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ABSTRACT Aim Design Methods Results Conclusions Impact Reporting Method Patient or Public Contribution Trial Registration To develop an evidence‐driven, behaviour change focused strategy to maximise implementation and uptake of HIRAID (History including Infection risk, Red flags, Assessment, Interventions, Diagnostics, communication and reassessment) in 30 Australian rural, regional and metropolitan emergency departments.An embedded, mixed‐methods study.This study is the first phase of a step‐wedge cluster randomised control trial of HIRAID involving over 1300 emergency nurses. Concurrent quantitative and qualitative data were collected via an electronic survey sent to all nurses to identify preliminary barriers and enablers to HIRAID implementation. The survey was informed by the Theoretical Domains Framework, which is a synthesis of behavioural change theories that applies the science of intervention implementation in health care to effect change. Quantitative data were analysed using descriptive statistics and qualitative data with inductive content analysis. Data were then integrated to generate barriers and enablers to HIRAID implementation which were mapped to the Theoretical Domains Framework. Corresponding intervention functions and Behaviour Change techniques were selected and an overarching implementation strategy was developed through stakeholder consultation and application of the APEASE criteria (Affordability, Practicability, Effectiveness and cost‐effectiveness, Acceptability, Side‐effects/safety and Equity).Six barriers to HIRAID implementation were identified by 670 respondents (response rate ~58%) representing all 30 sites: (i) lack of knowledge about HIRAID; (ii) high workload, (iii) lack of belief anything would change; (iv) not suitable for workplace; (v), uncertainty about what to do and (vi) lack of support or time for education. The three enablers were as follows: (i) willingness to learn and adopt something new; (ii) recognition of the need for something new and (iii) wanting to do what is best for patient care. The 10 corresponding domains were mapped to seven intervention functions, 21 behaviour change techniques and 45 mechanisms. The major components of the implementation strategy were a scaffolded education programme, clinical support and environmental modifications.A systematic process guided by the behaviour change wheel resulted in the generation of a multifaceted implementation strategy to implement HIRAID across rural, regional and metropolitan emergency departments. Implementation fidelity, reach and impact now require evaluation. HIRAID emergency nursing assessment framework reduced clinical deterioration relating to emergency care and improved self‐confidence and documentation in emergency departments in pilot studies. Successful implementation of any intervention in the emergency department is notoriously difficult due to workload unpredictability, the undifferentiated nature of patients and high staff turnover. Key barriers and enablers were identified, and a successful implementation strategy was developed. This study uses theoretical frameworks to identify barriers and enablers to develop a data‐driven, behavioural‐focused implementation strategy to optimise the uptake of HIRAID in geographically diverse emergency departments which can be used to inform future implementation efforts involving emergency nurses. The CROSS reporting method (Supporting Information S3) was used to adhere to EQUATOR guidelines.No Patient or Public Contribution.Australian New Zealand; Clinical Trials Registry (ANZCTR) number: ACTRN12621001456842, registered 25/10/2021 [ABSTRACT FROM AUTHOR]

Introduction Design Methods Results Conclusion Protocol Registration Accurate and rapid triage can reduce undertriage and overtriage, which may improve emergency department flow. This study aimed to identify the effects of a prospective study applying artificial intelligence‐based triage in the clinical field.Systematic review of prospective studies.CINAHL, Cochrane, Embase, PubMed, ProQuest, KISS, and RISS were searched from March 9 to April 18, 2023. All the data were screened independently by three researchers. The review included prospective studies that measured outcomes related to AI‐based triage. Three researchers extracted data and independently assessed the study's quality using the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) protocol.Of 1633 studies, seven met the inclusion criteria for this review. Most studies applied machine learning to triage, and only one was based on fuzzy logic. All studies, except one, utilized a five‐level triage classification system. Regarding model performance, the feed‐forward neural network achieved a precision of 33% in the level 1 classification, whereas the fuzzy clip model achieved a specificity and sensitivity of 99%. The accuracy of the model's triage prediction ranged from 80.5% to 99.1%. Other outcomes included time reduction, overtriage and undertriage checks, mistriage factors, and patient care and prognosis outcomes.Triage nurses in the emergency department can use artificial intelligence as a supportive means for triage. Ultimately, we hope to be a resource that can reduce undertriage and positively affect patient health.We have registered our review in PROSPERO (registration number: CRD 42023415232). [ABSTRACT FROM AUTHOR]

This study determined the level of competencies of the nurses in the emergency room. It tackled their age, civil status, highest educational attainment, position, number of years in service, and number of relevant trainings, and earning average income. It tackled the level of competency along the 11 core competency standards. The study utilized the descriptive research design and utilized a survey questionnaire as the main tool in gathering data. Several statistical tools were used like frequency and percentage, weighted mean, t-test, and ANOVA (Analysis of Variance). The nurse respondents were young adults, married, Bachelor's degree holder, staff nurses, had been in the service for more than 5 years, had undergone few numbers of trainings, and earn an income of below P20,000 a month. The nurses were all competent in the 11 core competencies however the highest in their competency level is along legal responsibility, ethico-moral responsibility, and collaboration and teamwork and lowest on health education and quality improvement. Significant differences were noted along safe and quality nursing practice, quality improvement, record management, communication, and collaboration and teamwork. Significant positive R-values are shown between civil status and number for years in services with clinical competency in health education. This indicates that the longer the length of service of the married emergency room nurse, the higher is their clinical competency in health education. [ABSTRACT FROM AUTHOR]

Background: The relationship between a nurse and a patient is a key part of nursing that can impact how happy the patient is with the care they receive. It appears that the nurse's mental health can also affect this connection. However, there is little research on this topic. So, the aim of the present study was to determine the correlation of nurse's mental health with nurse–patient relational care and nursing care satisfaction. Methods: A total of 532 nurses and 532 patients from 13 Level-III hospitals of Hubei province (China) completed a China Mental Health Survey, general information questionnaire, the Nursing Care Satisfaction Scale, and Relational Care Scale. Results: Age, nurse working years, and night shift last month were correlated with mental health score (r = -0.142, r = -0.150, r = 0.164, p < 0.05). Nurse's mental health was correlated with relational care score and nursing care satisfaction score (r = -0.177, r = -0.325, p < 0.05). Also, relational care score, patients age and gender were correlated with nursing care satisfaction score (r = 0.584 and r = 0.143, x2 = 11.636, p < 0.05). Descriptive information of nurses had a direct impact on nurses' mental health (direct effect = 0.612, 0.419–0.713). Nurses' mental health had a direct effect on relational care score (direct effect = 0.493, 0.298–0.428) and an indirect effect on nursing care satisfaction score (indirect effect = 0.051, 0.032–0.074). Relational care score and patient's descriptive information had also a direct effect on nursing care satisfaction score (direct effect = 0.232, 0.057–0.172 and 0.057, 0.347–0.493). Conclusion: This study showed that the better the mental health of nurses, the more patients feel satisfied with nursing services. [ABSTRACT FROM AUTHOR]

Aim Background Methods Results Discussion Conclusion Implications for nursing and health policy We evaluated Saudi Arabian nurses’ willingness to engage in nuclear and radiological disaster response.In the face of rising nuclear and radiological threats, it is essential that nurses are fully prepared to handle the health consequences of such emergencies. As frontline responders, nurses play a critical role in managing high‐stakes situations, making their readiness a key factor in ensuring public safety during these crises.A cross‐sectional survey was conducted among 612 registered nurses in Saudi Arabia. The survey used a structured questionnaire based on the theory of planned behavior, identifying behavioral intentions as the primary outcome and attitudes toward these behaviors, subjective norms, and perceived behavioral control as influencing factors. The data were analyzed using descriptive and inferential statistics.Most respondents lacked specialized training and reported strong behavioral intentions. Attitude and perceived behavioral control were key drivers of these behavioral intentions, with less impact from subjective norms. Behavioral intentions were also shaped by education, the perceived likelihood of nuclear and radiological emergencies in their region, peer influence, perceived self‐efficacy, and family concerns. Younger and married nurses showed significantly stronger behavioral intentions.Although most nurses lacked specialized training, their strong engagement intentions and positive responses to active learning and training indicate a desire to close this gap through further education. However, inadequate institutional support, trouble communicating with family, and concerns about personal radiation exposure emerged as potential barriers.Targeted educational initiatives and support systems are needed to enhance nurses’ confidence, competence, and willingness to engage in radiological and nuclear emergency scenarios.Policymakers should prioritize the development of specialized training programs and support mechanisms for nurses, ensuring they are adequately prepared to respond effectively to increasing radiological and nuclear threats. [ABSTRACT FROM AUTHOR]

Purpose: To assess the knowledge and confidence level regarding the basic first-aid for treating epistaxis among medical staff, including nurses and physicians across various medical disciplines. The study focused three aspects of first aid management: location of digital pressure, head position and duration of pressure. Methods: The study involved 597 participants, categorized into five groups according to their specialties: emergency medicine, internal medicine, surgery, pediatrics, and community-based healthcare. A paper-based multiple-choice questionnaire assessed knowledge of managing epistaxis. Correct answers were determined from literature review and expert consensus. Results: Most medical staff showed poor knowledge regarding the preferred site for applying digital pressure in epistaxis management. For head position, pediatricians and internal medicine physicians were most accurate (79.4% and 64.8%, respectively, p < 0.01), and nurses from the emergency department outperformed nurses from other disciplines; internal medicine, surgery, pediatrics, and community-based healthcare (61.1%, 41.5%, 43.5%, 60%, 45.6%, respectively, p < 0.05). While most medical staff were unfamiliar with the recommended duration for applying pressure on the nose, pediatricians and community clinic physicians were most accurate (47.1% and 46.0%, respectively, p < 0.01), while ER physicians were least accurate (14.9%, p < 0.01). Interestingly, a negative correlation was found between years of work experience and reported confidence level in managing epistaxis. Conclusions: Our findings indicate a significant lack of knowledge concerning epistaxis first-aid among medical staff, particularly physicians in emergency departments. This finding highlights the pressing need for education and training to enhance healthcare workers' knowledge in managing epistaxis. [ABSTRACT FROM AUTHOR]

Why you should read this article: • To refresh your knowledge of the aims of and processes involved in triage • To enhance your understanding of the strategies you can use to make triage as safe and effective as possible for patients and staff • To contribute towards revalidation as part of your 35 hours of CPD (UK readers) • To contribute towards your professional development and local registration renewal requirements (non-UK readers). Triage is the first stage of a patient’s journey through the emergency department and is used to determine patient acuity. There is no single quantifiable metric for determining acuity, which amalgamates different factors that are more or less relevant depending on the patient’s presentation. This article explains the aim and process of triage and how nurses can ensure the process is effective and safe. The author discusses strategies nurses can use to mitigate uncertainty and to make their acuity assessments rapid, targeted and comprehensive. The author also highlights triage safety considerations, including infection prevention and control and the physical and emotional safety of patients and staff. [ABSTRACT FROM AUTHOR]

Why you should read this article: • To consider the use of body-worn cameras for nurses in EDs in response to increasing violent and aggressive incidents • To read about one hospital’s experience of introducing body-worn cameras for ED nurses • To recognise the importance of testing and evaluating the use of body-worn cameras before full implementation of such equipment. Nurses and other emergency department (ED) staff often experience verbal and physical abuse as part of their everyday work. Body-worn cameras are one tool that ED staff can use to try to reduce workplace violence and abuse and have been shown to be effective in other healthcare environments, such as mental health units. This article describes a pilot service evaluation which used a survey to assess the effectiveness of using body-worn cameras for staff in the author’s ED. Findings suggest that nurses believed the cameras provided support when they were confronted by abusive or aggressive patients or relatives and in some instances diffused potentially violent situations. [ABSTRACT FROM AUTHOR]

Aim: This study was carried out to investigate the perception of the main competencies of disaster management in Iranian emergency department nurses in 2023 in hospitals affiliated with Kermanshah University of Medical Sciences. The present study was conducted to explore the perceived core disaster competencies in nurses of hospitals affiliated with Kermanshah University of Medical Sciences in 2023. Background: Due to the rise in natural disasters, their escalating severity and associated regulatory response necessitate a closer look at the preparedness and core competencies of nursing personnel. The main competencies of nurses are necessary to deal with disasters in unexpected events, and they are expected to use their professional expertise to provide the required nursing services to reduce the risks caused by disasters. Methodology: This descriptive‐analytical study was conducted cross‐sectionally between May and September 2023. In the study, a sample of 384 nurses working in the departments of four hospitals affiliated with Kermanshah University of Medical Sciences was selected through a random stratification. The data collection instrument was a 45‐item scale of nursesʼ perceived core competencies (NPDCC) in handling disasters. The data were analyzed using the Mann–Whitney U‐test, Kruskal–Wallis test, and independent samples t‐test. The significance level was set at 5%. Results: The mean total score of perceived core disaster competencies was 139.11 ± 37.65. The technical skills subscale got the highest score (51.81 ± 11.28) and critical thinking skills received the lowest (9.74 ± 3.92). Also, "technical skills" had the highest average and "critical thinking skills" had the lowest average in all three age groups. The results found a significant difference between the scores of nurses in perceived core disaster competencies in age groups, work environments, education degrees, marital statuses, and experiences of attending disaster workshops (p ≤ 0.05). Conclusions: The results showed that nurses had different levels of core disaster competencies in the department. There are gaps in the core disaster nursing competencies that need to be filled. Nursing managers should consistently evaluate the core nursing competencies to achieve efficacious disaster preparedness. To this aim, it is recommended that authorities implement training courses and programs to enhance the preparedness of nurses in responding to disasters. [ABSTRACT FROM AUTHOR]

Background: Armed conflicts are usually associated with high mortality and morbidity rates, with unpredictable workload, injuries and illnesses. Identifying emergency nurses' views of the core competencies required to enable them to work effectively in hospitals in areas of armed conflict is critical. It is important to inform the requisite standards of care and facilitate the translation of knowledge into safe, quality care. Aim: The aim of this study was to identify emergency nurses' perceptions of core competencies necessary to work in hospitals in the context of armed conflict. Method: A descriptive qualitative phase of a mixed‐method study using semi‐structured interviews with participants was conducted from June to July 2019. The COREQ guideline for reporting qualitative research was followed. Findings: A sample of 15 participants was interviewed. The participant perceptions provided a different perspective of core competencies required for emergency nurses in the context of armed conflict, culminating in four main areas: (i) personal preparedness , (ii) leadership, (iii) communication and (iv) assessment and intervention. Conclusion: This study identified emergency nurses' perceptions of their core competencies. Personal preparedness, leadership, communication, assessment and intervention were identified as contributing to calmness of character, confidence in care and cultural awareness for care in this setting and were essential for them to work effectively when managing victims of armed conflict in emergency departments. Implications for nursing practice and health policy: The findings of this study are important and novel because the researchers sought the perspectives of emergency nurses who have experience in receiving patients from armed conflict firsthand. The findings will inform policymakers in those settings regarding standard of care, education and drills for hospital nurses in optimizing armed conflict care response outcomes. [ABSTRACT FROM AUTHOR]

Doctors and nurses suffer different mental health conditions following traumatic incidents. We systematically synthesized existing evidence on the prevalence of anxiety, depression, and post-traumatic stress disorder (PTSD) and their associated risk factors among doctors and nurses following mass casualty incidents (MCIs). Systematic review. Seven databases were searched (2010–2022) with peer-reviewed articles in English using the predefined keywords. Two reviewers screened the titles, abstracts, and full texts using the eligibility criteria and extracted data independently. We used the National Institutes of Health Quality Assessment Tools (NIH-QAT) and the Critical Appraisal Skills Programme checklist (CASP) to measure the quality appraisal of the included studies. A total of 5170 articles were retrieved, and 2512 articles were assessed by title and abstract (53 were eligible for full-text review). Finally, we included 19 studies. Most were assessed as of fair quality with a considerable risk of bias. PTSD was the highest-reported mental health condition. Nurses reported higher mental conditions, particularly PTSD. Two sets of risk factors (personal and workplace) are associated with anxiety, depression, and PTSD were found. MCIs have a significant impact on the mental health outcomes of emergency health workers. Preventive measures should be designed considering the high-risk group, personal, and organizational risk factors of mental health outcomes. [ABSTRACT FROM AUTHOR]

Background: The pulse oximeter is a simple, cost‐effective and reliable device for estimating arterial blood oxygen saturation. Nurses are required to be knowledgeable in pulse oximeter use. Little is known about nurses' knowledge of pulse oximetry in the Middle East region. Aim: To assess nurses' knowledge of pulse oximetry among emergency and critical care nurses and to explore predictors of nurses' knowledge of pulse oximetry. Study Design: This is the second part of data analysis that was first presented in the 'proficiency in ECG' study conducted in Jordan. The original data used for both parts of analysis included a questionnaire with two tests; a knowledge of pulse oximeter test and an ECG proficiency test. Participants were asked to take, alone without receiving assistance, both tests. In this study, the second part of analysis, the focus is on the pulse oximeter test. The test consisted of 21 items that emphasize knowledge of basic physiological principles as well as device limitations; whether technical or interpretation. The test administration procedure also included asking participants to provide socio‐demographic variables. In the original data collected in both parts of analysis, nurses working in the emergency department, cardiac care units or intensive care units from nine different hospitals (1 governmental, 6 private and 2 educational) and holding a bachelor degree or higher were asked to participate. Results: The total number of participating nurses was 210; out of 247 approached (response rate, 85%). The mean score in the nurses' knowledge of pulse oximetry test was 12.33 out of 21, corresponding to 58.7%. The clinical area currently working in predicted the knowledge of pulse oximetry test score after controlling for all other variables. Emergency department and intensive care unit nurses scored higher than cardiac care unit nurses by 1.86 and 1.63 points respectively (58.2% and 60% respectively). Conclusion: Nurses consistently report inadequate education and training concerning pulse oximeter use and interpretation. A revision to hospital in‐service education seminars and undergraduate nurses' curriculum to assure adequate preparation is needed. Relevance to Clinical Practice: Knowledge of pulse oximetry among emergency and critical care nurses is modest. This is a challenge worldwide. Predictors of nurses' knowledge of pulse oximetery are the clinical area currently working in (ICU and ED nurses are more knowledgeable than CCU nurses), proficiency in electrocardiography and taking an advanced cardiac life support course. [ABSTRACT FROM AUTHOR]

Purpose The fast-paced environment of the emergency department (ED), with frequent admissions, discharges, and transfers, poses a challenge for pharmacy departments to effectively distribute and store medications. The purpose of this study is to propose a unique workflow of patient-specific medication delivery to the ED from a hospital pharmacy to reduce the number of missing medications resulting in medication messages and redispenses. Methods The medication delivery workflow proposed in this study consists of batching the preparation and distribution of patient-specific medications sent from the pharmacy to the ED in the 1 to 2 hours prior to their administration time. Chi-square analysis was completed to compare medication redispenses and "missing medication" messages before and after the intervention, with the significance level set at P < 0.05. Results The percentage of redispensed medications was effectively decreased following implementation of the workflow change from 21.6% to 9.2% (P < 0.001), with unit doses having the greatest reduction (25.8% vs 6.1%, P < 0.001). Benefits of this workflow change were also illustrated through a reduction in the percentage of missing-medication messages sent by nursing staff from 97.7% to 93.9% (P < 0.001). Conclusion This study showed that implementation of standard, hourly batches of medications dispensed from the pharmacy to the ED resulted in a significant reduction in the total percentage of redispensed medications and missing-medication messages. The overall reduction in redispensed medications as a result of this innovative workflow change not only benefited nursing and pharmacy staff but can reduce medication waste and improve patient care through timely administration of medications. [ABSTRACT FROM AUTHOR]

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. 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. 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. 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. [ABSTRACT FROM AUTHOR]

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. 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. The study compiled interviews from 10 participants and field notes from 191 observation episodes. Five key themes emerged, including diverse experience, barriers related to the learning process, factors influencing insertion success, and recommendations to enhance clinicians' acceptance. 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. 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. [ABSTRACT FROM AUTHOR]

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. 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. 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. 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. [ABSTRACT FROM AUTHOR]

Background: Effective information transfer during nursing shift handover is a crucial component of safe care in the emergency department (ED). Examining nursing handover models shows that they are frequently associated with errors. Disadvantages of the SBAR handover model include uncertainty of nursing staff regarding transfer of responsibility and non-confidentiality of patient information. To increase reliability of handover, written forms and templates can be used in addition to oral handover by the bedside. Aims: The purpose of this study is to compare the 'Situation, Background, Assessment, Recommendation (SBAR) method and modified handover model on the handover quality and nurse perception of shift handover in the ED. Methods: This research was designed as a semi-experimental study, with census survey method used for sampling. In order to collect data, Nurse Perception of Hanover Questionnaire (NPHQ) and Handover Quality Rating Tool (HQRT) were used after translating and confirming validity and reliability used to direct/collect data. A total of 31 nurses working in the ED received training on the modified shift handover model in a one-hour theory session and three hands-on bedside training sessions. This model was implemented by the nurses for one month. Data was analyzed with SPSS (version 26) using paired t-tests and analysis of covariance. Results: Results indicated significant difference between the modified handover model and SBAR in components of information transfer (P < 0.001), shared understanding (P < 0.001), working atmosphere (P = 0.004), handover quality (P < 0.001), and nurse perception of handover (P < 0.001). The univariate covariance test did not show demographic variables to be significantly correlated with handover perception or handover quality in SBAR and modified methods (P > 0.05). Conclusions: The results of this study can be presented to nursing managers as a guide in improving the quality of nursing care via implementing and applying the modified handover model in the nursing handover. The resistance of nurses against executing a new handover method was one of the limitations of the research, which was resolved by explanation of the plan and goals, as well as the cooperation of the hospital matron, and the ward supervisor. It is suggested to carry out a similar investigation in other hospital departments and contrast the outcomes with those obtained in the current study. [ABSTRACT FROM AUTHOR]

Background: Patient trust in medical staff is an important ethical issue that can influence various patient behaviors and attitudes, such as seeking healthcare, sharing confidential information, accepting treatment, and adhering to recommendations. This study aimed to assess patient trust in nurses and its relationship to the quality of care and communication skills of nurses in emergency departments. Methods: This descriptive correlational study was conducted in 2023 in the emergency departments of medical training centers of Ardabil University of Medical Sciences, Iran. A total of 378 patients was selected using a quota sampling method. Data were collected using three valid and reliable tools: the Quality Patient Care (QUALPAC) scale, the Health Communication Feedback Questionnaire (HCFQ), and the Trust in Nurses Scale (TNS).The data were analyzed using independent t-tests, one-way analysis of variance, and Pearson's correlation coefficient tests using SPSS version 24. Results: The majority of patients (99.2%) rated nurses' communication skills as moderate, with none rating them as poor. The average scores were 27.59 ± 2.76 for patient trust in nurses, 72.43 ± 3.30 for nurses' communication skills, and 198.30 ± 14.60 for the quality of nursing care. A significant correlation was found between patient trust in nurses and the overall quality of nursing care (r = 0.256, P < 0.001) as well as its dimensions. However, there was no significant relationship between patient trust in nurses and patient's perception of the nurses' communication skills (r = 0.046, P = 0.369). Conclusions: The findings indicate that patient trust in nurses is positively and significantly associated with the perceived quality of nursing care. As the quality of care improves, patient trust in nurses also increases. Therefore, nurses should focus on providing high-quality care to enhance patient trust. [ABSTRACT FROM AUTHOR]

Background: Considering the vital role of nurses in responding to disasters, it is essential to measure their readiness with a valid and reliable tool. The present study aimed to assess the psychometric properties of the Farsi version of the Disaster Nursing Readiness Evaluation Index (F-DNREI). Methods: This cross-sectional study was conducted between 2023 and 2024 among 200 nurses working at educational hospitals affiliated with one of the medical universities in Tehran, Iran. The Disaster Nursing Readiness Evaluation Index was translated into Persian. The face, content, and construct validity, as well as internal consistency, were analyzed. Results: In the exploratory factor analysis, five factors were extracted: practical skills for disaster response, adaptability to stressful situations at the disaster site, communication and cooperation skills for teamwork, emergency nursing skills, and effective coping with daily stress. Together, these factors accounted for 39.7% of the total variance. The results of the confirmatory factor analysis indicated that the extracted model fit well: CMIN/DF = 1.519, CFI = 0.889, RMSEA = 0.051. The Cronbach's alpha and McDonald's omega coefficients for the entire questionnaire were 0.890 and 0.891, respectively. Conclusions: Given that Iran is frequently exposed to disasters, it becomes essential to assess the preparedness of Iranian nurses using a valid and reliable scale. The availability of the Farsi version of the Disaster Nursing Readiness Evaluation Index (F-DNREI), which has undergone validation and reliability testing, facilitates accurate measurement of this concept. [ABSTRACT FROM AUTHOR]

Background: Sepsis is a major cause of mortality worldwide and an important public health problem. The quality of patient care is negatively impacted when nurses lack adequate knowledge regarding the management of sepsis. On the other hand, little is known regarding Ethiopian nurses' knowledge of sepsis management. Objective: To assess the level of knowledge and the associated factors towards sepsis management among nurses working in emergency departments in public hospitals in Addis Ababa, Ethiopia. Method: From March 18 to April 18, 2022, a health facility-based cross-sectional study was conducted. A simple sampling technique (lottery method) was used to select the hospitals. The data was analyzed using SPSS version 25. The study employed logistic regression analysis to examine the association between the independent variables and the level of knowledge. Variables were significantly associated with a level of knowledge if they had a p-value of less than 0.05 and a 95% confidence interval. Result: Of the 127 participants, more than half (56.7%) had poor knowledge. Nurses' knowledge of managing sepsis was significantly associated with not having regular training, a low level of education, and working experience of less than five years. The findings of the multivariable regression analysis revealed that the following variables were associated with a nurse's knowledge of sepsis management: low level of education (AOR = 3.2 (95% CI, 1.16–8.77), lack of training adjusted odd ratio (AOR = 2.5 (95% CI, 1.07–5.93), and less than five years of work experience (AOR = 3.6 (95% CI, 1. 29–9.830). Conclusion: The majority of nurses had inadequate knowledge of managing sepsis. On the other hand, the majority of nurses had a favourable attitude toward sepsis management. Lack of prior training, a low level of education, and less than five years of work experience were all significantly associated with nurses' poor knowledge regarding sepsis management. This study recommends that hospital managers should provide on-the-job and long-term training for nurses working in the emergency department to enhance the level of nurses' knowledge towards sepsis management at their institutions. [ABSTRACT FROM AUTHOR]

Background: Electrocardiography (ECG) is a noninvasive diagnostic method used to examine electrical and muscular cardiac activity. It is usually the first-line diagnostic tool for patients with chest pain. Late recognition of electrocardiography abnormalities can cause in-hospital cardiac arrest, further complicate care, increase the cost of health care, and prolong admission. Hence, the objective of this study was to determine the knowledge, practice, and associated factors of nurses regarding the interpretation of electrocardiography. Methods: A cross-sectional study was carried out on 334 nurses working at randomly selected public hospitals from March 06, 2023, to April 05, 2023. Since our study populations were less than the calculated sample size, all nurses who fulfilled the inclusion criteria were included. The collected data were coded and cleaned using EpiData version 4.2 and analysed using Statistical Package for the Social Sciences (SPSS) version 25. Both bivariate and multivariate logistic regression was run to find an association between dependent and independent variables. Odds ratios (ORs) with 95% confidence levels were used to measure the strength of associations. Results: A total of 334 nurses responded to the survey, yielding a 93% response rate. Only 15.4% and 9% of them had satisfactory knowledge and good practice, respectively. Nurses who had 2–4 years of experience in the current unit were 3.13 times more likely (AOR = 3.13 (1.23, 7.92) to have sufficient knowledge. Nurses working in cardiac care units were 3.45 times more likely to have good practices than those working in intensive care units (AOR = 3.45 (1.02, 13.73)). Conclusion: The study revealed that educational qualifications, in-service training, and current working units were significantly associated with nurses' knowledge and practice of electrocardiography interpretation. The concerned body must provide continuous on-the-job training related to ECG interpretation to all nurses working in adult emergency and critical care unit. [ABSTRACT FROM AUTHOR]

Background: Due to the unique working environment and nature of work in emergency departments, nurses are prone to experiencing compassion fatigue (CF), leading to job burnout and attrition. As more Generation Z (Gen Z) nurses enter the emergency department with distinct personality traits compared to previous generations, studying their experiences with CF will inform future management strategies. Methods: The qualitative phenomenological research method was utilised to investigate CF among Gen Z emergency nurses at a hospital in Shanghai, China. Data were collected through face-to-face semi-structured interviews and analyzed using Colaizzi's seven-step phenomenological analysis method. Study participants were purposively selected. Results: Three main themes and nine sub-themes emerged from the study: secondary traumatic stress, including physiological symptoms, psychological symptoms, and behavioral changes; cumulative effects, including impaired empathy, interference with family life, and post-traumatic growth (PTG); coping strategies, including cognitive reconstruction, seeking support, and facilitating action. Conclusions: The aim of this study is to investigate the experience of CF among Gen Z emergency nurses, providing managers with a reference for future management strategies. The significance of multi-dimensional support for Gen Z emergency nurses is underscored by our findings. Additionally, interventions that enhance resilience and competency can facilitate their psychological transformation after experiencing CF and promote accelerated personal growth. [ABSTRACT FROM AUTHOR]

Aim Design Methods Findings Conclusion Implications for the Profession Impact Reporting Method Patient or Public Contribution To explore how emergency nurses experienced caring for brought‐in‐dead persons and their relatives, and what hindered or facilitated this care in an emergency setting.A qualitative study using Interpretive Description.Data were collected as individual interviews with 13 nurses at seven Danish emergency departments from February to June 2023.Our analysis revealed the overarching theme ‘Navigating the complexities of providing holistic care in a constrained environment’, covering five sub‐themes: (1) An important yet not recognized nursing task; (2) Pending care needs of the living and the dead; (3) No physical or mental room for the brought‐in‐dead persons; (4) Utilizing personal experiences in the absence of formal education and training and (5) Navigating professionalism and empathy.Emergency departments posed unique challenges in providing care to brought‐in‐dead persons and their relatives.The unrecognized nature of caring for brought‐in‐dead persons and their relatives suggests a universal undervaluation of this care in emergency departments.Care for brought‐in‐dead persons and their relatives is neither recognized nor evidence‐based. This study initiates a discussion of the circumstances for delivering care for persons brought‐in‐dead and has an impact on nurses and nursing leaders employed in emergency departments.The Consolidated Criteria for Reporting Qualitative Research (COREQ).None. [ABSTRACT FROM AUTHOR]

Objective To explore the mediating role of work passion in the association between psychological capital and occupational well -being among emergency department nurses, providing reference for enhancing their well -being and thereby contributing to the stability of the emergency nursing team. Methods A cross-sectional survey was conducted from August 2023 to September 2023 among 210 emergency department nurses from two top tertiary general hospitals and two secondary hospitals in Shanghai. The questionnaires of the Occupational Well -being Scale for Medical Workers, the Nurses’ Psychological Capital Scale, and the Work Passion Scale were utilized for data collection. Data analysis was performed using SPSS 24.0 software, followed by mediation effect analysis with the Process V3.3 plugin. Results A total of 203 valid questionnaires were collected, with a response rate of 96.7%. The occupational well-being score of emergency department nurses was (81.33 ± 13.93), the psychological capital score was (85.82 ± 15.73), and the work passion score was (64.60 ± 13.05). Nurses with a bachelor’s degree, voluntarily choosing nursing as a profession, as the only child of family, and receiving non -resident training scored higher in occupational well -being (all P < 0.05); the scores of occupational well-being showed a trend of increasing with the years of nursing experience before decreasing (P < 0.05). Occupational well-being was positively correlated with work passion and psychological capital (r = 0.751, 0.685， both P < 0.01), and psychological capital was positively correlated with work passion (r = 0.601， P < 0.01). Psychological capital had a direct impact on the occupational well -being of emergency department nurses, accounting for 41.85% of the total effect, while work passion served as a mediator between psychological capital and occupational well -being, and the mediating effect accounted for 58.15% of the total effect. Conclusions Nursing managers can enhance the occupational well-being of emergency department nurses by strengthening their psychological capital and regulating their work passion. [ABSTRACT FROM AUTHOR]

Objective To explore the potential categories of resilience in emergency nurses and to analyze the influencing factors in these categories in Shanghai, providing a basis for nursing managers to formulate personalized intervention programs. Methods From June to July 2021, 349 nurses in the emergency department from two top tertiary general hospitals and two secondary hospitals in Shanghai were selected by convenience sampling and surveyed using the questionnaires of the Resilience Scale of Medical Staff, the Job Crafting Scale, the Employee Work Passion Scale, and the Perceived Leader Selection Scale. The potential profile analysis model was used to identify the potential categories of stress resistance, and the multi-classification logistic regression model was used to explore the influencing factors of the potential categories. Results A total of 343 valid questionnaires were collected, with a response rate of 98.28% . The mean of the total resilience score of the 343 participants was (71.33 ± 11.41), including decisional coping (24.84 ± 3.91), interpersonal connections (16.93 ± 2.57), rational thinking (15.70 ± 2.93), and flexible adjustment (15.87 ± 3.02). Three latent classes of resilience were identified: the low resilience group (51, 14.9% ), the moderate resilience group (103, 30.0%), and the high resilience group (189, 55.1%). Logistic regression analysis showed that for each point increase in work remodeling score, the odds of low resilience nurses transitioning to the moderate resilience group increased to 1.109 times (P < 0.001). For each point increase in work remodeling and work passion scores, the odds of low resilience nurses transitioning to the high resilience groups increased to 1.194 and 1. 094 times, respectively (both P < 0.01). Conclusions Three latent classes of resilience were identified among emergency department nurses with distinct group characteristics. Nursing managers should adopt individualized and phased intervention measures, such as enhancing nurses’ work passion and work remodeling, to improve the resilience level of emergency department nurses. [ABSTRACT FROM AUTHOR]

Background: Emergency nurses who thrive at work experience positive emotions that help reduce burnout and thus enhance career calling. However, few studies have focused on the relationships among thriving at work, career calling, and moral distress among emergency nurses. Objectives: To investigate the relationships among thriving at work, career calling, and moral distress and to explore the mediating role of career calling in the relationship between thriving at work and moral distress among emergency nurses. Design: A quantitative, cross-sectional study. Methods: A cross-sectional study was conducted by reference to 390 emergency nurses in China using an online survey that include the Thriving at Work Scale, the Career Calling Scale, and the Moral Distress Scale-Revised. The data were analyzed using SmartPLS software. Ethical consideration: The study was approved by the Ethics Committee of Hunan Normal University (No. 2023-388). Findings: Among emergency nurses, thriving at work is positively associated with career calling, while career calling is negatively associated with moral distress. Career calling negatively and completely mediates the relationship between thriving at work and moral distress (β = −0.087, p < 0.01). Discussion: Theoretically, the findings enhance our understanding of the relationships among thriving at work, career calling, and moral distress among emergency nurses. Conclusion: By emphasizing the benefits of thriving at work, nursing managers can improve nurses' level of thriving at work by providing a favorable environment, a flexible scheduling system, and appropriate authorization as well as by ensuring organizational fairness and providing training opportunities in a hierarchical manner. [ABSTRACT FROM AUTHOR]

Purpose: This study analyzed the effect of emergency nurses' psychological resilience on their thanatophobic behaviors. Methods: The research was conducted with 156 emergency nurses. In the data collection process, the Socio-Demographic Information Form, the Brief Resilience Scale, and the Thanatophobia Scale were used. Results: It was found that emergency nurses had medium-level psychological resilience and high-level thanatophobia. Besides, it was discerned that there was a moderate negative relationship between psychological resilience and thanatophobia (r:−.643, p : 0.000). Lastly, as per the simple linear regression analysis, it was identified that the predictor variable of psychological resilience accounted for 40.9% of the variance in the predicted variable of thanatophobia (R 2:.409, p : 0.000). Practice Implications: Emergency nurses, who are faced with many negative situations, need to have a high level of psychological resilience in order to get out of the mental state brought by negative conditions as soon as possible, and it is recommended to carry out applications to increase psychological resilience. [ABSTRACT FROM AUTHOR]

Background: Multidisciplinary team meetings (MDTMs) are crucial in the ICU. However, daily rounds may not address all sensitive issues due to time constraints and the complexity of cases. This study aimed to describe detailed information and characteristics of ad hoc MDTMs in the ICU. Methods: This single-center, retrospective study analyzed adult emergency ICU admissions at Okayama University Hospital from 1 January 2019 to 31 December 2023. During this period, weekly regular multidisciplinary team ICU rounds were introduced in June 2020, and regular weekday morning MDTMs began in April 2022. A multiple logistic regression analysis was applied to determine the impact of these changes on the frequency of ad hoc MDTMs, adjusting for variables including annual changes. Results: The study analyzed 2487 adult EICU patients, with a median age of 66, and 63.3% of them male. MDTMs were held for 168 patients (6.8%), typically those with severe conditions, including higher COVID-19 prevalence and APACHE II scores, and longer ICU stays. Despite a constant total number of MDTMs, the likelihood of conducting ad hoc MDTMs increased annually (adjusted OR 1.19; 95% CI, 1.04–1.35). Of the 329 MDTMs conducted for these patients, 59.0% addressed end-of-life care, involving an average of 11 participants, mainly nurses and emergency and critical-care physicians. Conclusions: Changes in ICU round and meeting structures might be associated with a higher frequency of conducting ad hoc MDTMs, highlighting their evolving role and importance in patient care management. [ABSTRACT FROM AUTHOR]

Aims: This study aims to reveal the violent experiences of nurses working in the emergency department and the meanings they attribute to them. Methods: This research was conducted as narrative inquiry and interpretive phenomenology and recruited 15 nurses. Interviews with nurses actively working in the emergency department and who had been exposed to violence by patients or their relatives were conducted with a semi‐structured interview form. The consolidated criteria for reporting qualitative research (COREQ) checklist was used. Results: In the study, three themes were determined (1) Unpredictable event, (2) Interminable effects of violence, and (3) Like a bottomless pit. With seven sub‐themes. Conclusions: This study underlined that violence applied to nurses by patients or relatives of patients in the emergency department is an unexpected situation that causes negative emotions. Violence affects all aspects of life and limits communication with the patient. Coping with a violent situation is challenging for nurses, and they demand support from the management. Summary Statement: What is already known about this topic? Violence is most commonly reported as experienced by nurses in the emergency department.Violence affects nurses deeply and causes negative effects in daily life. What this paper adds: Nurses described the violence perpetrated by patients or by patients' relatives as a situation that causes negative feelings such as anger, worthlessness, and injustice.Nurses emphasized that violence affects their clinical environment and their daily lives. The implications of this paper: The multidimensional and destructive effects of violence on nurses have shown that it is important to make the necessary arrangements quickly to reduce violence in the emergency departmentThe study provides information about the experiences of nurses who have been exposed to violence by patients or their relatives in the emergency department. [ABSTRACT FROM AUTHOR]

Operator syndrome is a common and predictable constellation of interrelated medical and psychiatric conditions and social and functional impairments experienced by special operations forces. Nurses in all settings should be aware of this emerging trend among veterans they encounter in practice so they may identify and intervene using evidence-based approaches and effect a positive outcome. [ABSTRACT FROM AUTHOR]

This article examines the use of cricoid pressure (CP) by anesthesia nurses in Singapore public hospitals. CP is a technique used during anesthesia induction to prevent gastric regurgitation, but its effectiveness and safety are controversial. A survey conducted among anesthesia nurses revealed gaps in their training and knowledge of CP, indicating a need for improved education and collaboration between nurse educators and anesthesiologists. The study emphasizes the importance of standardized training and ongoing education to ensure the safe and effective use of CP. [Extracted from the article]

Background: COVID-19 has probably contributed to sleep disturbance among nurses, especially those working at emergency departments (EDs). Sleep disorders in nurse managers can negatively impact their health and impair work performance and decision-making. This study aimed to explore the quality of sleep among nurses working in EDs and its influencing factors during the COVID-19 pandemic. Method: In this study, a cross-sectional design was employed to assess the sleep quality of nurses working in EDs during the COVID-19 pandemic. The research recruited a convenience sample of emergency nurses, who were selectively sourced from four hospitals in Hail City. This recruitment occurred over the period from April to July 2022. Descriptive data analysis was conducted using SPSS, with the significance level set at 0.05. Results: Among the 216 participants in the study, the majority (55.6%) were aged between 30 and 39 years, and 73.6% were female. Additionally, 64.4% were married, while 69.4% had a bachelor's degree, 20% held a diploma, and the remaining had a master's degree. Notably, a significant 81.5% of the nurses reported poor sleep quality, as assessed by the Pittsburgh Sleep Quality Index (PSQI), with an overall mean score of 10.55 indicating poor sleep. The study highlighted that poor sleep quality among nurses was linked to being female, being married, and not exercising regularly. Better sleep was associated with nurses who manage fewer patients per shift and have adequate monthly income. Conclusion: The prevalence of poor sleep quality among Emergency nurses during the COVID-19 pandemic is high. There is a pressing need for targeted interventions to enhance sleep quality among ED nurses. Improving sleep quality is not only essential for the wellbeing of these nurses but is also likely to contribute to better patient care. [ABSTRACT FROM AUTHOR]

Over 10 million ED visits occur each year across Australia and Aotearoa New Zealand. Outside basic administrative data focused on time‐based targets, there is minimal information about clinical performance, quality of care, patient outcomes, or equity in emergency care. The lack of a timely, accurate or clinically useful data collection represents a missed opportunity to improve the care we deliver each day. The present paper outlines a proposal for a National Acute Care Secure Health Data Environment, including design, possible applications, and the steps taken to date by the Australasian College for Emergency Medicine ED Epidemiology Network in collaboration with the College of Emergency Nursing Australasia. Optimal use of the existing information collected routinely during clinical care of emergency patients has the potential to enable data‐driven quality improvement and research, leading to better care and better outcomes for millions of patients and families each year. [ABSTRACT FROM AUTHOR]

Aims Design Methods Results Conclusion Implications for the Profession and/or Patient Care Reporting Method Patient or Public Contribution To investigate the interrelationships of patient safety, caring behaviours, professional self‐efficacy and missed nursing care among emergency room nurses.Cross‐sectional, correlational study.Filipino emergency room nurses (n = 345) participated via convenience sampling from September 2023 to January 2024. Four validated self‐report scales were used to collect data and were analysed using Spearman rho, covariance‐based structural equation modelling, mediation and path analyses.The emerging model of study variables displayed satisfactory fit indices. Patient safety directly influenced caring behaviours and professional self‐efficacy, while negatively influencing missed nursing care. Caring behaviours directly and indirectly affected professional self‐efficacy and missed nursing care, respectively. Professional self‐efficacy negatively influences missed nursing care. Finally, caring behaviours and professional self‐efficacy were significant mediators between the association of patient safety and missed nursing care.Caring behaviours and professional self‐efficacy of emergency room nurses demonstrated mediating effects that can potentially improve patient safety practices thereby minimizing unfinished or missed nursing care.Nurses and healthcare organizations should commit to consistently maintain a workplace culture that fosters patient safety, caring behaviours and professional self‐efficacy to minimize avoidable injuries and omitting nursing care tasks.STrengthening the Reporting of OBservational studies in Epidemiology (STROBE).No Patient or Public Contribution. [ABSTRACT FROM AUTHOR]

Objective: To investigate the current situation of emergency preparation and emergency drill in the CSSD, and analyze its influence on the nurses' emergency attitude and ability. Methods: This study employed a multicenter stratified sampling method, conducted from January to June 2023 using the online survey, participants completed the general data, emergency preparedness and drill questionnaire, public health emergency response questionnaire and emergency capacity scale. An independent samples t test or Kruskal-Wallis test was used to analyse differences in nurses' emergency capacity and attitudes. Results: The data from 15 provinces 55 hospitals in China. Overall, 77.58% of participants' institutions set up emergency management teams, 85.45% have an emergency plan and revise it regularly. 92.12% store emergency supplies. All survey staff participated in the emergency drill, which predominantly consisted of individual drills (51.52%), with 90.30% being real combat drills, 49.09% of participants engaging in drills every quarter, and 91.52% of the drill's participants exceeding 50%. The respondents' emergency attitude score was (29.346 ± 6.029), their emergency ability score was (63.594 ± 10.413), and those with rescue experience showed a more positive attitude (Z = -2.316, P = 0.021). Different titles, education levels, rescue experience and the frequency of emergency drill affected the emergency rescue ability of the respondents (P < 0.05). Conclusions: Most medical institutions establish emergency management systems and plans, yet the content lacks geographical specificity.The duration and participation of emergency drills are high, but the effectiveness of the drills needs to be further improved, and the response capacity and attitudes of CSSD nurses are low. It is recommended that agencies develop comprehensive and targeted contingency plans to strengthen the inspection and evaluation of team strength, equipment and safeguards against the contingency plans, so as to ensure that the measures mandated by the contingency plans can be implemented promptly after the emergency response is initiated. [ABSTRACT FROM AUTHOR]

Background: Implementing evidence that changes practice in emergency departments (EDs) is notoriously difficult due to well-established barriers including high levels of uncertainty arising from undifferentiated nature of ED patients, resource shortages, workload unpredictability, high staff turnover, and a constantly changing environment. We developed and implemented a behaviour-change informed strategy to mitigate these barriers for a clinical trial to implement the evidence-based emergency nursing framework HIRAID® (History including Infection risk, Red flags, Assessment, Interventions, Diagnostics, communication, and reassessment) to reduce clinical variation, and increase safety and quality of emergency nursing care. Aim: To evaluate the behaviour-change-informed HIRAID® implementation strategy on reach, effectiveness, adoption, quality (dose, fidelity) and maintenance (sustainability). Methods: An effectiveness-implementation hybrid design including a step–wedge cluster randomised control trial (SW-cRCT) was used to implement HIRAID® with 1300 + emergency nurses across 29 Australian rural, regional, and metropolitan EDs. Evaluation of our behaviour-change informed strategy was informed by the RE-AIM Scoring Instrument and measured using data from (i) a post HIRAID® implementation emergency nurse survey, (ii) HIRAID® Instructor surveys, and (iii) twelve-week and 6-month documentation audits. Quantitative data were analysed using descriptive statistics to determine the level of each component of RE-AIM achieved. Qualitative data were analysed using content analysis and used to understand the 'how' and 'why' of quantitative results. Results: HIRAID® was implemented in all 29 EDs, with 145 nurses undertaking instructor training and 1123 (82%) completing all four components of provider training at 12 weeks post-implementation. Modifications to the behaviour-change informed strategy were minimal. The strategy was largely used as intended with 100% dose and very high fidelity. We achieved extremely high individual sustainability (95% use of HIRAID® documentation templates) at 6 months and 100% setting sustainability at 3 years. Conclusion: The behaviour-change informed strategy for the emergency nursing framework HIRAID® in rural, regional, and metropolitan Australia was highly successful with extremely high reach and adoption, dose, fidelity, individual and setting sustainability across substantially variable clinical contexts. Trial registration: ANZCTR, ACTRN12621001456842. Registered 25 October 2021. [ABSTRACT FROM AUTHOR]

Background. Emergency nurses may experience various fatiguing duties and suffer more pressure, so it is necessary to promote their professional or work‐related quality of life, especially during tough periods. Aim. To describe the development of the multidimensional narrative support system and explore its effectiveness and feasibility among emergency nurses. Design. An action research was conducted in Shanghai, China, from 2022 to 2023. Methods. Two cycles of action research were adopted in the emergency departments of two tertiary general hospitals in Shanghai, China. A total of 20 and 13 emergency nurses from different posts participated in each cycle. Multiple methods and tools, such as validated instruments, self‐designed questionnaires, and individual and focus group interviews, were used to collect short‐ and long‐term data. The EQUATOR guidelines on reporting action research were used as the guideline for this study. Results. The multidimensional narrative support system was gradually modified to promote its feasibility. Involved emergency nurses actively participated in different activities and proposed relatively positive and satisfying remarks. Quantitative data showed the significantly instant or long‐lasting improvements in emergency nurses' professional and work‐related quality of life, as well as their self‐compassion, and perceived social support. Various categories were summarized about the participants' experiences, perceived long‐term effects, and suggestions on the multidimensional narrative support system. Conclusion. The multidimensional narrative support system integrates narrative methods and psychological activities and provides multidimensional support for emergency nurses. In spite of various challenges, the system shows good feasibility and significant influences on emergency nurses' well‐being and quality of life. Implications for Nursing Management. The multidimensional narrative support system may action as a novel intervention for the overall improvements of clinical emergency nurses, which can be recommended to other populations with targeted modifications and training, so as to achieve good generalization in different departments. [ABSTRACT FROM AUTHOR]

The aim Methods Results Conclusion To explore and describe workplace stress levels and health‐promoting behaviours reported by emergency nurses in China, and to investigate factors associated with workplace stress and health‐promoting lifestyle behaviours among emergency nurses.A cross‐sectional study was conducted between October 2019 and January 2020. Nurses (n = 1565) were recruited from the emergency departments of 54 hospitals within the Sichuan Province of West China. Each subject completed the Chinese versions of the Nurse Workplace Stress Scale, the Health‐Promoting Lifestyle Profile (HPLP‐II) and demographic questions. Linear regression analyses were used to identify associations between workplace stress and the health‐promoting lifestyle and risk factors correlated with these two measurements.Workplace stress was negatively associated with health‐promoting behaviours. Linear regression analysis showed that gender, marital status, whether wages met expected standards and professional rank were found to be associated with health promotion behaviours; marital status, whether income met expected standards, the number of night shifts per month and health promotion behaviours were found to be associated with workplace stress.Higher levels of workplace stress are associated with lower levels of engagement in health‐promoting behaviours, suggesting the potential for reducing workplace stress through the adoption of healthier habits. Policies should prioritize workplace stress by promoting healthy lifestyle initiatives. [ABSTRACT FROM AUTHOR]

Background: Emergency nurses play a pivotal role in delivering efficient emergency healthcare, yet they often encounter numerous challenges, especially while managing life-threatening cases, impacting both their well-being and patient satisfaction. This study seeks to identify the prevalent challenges faced by these nurses in Saudi hospitals when handling Canadian Triage and Acuity Scale (CTAS1 and CTAS2) cases, with the aim of mitigating or managing these issues in the future. Methods: This study incorporated a mixed-method approach to identify obstacles in Emergency Department (ED) nursing treatment of CTAS1 and CTAS2 cases in two major Saudi Arabian hospitals. The research began with qualitative focus group interviews with expert ED nurses, followed by a quantitative survey to measure and explore relationships among the qualitative findings. Data analysis leveraged qualitative thematic analysis and principal component analysis, ensuring rigorous examination and validation of data to drive meaningful conclusions. Findings: From expert interviews, key challenges for emergency nurses were identified, including resource management, communication, training compliance, and psychological factors. A survey of 172 nurses further distilled these into five major issues: patient care management, handling critical cases, administration support, patient care delay, and stress from patients' families. Conclusion: Through a mixed-method approach, this study pinpoints five pivotal challenges confronting emergency nurses in Saudi hospitals. These encompass difficulties in patient care management, the psychological toll of handling critical cases, inadequate administrative support, delays due to extended patient stays, and the stress induced by the presence of patients' families, all of which significantly impede emergency department efficiency and compromise nurse well-being. [ABSTRACT FROM AUTHOR]

Background: Nursing work in the Eye, Ear, Nose, and Throat (EENT) emergency department is highly specialised and faces significant challenges. Therefore, a high level of nursing competence is necessary for nurses. To develop core competencies, a systematic and standardised training program is required. This study aims to construct a standardised, systematic, and professional training program for nurses working in the EENT emergency department in China. Methods: Based on a literature review and semi-structured interviews, the training scheme draft was developed according to the theoretical framework of core competency for emergency nurses. From July 2023 to October 2023, a total of 21 experts including clinical experts, and nursing experts were selected to conduct 2 rounds of Delphi consultation to construct the training program for EENT emergency nurses. Results: The effective response rate for 2 rounds of expert consultation was 100%. The expert authority coefficient was 0.905, and Kendall's W coefficients were found to be 0.359 and 0.340, respectively. The coefficients of variation for each item of the second round of expert consultation ranged from 0 to 0.19. The finalised training program for EENT emergency nurses consisted of 4 first-level indexes (training objectives, training management, training contents, and training assessment). The training objectives included 3 secondary indicators and 16 tertiary indicators. Training management included 5 secondary indicators and 8 tertiary indicators. Training contents included 4 secondary indicators and 16 tertiary indicators. Training assessment included 3 secondary indicators and 6 tertiary indicators. Conclusion: This study systematically and comprehensively explores the cultivation of nurses working in the EENT emergency department from the aspects of training objectives, training management, training contents, and training assessment. This training program is based on the theoretical framework of core competency standards for emergency nurses. It is in line with the actual needs of the clinic, and the training program is scientific and reliable, which can be promoted nationwide to provide a reference basis for the improvement of the training of emergency specialist nurses. Trial registration: Not applicable. [ABSTRACT FROM AUTHOR]

AbstractObjectiveDesignSettingSubjectsMain outcome measuresResultsConclusions\nKEY POINTSTo investigate whether the location and the number of nurse consultations have changed in response to the continuously decreasing number of GP consultations in the fourth-largest city in Finland. It has been suggested that nurse consultations are replacing GP consultations.A retrospective register-based follow-up cohort study.Public primary health care in the City of Vantaa, Finland.All documented face-to-face office-hour consultations with practical and registered nurses, and consultations with practical and registered nurse in the emergency department of Vantaa primary health care between 1 January 2009 and 31 December, 2014.Change in the number of consultations with practical and registered nurses between 2009 and 2014 in primary health care both during office-hours and in the emergency department.Over the follow-up period, the monthly median number of practical nurse consultations in the emergency department per 1000 inhabitants increased from 1.6 (interquartile range [IQR] 1.3–1.7) to 10.5 (10.3–12.2) (p < 0.001) and registered nurse consultations from a median of 3.6 (3.0–4.0) to 14.5 (13.0–16.6) (p < 0.001). However, there was no significant change in the median monthly number of office-hour consultations with practical or registered nurses.It appears that in primary health care, medical consultations have shifted from GPs to nurses with lower education levels, and from care during office-hours to emergency care.The number of general practitioner (GP) consultations are decreasing. Tasks are being transferred from GPs to nurses to improve access to care.The number of office-hour consultations with nurses did not change, despite the decrease in GP consultations.In the emergency department, the number of nurse consultations increased significantly when GP consultations decreased.Medical consultations seem to have shifted to the emergency department and the nurses.The number of office-hour consultations with nurses did not change, despite the decrease in GP consultations.In the emergency department, the number of nurse consultations increased significantly when GP consultations decreased.Medical consultations seem to have shifted to the emergency department and the nurses. [ABSTRACT FROM AUTHOR]

Introduction: As opioid overdose deaths continue to rise, the emergency department (ED) remains an important point of contact for many at risk for overdose. In this study our purpose was to better understand the attitudes, beliefs, and knowledge of ED nurses in caring for patients with opioid use disorder (OUD). We hypothesized a difference in training received and attitudes toward caring for patients with OUD between nurses with <5 years and ≥6 years of clinical experience. Methods: We conducted a survey among ED nurses in a large academic medical center from May-July 2022. All ED staff nurses were surveyed. Data entry instruments for the nursing surveys were programmed in Qualtrics, and we analyzed results R using a chi-square test or Fisher exact test to compare nurses with <5 years and ≥6 years of clinical experience. A P-value of < 0.05 was considered statistically significant. Results: We distributed 74 surveys, and 69 were completed (93%). Attitudes toward naloxone distribution from the ED were positive, with 72% of respondents reporting they were “very” or “extremely” supportive of distributing naloxone kits to individuals at risk of overdose. While attitudes were positive, barriers included limited time, lack of system support, and cost. Level of comfort in caring for patients with OUD was high, with 78% of respondents “very” or “extremely” comfortable. More education is needed on overdose education and naloxone distribution (OEND) with respondents 38% and 45% “a little” or “somewhat” comfortable, respectively. Nurses with <5 years of experience reported receiving more training on OEND in nursing school compared to those with ≥6 years of experience (P = 0.03). There were no significant differences in reported attitudes, knowledge, or comfort in caring for patients with OUD. Conclusion: In this single-center survey, we found ED nurses were supportive of overdose education and naloxone distribution. There are opportunities for targeted education and addressing systemic barriers to OEND. All interventions should be evaluated to gauge impact on knowledge, attitudes, and behaviors. [ABSTRACT FROM AUTHOR]

Background: Workplace violence (WPV) in Emergency Departments (EDs) is an increasingly recognized challenge healthcare providers face in low-resource settings. While studies have highlighted the increased prevalence of WPV in healthcare, most of the existing research has been conducted in developed countries with established laws and repercussions for violence against healthcare providers. More data on WPV against ED providers practicing in low-resource settings is necessary to understand these providers' unique challenges. Objective: This study aims to gain insight into the incidence and characteristics of WPV among ED healthcare providers in India. Methods: This study was conducted at two EDs in geographically distinct regions of India. A survey was designed to assess violence in EDs among healthcare providers. Surveys were distributed to ED workplace providers, completed by hand, and returned anonymously. Data was entered and stored in the RedCAP database to facilitate analysis. Results: Two hundred surveys were completed by physicians, nurses, and paramedics in Indian EDs. Most reported events involved verbal abuse (68%), followed by physical abuse (26%), outside confrontation (17%), and stalking (5%). By far, the most common perpetrators of violence against healthcare workers were bystanders including patient family members or other accompanying individuals. Notably, reporting was limited, with most cases conveyed to ED or hospital administration. Conclusion: These results underscore the prevalence of WPV among Indian ED healthcare providers. High rates of verbal abuse followed by physical abuse are of concern. Most perpetrators of WPV against healthcare providers in this study were patient family members or bystanders rather than the patients themselves. It is imperative to prioritize implementing prevention strategies to create safer work environments for healthcare workers. [ABSTRACT FROM AUTHOR]

The aim of the Research to Practice column is to enhance the research critique abilities of both advanced practice registered nurses and emergency nurses (RNs), while also aiding in the translation of research findings into clinical practice. Each column focuses on a specific topic and research study. In this article, we used two patient scenarios as a framework to delve into the 2023 secondary analysis of Papp and Emerman’s study on “Disparities in Emergency Department Naloxone and Buprenorphine Initiation.” [ABSTRACT FROM AUTHOR]

BackgroundAimDesign and MethodsFindingsConclusionsSepsis is a frequent cause of global deaths with time critical diagnosis and treatment impacting outcomes. Prehospital emergency nurses are pivotal in assessment that influences timely diagnosis.To gain a deep understanding of nurse’s experiences when caring for those with suspected sepsis.A qualitative study using semi-structured interviews and inductive content analysis according to the Elo Kyngäs method.Early identification of sepsis by prehospital emergency nurses (n = 13) was augmented through a combination of clinical experience and the implementation of practice guidelines. There were three key components to practice improvement a) clinical experience, b) continuous education and c) explicit guidelines.Identification of sepsis in the prehospital environment can shorten the time to treatment for patients with sepsis. Early identification can be achieved by continuous education in the Emergency Medical Service (EMS), ensuring experienced personnel and including the EMS in medical guidelines. [ABSTRACT FROM AUTHOR]

Healthcare is often conducted by interprofessional teams. Research has shown that diverse groups with their own terminology and culture greatly influence collaboration and patient safety. Previous studies have focused on interhospital teams, and very little attention has been paid to team collaboration between intrahospital and prehospital care. Addressing this gap, the current study simulated a common and time-critical event for ambulance nurses (AN) that also required contact with a stroke specialist in a hospital. Today such consultations are usually conducted over the phone, this simulation added a video stream from the ambulance to the neurologist on call. The aim of this study was to explore interprofessional collaboration between AN's and neurologists when introducing video-support in the prehospital stroke chain of care. The study took place in Western Sweden. The simulated sessions were video recorded, and the participants were interviewed after the simulation. The results indicate that video has a significant impact on collaboration and can help to facilitate better understanding among different professional groups. The participants found the video to be a valuable complement to verbal information. The result also showed challenges in the form of a loss of patient focused care. Both ANs and neurologists saw the video as benefiting patient safety. [ABSTRACT FROM AUTHOR]

Aim: To determine the association between nurse and institutional characteristics and perceived professional nurse knowledge and self‐efficacy of reporting child abuse and neglect. Design: A sample of N = 166 nurses were recruited to respond to the Reporting of Suspected Child Abuse and Neglect (RSCAN) survey. Methods: A multiple linear regression examined whether nurse characteristics and institutional characteristics were associated with the two RSCAN survey domain scores. Results: Perceived knowledge of a workplace child abuse and neglect protocol was associated with the knowledge subscale. Education and child abuse and neglect expertise were significant predictors of the self‐efficacy subscale. Nurses with a master's or higher degree and those who identified as being either forensic, paediatric or Emergency Department nurses, had less perceived institutional barriers to self‐efficacy of reporting child abuse and neglect. Conclusion: This study provides a preliminary insight into the institutional barriers and facilitators of nurses as child abuse and neglect mandated reporters. Implications for the profession and/or patient care: To encourage innovative education and collaborations to support nurses as fully informed child abuse and neglect mandated reporters. Impact: This research identifies the gaps and facilitators of nurses as child abuse and neglect mandated reporters to inform healthcare professionals and academic institutions on the importance of nurse education and experience in nurse knowledge and self‐efficacy in reporting suspected child abuse and neglect. Reporting methods: The authors of this study have adhered to relevant EQUATOR guidelines: STROBE. Patient or public contribution: There is no patient or public contribution as the study only looked at nurses. [ABSTRACT FROM AUTHOR]

Background: Mental workload (MW) and occupational fatigue (OF) are among the harmful factors in the working environment of the emergency nursing profession, which can be related to the quality of care provided and job stress (JS) in emergency nurses. Accordingly, this study investigates the relationship between MW, MF and JS in emergency nurses in 2023 in Ardabil, Iran. Materials and Methods: This cross-sectional study was conducted by measuring OF, JS and MW of emergency nurses in hospitals of Ardabil Province, Iran. Information was collected through a checklist that recorded the demographic information in addition to the NASA task load index, JS by Orly and Giordano and the Swedish OF inventory questionnaires. The statistical analysis was conducted by the SPSS software, version 22. Results: The mean mental state of the participants was 16.7±3.6. Meanwhile, 40% of nurses had a high mental load. The mean condition of the OF was high (49.02±4.2; 23.2%). Regarding JS, 45.5%, 25.9% and 28.6% were the high, medium, and low levels, respectively. A direct and significant relationship was detected between MW, JS and OF (P<0.05). Conclusion: The mean MW, JS and OF among emergency nurses were high. Almost half and about a quarter of the emergency nurses are under JS and OF, respectively. Therefore, to improve emergency nurses' health conations, and productivity, and create safe conditions in emergencies, the control and management of this harmful occupational factor should be under continuous monitoring. [ABSTRACT FROM AUTHOR]

Aim Design Methods Results Conclusion Impact Statement Reporting Method Patient or Public Contribution To examine the experiences of emergency nurses and develop a substantive theory that describes the processes they use to support or prevent sustainability in their nursing practice.Constructivist grounded theory.Between February 2018 and January 2019, observations and semi‐structured interviews were conducted with 29 emergency nurses. Data underwent constant comparison, and coding was performed in three phases: open, focused, and theoretical, employing constructivist grounded theory. Additionally, some situational analysis mapping was undertaken and integrated as a method to explore the broader context affecting nursing practice. The study achieved theoretical saturation and rigour was ensured through evaluations of credibility, transferability, and confirmability.A substantive grounded theory was constructed to describe the basic social process of ‘Achieving Personal and Professional Sustainability’ with subprocesses that included ‘Driving forces’, ‘Developing and using armouries’, ‘Balancing work‐life’, and ‘Making emergency work effective’. This theory delineates two phases, ‘exploration and establishment’ and ‘maintenance’, and two key properties: ‘Constructing and evolving professional identity’ and ‘Perceiving and reshaping the meaning of effective work and care’. The theory also highlights the dynamic interplay of individual, social, and institutional elements.‘Achieving Personal and Professional Sustainability’ is important for emergency nurses to sustain themselves personally and professionally in their work.This research has substantial and global impacts. Emergency nursing can use this information as a guide to better understand strategies for both personal and professional sustainability. Policymakers may use the findings to foster a supportive work environment and enhance nurse well‐being. Implementation of recommendations can lead to improved patient care outcomes. The methodological approach offers potential for future research, positively impacting emergency nursing practice and workforce sustainability worldwide.Reporting adheres to EQUATOR's COREQ guidelines for qualitative studies.No patient or public contribution. [ABSTRACT FROM AUTHOR]

Blood Sampling Guidelines have been developed to target European emergency medicine-related professionals involved in the blood sampling process (e.g. physicians, nurses, phlebotomists working in the ED), as well as laboratory physicians and other related professionals. The guidelines population focus on adult patients. The development of these blood sampling guidelines for the ED setting is based on the collaboration of three European scientific societies that have a role to play in the preanalytical phase process: EuSEN, EFLM, and EUSEM. The elaboration of the questions was done using the PICO procedure, literature search and appraisal was based on the GRADE methodology. The final recommendations were reviewed by an international multidisciplinary external review group. The document includes the elaborated recommendations for the selected sixteen questions. Three in pre-sampling, eight regarding sampling, three post-sampling, and two focus on quality assurance. In general, the quality of the evidence is very low, and the strength of the recommendation in all the questions has been rated as weak. The working group in four questions elaborate the recommendations, based mainly on group experience, rating as good practice. The multidisciplinary working group was considered one of the major contributors to this guideline. The lack of quality information highlights the need for research in this area of the patient care process. The peculiarities of the emergency medical areas need specific considerations to minimise the possibility of errors in the preanalytical phase. [ABSTRACT FROM AUTHOR]