participation and comfort); the Taiwanese data also demonstrated a four‐factor solution comprised of 13 items (support, communication, participation and comfort); alternatively, the South African data revealed a two‐factor solution comprised of nine items (communication and participation). Fifteen items did not match across the countries. However, loading for four items common across all three countries was related to family participation (3) and communication (1). Conclusions: The findings suggest family members from different countries responded to Critical Care Family Needs Inventory—Emergency Department items in different ways. Consistent with concepts of family‐centred care, the study identified participation and communication needs that were common across the countries. The outcomes illustrate the challenge of providing appropriate care for family members during critical illness of a relative in the ED. Relevance to clinical practice: Family perceptions of important needs during critical illness in the Emergency Department differ across countries; hence, the Critical Care Family Needs Inventory—Emergency Department has limited utility. Participation and communication needs emerged as common family needs. [ABSTRACT FROM AUTHOR]

Triage classifies and prioritizes patients’ care based on the acuity of the illness in emergency departments (EDs). In Taiwan, the five-level Taiwan Triage and Acuity Scale (TTAS) computerized system was implemented nationally in 2010. The purpose of this study was to understand which factors affect decision-making practices of triage nurses in the light of the implementation of the new TTAS tool and computerized system. The qualitative data were collected by in-depth interviews. Data saturation was reached with 16 participants. Content analysis was used. The results demonstrated that the factors affecting nurses’ decision making in the light of the newly implemented computerized system sit within three main categories: external environmental, patients’ health status, and nurses’ experiences. This study suggests ensuring the patient’s privacy while attending the triage desk, improving the critical thinking of triage nurses, and strengthening the public’s understanding of the ED visits. These will make ED triage more efficient. [ABSTRACT FROM AUTHOR]

Background Workplace violence (WPV) is a serious problem in health care in Taiwan, as it is worldwide. Among all nursing staff, emergency department (ED) nurses are at the highest risk of WPV; yet, little attention has been paid to nurses as WPV victims. Purpose The purpose of the study was to understand ED nurses' WPV experiences and perspectives. Methods An interpretive qualitative phenomenographic design was used to answer the following research question: what are the qualitatively different ways in which nurses in Taiwan experience WPV in the ED? Thirty ED nurses who identified as experienced with WPV were interviewed, and phenomenographic analysis was used to assess the data. Findings Four categories of description emerged. WPV was seen as a continuing nightmare, a part of daily life, and a direct threat, and it had a negative impact on nurses' passion for emergency care. WPV adversely affected nurses on physical, psychological, social, personal, and professional levels. Conclusion The findings of this study have practical implications for in-service WPV training programs and may be used to inform potential changes to policy and legislation designed to establish a safer ED environment for staff. [ABSTRACT FROM AUTHOR]

Introduction Family members’ experience a range of physiological, psychological and emotional impacts when accompanying a critically ill relative in the emergency department. Family needs are influenced by their culture and the context of care, and accurate clinician understanding of these needs is essential for patient- and family-centered care delivery. The aim of this study was to describe the needs of Taiwanese family members accompanying critically ill patients in the emergency department while waiting for an inpatient bed and compare these to the perceptions of emergency nurses. Methods A prospective cross-sectional survey was conducted in a large medical center in Taiwan. Data were collected from 150 family members and 150 emergency nurses who completed a Chinese version of the Critical Care Family Needs Inventory. Results Family members ranked needs related to ‘communication with family members,’ as most important, followed by ‘family member participation in emergency department care’, ‘family member support’ and ‘organizational comfort’; rankings were similar to those of emergency nurses. Compared to nurses, family members reported higher scores for the importance of needs related to ‘communication with family members’ and ‘family members’ participation in emergency department care’. Conclusions Family members place greater importance than emergency nurses on the need for effective communication. [ABSTRACT FROM AUTHOR]

Published research on discharge planning is written from the perspective of hospital wards and community services. Limited research focuses on discharge planning in the emergency department (ED). The objective of this study was to identify ED nurses’ perceptions of factors influencing the implementation of discharge planning. This qualitative study collected data from 25 ED nurses through in-depth interviews and a drawing task in which participants were asked to depict on paper the implementation of discharge planning in their practice. Factors influencing discharge planning were grouped into three categories: discharge planning as a neglected issue in the ED, heavy workload, and the negative attitudes of ED patients and their families. The study highlighted a need for effective discharge planning to be counted as an essential clinical competency for ED nurses and factored into their everyday workload. Nurses perceived that organizational culture, and parents’ and relatives’ attitudes were barriers to implementing discharge teaching in the ED. [ABSTRACT FROM AUTHOR]

Aims and objectives. The purpose of this research was to explore the medical decision-making processes of patients in emergency departments. Background. Studies indicate that patients should be given enough time to acquire relevant information and receive adequate support when they need to make medical decisions. It is difficult to satisfy these requirements in emergency situations. Limited research has addressed the topic of decision-making among emergency patients. Design. This qualitative study used a broadly defined grounded theory approach to explore decision-making in an emergency department in Taiwan. Methods. Thirty emergency patients were recruited between June and December 2011 for semi-structured interviews that were audio-taped and transcribed verbatim. Results. The study identified three stages in medical decision-making by emergency patients: predecision (interpreting the problem); decision (a balancing act) and postdecision (reclaiming the self). Transference was identified as the core category and pattern of behaviour through which patients resolved their main concerns. This transference around decision-making represents a type of bricolage. Conclusions. The findings fill a gap in knowledge about the decision-making process among emergency patients. Relevance to clinical practice. The results inform emergency professionals seeking to support patients faced with complex medical decision-making and suggest an emphasis on informed patient decision-making, advocacy, patient-centred care and in-service education of health staff. [ABSTRACT FROM AUTHOR]