International Emergency Nursing最新文献_第2页

Reframing barriers to evidence-based practice in early pregnancy bleeding: Insights from nursing theory and implementation science 重构妊娠早期出血循证实践的障碍：护理理论和实施科学的见解。

IF 1.8 4区医学 Q2 NURSING

International Emergency Nursing

Pub Date : 2026-03-01 Epub Date: 2026-02-27 DOI: 10.1016/j.ienj.2026.101779

Iman Nurjaman, Intihan Nurzaeni, Ina Saparlina

引用次数: 0

Urgent care in Australia: Unblocking nurse practitioner capacity to address systemic access issues 紧急护理在澳大利亚：解锁护士执业能力，以解决系统访问问题

IF 1.8 4区医学 Q2 NURSING

International Emergency Nursing

Pub Date : 2026-03-01 Epub Date: 2026-01-16 DOI: 10.1016/j.ienj.2025.101741

Natasha Jennings , Vanessa Clothier

引用次数: 0

Mapping the advanced practice nursing in emergency and intensive care units: A scoping review 绘制高级实践护理在急诊和重症监护室：范围审查。

IF 1.8 4区医学 Q2 NURSING

International Emergency Nursing

Pub Date : 2026-03-01 Epub Date: 2026-02-10 DOI: 10.1016/j.ienj.2026.101764

Oscar Fidel Antunez Martinez , Yoselin Isabel Vallejo Bustamante , Nelson Orlando Varela Zuniga

Background

Advanced Practice Nurses (APNs), including Nurse Practitioners and Clinical Nurse Specialists, contribute significantly to quality, efficiency, and leadership in emergency departments (EDs) and intensive care units (ICUs). However, role variability, inconsistent regulation, and limited post-pandemic evidence remain challenges.

Purpose

To synthesize recent global evidence on APN roles, competencies, outcomes, and implementation challenges in EDs and ICUs, and identify strategies for effective integration.

Method

A scoping review, following Arksey and O’Malley’s framework and PRISMA-ScR guidelines, searched six databases. Eligible sources focused on APNs in EDs or ICUs. Two reviewers independently screened, extracted, and synthesized data descriptively and thematically.

Findings

Twenty-five studies were included, showing APNs’ main competences as advanced clinical reasoning, procedural skills, leadership, and evidence-based practice. Challenges involved role ambiguity, regulatory gaps, and limited autonomy. Post-COVID-19 developments expanded APN responsibilities but exposed workforce and educational gaps. Solutions proposed included standardized competencies, policy reform, postgraduate education, and interprofessional collaboration.

Conclusions

APNs enhance outcomes and efficiency in EDs and ICUs, but variability in role definitions limits impact. The current body of evidence surrounding APN practice in ICUs and EDs is primarily based on studies with low levels of evidence. Future implementation should be accompanied by rigorous evaluations to generate robust statistical evidence that supports the transferability of APN-led models.

背景：高级执业护士（apn），包括执业护士和临床专科护士，对急诊科（EDs）和重症监护病房（ICUs）的质量、效率和领导能力做出了重要贡献。然而，角色可变性、不一致的监管和有限的大流行后证据仍然是挑战。目的：综合最近全球关于急诊和icu中APN角色、能力、结果和实施挑战的证据，并确定有效整合的策略。方法：根据Arksey和O'Malley的框架和PRISMA-ScR指南，检索了6个数据库。合格的来源集中在急诊室或icu的apn。两名审稿人独立筛选、提取和合成数据，描述和主题。结果：纳入25项研究，显示apn的主要能力为高级临床推理、程序技能、领导能力和循证实践。挑战包括角色模糊、监管空白和有限的自主权。covid -19后的发展扩大了APN的职责，但暴露了劳动力和教育方面的差距。提出的解决方案包括标准化能力、政策改革、研究生教育和跨专业合作。结论：apn提高了急诊科和icu的预后和效率，但角色定义的可变性限制了影响。目前关于icu和急诊科APN实践的证据主要基于证据水平较低的研究。未来的实施应伴随着严格的评估，以产生强有力的统计证据，支持apn主导的模型的可转移性。

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引用次数: 0

Use of virtual clinical education in emergency nursing care: a scoping review 虚拟临床教育在急诊护理中的应用：范围综述。

IF 1.8 4区医学 Q2 NURSING

International Emergency Nursing

Pub Date : 2026-03-01 Epub Date: 2026-02-21 DOI: 10.1016/j.ienj.2026.101776

Liesel Smit , Tanya Heyns , Maria Elizabeth Cochrane , Marlize Kuhn

Background

Head-mounted devices (HMDs), such as smart glasses, are being implemented to deliver virtual clinical education (VCE) in emergency care, yet their value and practical limitations remain unclear.

Objective

To synthesise evidence on HMDs enabled VCE usage by healthcare professionals and students in emergency care, and to identify reported benefits and challenges.

Methods

A Joanna Briggs Institute (JBI) guided scoping review was conducted. Five databases and grey literature sources were searched, without date restrictions, for English-language studies describing HMD use for VCE in emergency care. Sixteen studies met the eligibility criteria. Data were charted and summarised descriptively.

Results

Most studies (50%) were published after 2021, originating from high-income countries. Reported advantages included enhanced two-way communication, faster clinical decision-making, hands-free documentation and remote supervision. Recurrent barriers were short battery life, unstable connectivity, restricted field-of-view, hygiene concerns and medicolegal uncertainty. Small sample sizes, heavy reliability of simulated environments and varied use of outcome measures limits generalisability of the findings.

Conclusion

Early evidence suggests that VCE using HMDs, can enrich emergency care, workflow and teaching, but technical, human-factors and regulatory obstacles persist. Larger, multi-centre studies using standardised metrics and real-world deployment are required before routine adoption can be recommended.

背景：头戴式设备（hmd），如智能眼镜，正被用于在急诊护理中提供虚拟临床教育（VCE），但其价值和实际局限性尚不清楚。目的：综合医疗保健专业人员和学生在急诊护理中使用hmd的证据，并确定报告的益处和挑战。方法：采用乔安娜布里格斯研究所（Joanna Briggs Institute， JBI）指导的范围评估方法。在没有日期限制的情况下，检索了五个数据库和灰色文献来源，以获取描述HMD在急诊护理中用于VCE的英语研究。16项研究符合入选标准。将数据绘制成图表并进行描述性总结。结果：大多数研究（50%）发表于2021年之后，来自高收入国家。报告的优势包括增强双向沟通，更快的临床决策，免提文件和远程监督。常见的障碍包括电池寿命短、连接不稳定、视野受限、卫生问题和医学上的不确定性。样本量小，模拟环境的高可靠性和结果测量方法的不同使用限制了研究结果的普遍性。结论：早期证据表明，使用hmd可以丰富急诊护理、工作流程和教学，但技术、人为因素和监管方面的障碍仍然存在。在推荐常规采用之前，需要使用标准化指标和实际部署进行更大规模的多中心研究。

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引用次数: 0

Building clinical confidence, the impact of de-escalation training on nurses’ management of aggression: An integrative review 建立临床信心，降级训练对护士攻击管理的影响：一项综合回顾。

IF 1.8 4区医学 Q2 NURSING

International Emergency Nursing

Pub Date : 2026-03-01 Epub Date: 2026-01-19 DOI: 10.1016/j.ienj.2026.101745

Omar Almulla, Eman Tawash, Maryam Alaradi, Bindhu Nair

Objective

This integrative literature review aimed to examine the impact of de-escalation training on nurses’ ability to recognise and manage aggressive patient behaviour with a particular focus on emergency care settings.

Design

An integrative review of the literature.

Data Sources

A comprehensive search was conducted across multiple databases including PubMed, CINAHL (EBSCO), and Scopus. Peer-reviewed articles published between 2013 and 2023 were considered. Search terms included “de-escalation techniques”, “workplace violence” and “emergency department staff”.

Review Methods

Nine studies met the inclusion criteria and were critically appraised using the Mixed Methods Appraisal Tool. Data were analysed thematically to identify recurring patterns and concepts.

Results

Three main themes emerged: 1) the impact of de-escalation training on nurses’ confidence and clinical practice, 2) the effectiveness of de-escalation training in reducing the frequency and severity of violent incidents, and 3) the recurring factors contributing to the emergence of aggression in healthcare settings. De-escalation training was found to consistently improve nurses’ self-efficacy and patient-centred practices, though its direct impact on reducing violent incidents varied across contexts.

Conclusions

De-escalation training demonstrates strong potential to improve nurses’ responses to aggression in emergency care settings. However, its effectiveness is closely linked to contextual factors such as organisational support, environmental conditions, and staff resources. Future research should explore longitudinal impacts, optimal training modalities, and the integration of broader systemic strategies to support violence prevention in emergency departments.

目的：本综合文献综述旨在研究降级培训对护士识别和管理患者攻击行为能力的影响，特别是在急诊护理环境中。设计：对文献进行综合综述。数据来源：在PubMed、CINAHL （EBSCO）和Scopus等多个数据库中进行了全面的搜索。2013年至2023年间发表的同行评议文章被纳入考虑范围。搜索词包括“降级技术”、“工作场所暴力”和“急诊室工作人员”。回顾方法：9项研究符合纳入标准，并使用混合方法评价工具进行批判性评价。对数据进行了专题分析，以确定重复出现的模式和概念。结果：出现了三个主要主题：1)降级培训对护士信心和临床实践的影响，2)降级培训在减少暴力事件发生频率和严重程度方面的有效性，以及3)导致医疗环境中攻击行为出现的反复因素。降级培训被发现能够持续提高护士的自我效能和以病人为中心的做法，尽管其对减少暴力事件的直接影响因环境而异。结论：降级培训显示了在急诊护理环境中提高护士对攻击反应的强大潜力。然而，其有效性与组织支持、环境条件和人员资源等背景因素密切相关。未来的研究应探讨纵向影响，最佳培训模式，以及更广泛的系统战略的整合，以支持急诊部门的暴力预防。

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引用次数: 0

Factors associated with stroke prenotification in emergency medical service among stroke code patients: A retrospective analysis 卒中码患者急诊医疗服务中卒中预报相关因素的回顾性分析

IF 1.8 4区医学 Q2 NURSING

International Emergency Nursing

Pub Date : 2026-03-01 Epub Date: 2026-02-09 DOI: 10.1016/j.ienj.2026.101766

Yuan Li , Sidarrth Prasad , Suzanne Stone , Aubrey Day , Thuy-Tien Ho , Mehari Gebreyohanns , Erica Jones , Nneka Ifejika , Kim Barker , Jane A. Anderson , Sean I. Savitz , Salvador Cruz-Flores , Amber Salter , Yohan Kim , DaiWai M. Olson

Background

Emergency medical service stroke prenotification (EMS-SP) and stroke code activation improves stroke process measures for patients transported to the emergency department (ED) with stroke symptoms. We aimed to identify predictors of EMS-SP.

Methods

This retrospective analysis includes data collected from an ongoing quality improvement project at a University hospital for all adult stroke code activations for the last 4 months of 2024 and first month of 2025. Multivariable models were used to explore associations between patient demographics, clinical characteristics, and having EMS-SP versus not having EMS-SP.

Results

The mean age of the 149 patients in our sample was 67.2 (14.7) years, 85 (57%) were female, 107 (71.8%) were white, 23 (15.4%) were Hispanic, and 95 (63.8%) were determined to be mimics. There were no statistically significant differences in demographics for the 65 (43.6%) patients without EMS-SP versus the 84 (56.4%) patients with EMS-SP. Logistic model shows non-White race was associated with a higher odds of EMS-SP (OR, 2.44; 95%CI = 1.04–5.72); aphasia assessment being performed was associated with a higher odds of EMS-SP (OR, 6.89; 95%CI = 2.82–15.86); a nominally higher odds of EMS-SP was noted for every 5 year increase in age (OR, 1.11; 95%CI = 0.97–1.27); and a higher odds of EMS-SP was noted for every 10 mmHg increase in diastolic blood pressure (OR, 1.24; 95%CI = 1.02–1.47).

Conclusions

Patients with aphasia assessment done, who were older, not White, and had higher diastolic blood pressures were more likely to have EMS-SP. Pre-hospital stroke management, including education and feedback for emergency medical service, is warranted.

背景：紧急医疗服务卒中预通知（EMS-SP）和卒中代码激活改善了卒中症状患者被送往急诊科（ED）的卒中过程措施。我们的目的是确定EMS-SP的预测因素。方法：本回顾性分析包括从一所大学医院正在进行的质量改进项目中收集的2024年最后4个月和2025年第一个月所有成人卒中代码激活的数据。多变量模型用于探讨患者人口统计学、临床特征和是否患有EMS-SP之间的关系。结果：149例患者的平均年龄为67.2（14.7）岁，女性85例（57%），白人107例（71.8%），西班牙裔23例（15.4%），模仿者95例（63.8%）。65例（43.6%）无EMS-SP患者与84例（56.4%）有EMS-SP患者的人口统计学差异无统计学意义。Logistic模型显示，非白种人与较高的EMS-SP发生率相关（OR, 2.44; 95%CI = 1.04-5.72）；进行失语症评估与较高的EMS-SP几率相关（OR, 6.89; 95%CI = 2.82-15.86）；年龄每增加5岁，EMS-SP的几率名义上就会增加（OR, 1.11; 95%CI = 0.97-1.27）；舒张压每升高10毫米汞柱，EMS-SP的几率就会增加（OR, 1.24; 95%CI = 1.02-1.47）。结论：完成失语评估的患者，年龄较大，非White，舒张压较高，更容易发生EMS-SP。院前卒中管理，包括紧急医疗服务的教育和反馈，是必要的。

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引用次数: 0

Interactive effects of cardiac arrest duration and lactate levels on six-month mortality in patients surviving cardiac arrest and cardiopulmonary resuscitation 心脏骤停持续时间和乳酸水平对心脏骤停和心肺复苏存活患者6个月死亡率的相互作用

IF 1.8 4区医学 Q2 NURSING

International Emergency Nursing

Pub Date : 2026-03-01 Epub Date: 2026-02-14 DOI: 10.1016/j.ienj.2026.101765

Jianping Lu , Yuqi Zeng , Nan Lin , Qinyong Ye

Background

The duration of cardiac arrest (CA) and the level of lactate within 24 h of CA are both associated with a poor prognosis in patients who have received cardiopulmonary resuscitation (CPR) but their combined effect remains unclear.

Objectives

Assess the independent associations of CA duration and post-resuscitation lactate level with 6-month mortality in patients undergoing CPR.

Hypotheses

CA duration and post-resuscitation lactate level have a multiplicative and additive interaction, such that their combined effect on mortality is greater than the sum of their individual effects.

Methods

A retrospective cohort study was conducted on patients who underwent CPR and achieved return of spontaneous circulation (ROSC) in the emergency department (ED) of XX Hospital from January 2018 to June 2022. Inclusion criteria included: (1) aged ≥ 18 years; (2) successful CPR with ROSC lasting ≥ 1 h; (3) available CA duration and post-resuscitation lactate level data; (4) 6-month follow-up completed. Exclusion criteria included: (1) systolic blood pressure ≤ 40 mmHg on ED presentation; (2) pre-existing severe liver or kidney dysfunction; (3) missing key data.

Results

CA duration and the level of lactate within 24 h of CA were independently associated with the mortality of post-arrest survivors of CPR at six months (odds ratio [OR] = 1.065; 95% confidence interval [CI]: 1.032–1.098; P < 0.001, and OR = 0.323; 95% CI: 0.104–0.997; P = 0.049, respectively). The sensitivity and specificity of CA duration for the prognosis of death were 68.0% and 88.4%, respectively, using a cut-off value of 20.5 min. The area under curve (AUC) was 0.805 (95% CI: 0.745–0.866). Furthermore, these factors were associated, in a multiplicative manner, with death, with an adjusted OR of 1.010 (95% CI: 1.006–1.013). The additive interaction between these factors was associated with death, with a synergy index (SI) of 1.0985 (95%: CI 1.0746–1.1229).

Conclusion

CA time and lactate level after CA were associated with the six-month mortality of post-arrest CPR survivors and has both multiplicative and additive interaction.

背景：心脏骤停（CA）持续时间和CA后24小时内乳酸水平均与接受心肺复苏（CPR）的患者预后不良相关，但其综合影响尚不清楚。目的评估心肺复苏术患者CA持续时间和复苏后乳酸水平与6个月死亡率的独立关系。假设ca持续时间和复苏后乳酸水平具有乘法和加性相互作用，因此它们对死亡率的综合影响大于其单个影响的总和。方法回顾性队列研究2018年1月至2022年6月XX医院急诊科（ED）行心肺复苏术并实现自主循环恢复（ROSC）的患者。纳入标准包括：(1)年龄≥18岁；(2) CPR成功且ROSC持续≥1 h；(3)可用CA持续时间和复苏后乳酸水平数据；(4)随访6个月。排除标准包括：(1)出现ED时收缩压≤40 mmHg；(2)既往存在严重肝肾功能障碍的；(3)关键数据缺失。结果心脏骤停持续时间和心脏骤停24 h内乳酸水平与心肺复苏术术后6个月生存率独立相关（优势比[OR] = 1.065； 95%可信区间[CI]: 1.032 ~ 1.098; P < 0.001, OR = 0.323; 95% CI: 0.104 ~ 0.997; P = 0.049）。CA持续时间对死亡预后的敏感性和特异性分别为68.0%和88.4%，临界值为20.5 min。曲线下面积（AUC）为0.805 （95% CI: 0.745 ~ 0.866）。此外，这些因素以乘法方式与死亡相关，校正OR为1.010 （95% CI: 1.006-1.013）。这些因素之间的加性相互作用与死亡相关，协同指数（SI）为1.0985 （95% CI 1.0746 ~ 1.1229）。结论CA时间和CA后乳酸水平与骤停后CPR存活者6个月死亡率相关，且存在乘法和加法相互作用。

{"title":"Interactive effects of cardiac arrest duration and lactate levels on six-month mortality in patients surviving cardiac arrest and cardiopulmonary resuscitation","authors":"Jianping Lu , Yuqi Zeng , Nan Lin , Qinyong Ye","doi":"10.1016/j.ienj.2026.101765","DOIUrl":"10.1016/j.ienj.2026.101765","url":null,"abstract":"<div><h3>Background</h3><div>The duration of cardiac arrest (CA) and the level of lactate within 24 h of CA are both associated with a poor prognosis in patients who have received cardiopulmonary resuscitation (CPR) but their combined effect remains unclear.</div></div><div><h3>Objectives</h3><div>Assess the independent associations of CA duration and post-resuscitation lactate level with 6-month mortality in patients undergoing CPR.</div></div><div><h3>Hypotheses</h3><div>CA duration and post-resuscitation lactate level have a multiplicative and additive interaction, such that their combined effect on mortality is greater than the sum of their individual effects.</div></div><div><h3>Methods</h3><div>A retrospective cohort study was conducted on patients who underwent CPR and achieved return of spontaneous circulation (ROSC) in the emergency department (ED) of XX Hospital from January 2018 to June 2022. Inclusion criteria included: (1) aged ≥ 18 years; (2) successful CPR with ROSC lasting ≥ 1 h; (3) available CA duration and post-resuscitation lactate level data; (4) 6-month follow-up completed. Exclusion criteria included: (1) systolic blood pressure ≤ 40 mmHg on ED presentation; (2) pre-existing severe liver or kidney dysfunction; (3) missing key data.</div></div><div><h3>Results</h3><div>CA duration and the level of lactate within 24 h of CA were independently associated with the mortality of post-arrest survivors of CPR at six months (odds ratio [OR] = 1.065; 95% confidence interval [CI]: 1.032–1.098; <em>P</em> < 0.001, and OR = 0.323; 95% CI: 0.104–0.997; <em>P =</em> 0.049, respectively). The sensitivity and specificity of CA duration for the prognosis of death were 68.0% and 88.4%, respectively, using a cut-off value of 20.5 min. The area under curve (AUC) was 0.805 (95% CI: 0.745–0.866). Furthermore, these factors were associated, in a multiplicative manner, with death, with an adjusted OR of 1.010 (95% CI: 1.006–1.013). The additive interaction between these factors was associated with death, with a synergy index (SI) of 1.0985 (95%: CI 1.0746–1.1229).</div></div><div><h3>Conclusion</h3><div>CA time and lactate level after CA were associated with the six-month mortality of post-arrest CPR survivors and has both multiplicative and additive interaction.</div></div>","PeriodicalId":48914,"journal":{"name":"International Emergency Nursing","volume":"85 ","pages":"Article 101765"},"PeriodicalIF":1.8,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146174154","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Barriers encountered by walk-in international patients in hospital emergency departments in Japan: A qualitative study 日本医院急诊科国际病人免预约障碍：一项质性研究。

IF 1.8 4区医学 Q2 NURSING

International Emergency Nursing

Pub Date : 2026-03-01 Epub Date: 2026-02-15 DOI: 10.1016/j.ienj.2026.101768

Shoko Asakawa , Yuko Takeda , Richard Henker

Introduction

The rise in international residents and visitors has increased the number of patients from diverse cultural and linguistic backgrounds in Japanese emergency departments (EDs). However, the challenges encountered by walk-in international patients seeking emergency care remain underexplored, highlighting the need for a better understanding of these barriers and the care provided by ED nurses. This study aimed to investigate the barriers perceived by walk-in international patients visiting EDs in Japan and their perceived experiences of the support provided by ED nurses.

Methods

We adopted a qualitative descriptive approach utilizing purposive sampling and the snowball technique. Semi-structured virtual interviews were conducted with 15 international patients to explore their experiences in Japanese EDs. Data were analyzed using reflexive thematic analysis, and the Standards for Reporting Qualitative Research checklist ensured comprehensive reporting.

Results

The analysis revealed four major themes: “conflict of culture,” “provider-centered care,” “hesitation to engage in culturally sensitive care,” and “building connections beyond language barriers.”

Conclusion

This study highlights the challenges of providing emergency care to international patients in Japan, and stresses the need for culturally competent care to improve patient safety and treatment quality.

导读：国际居民和访客的增加增加了日本急诊科（EDs）中来自不同文化和语言背景的患者数量。然而，寻求紧急护理的非预约国际患者所遇到的挑战仍未得到充分探讨，这突出表明需要更好地了解这些障碍和急诊科护士提供的护理。本研究旨在探讨免预约到日本急诊科就诊的国际患者所感受到的障碍，以及他们对急诊科护士所提供支持的感知体验。方法：采用有目的抽样和滚雪球法进行定性描述。对15名国际患者进行了半结构化的虚拟访谈，以探讨他们在日本急诊室的经历。数据分析采用反身性专题分析，定性研究报告标准检查表确保全面报告。结果：分析揭示了四个主要主题：“文化冲突”、“以提供者为中心的护理”、“参与文化敏感护理的犹豫”和“建立超越语言障碍的联系”。结论：本研究强调了在日本为国际患者提供急诊护理的挑战，并强调需要文化上合格的护理，以提高患者安全和治疗质量。

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引用次数: 0

The application of HFMEA in integrated transport for pediatric emergencies and critical conditions HFMEA在儿科急诊和危重情况综合运输中的应用

IF 1.8 4区医学 Q2 NURSING

International Emergency Nursing

Pub Date : 2026-03-01 Epub Date: 2026-01-28 DOI: 10.1016/j.ienj.2026.101748

Yuru Zhang , Zhushengying Ma , Wen Qian , Huangjia Song , Xiaohua Ge , Lili Xu

Objective

To study the effectiveness of HFMEA in integrated transport for critically ill pediatric patients.

Methods

Since January 2024, HFMEA has been implemented in our hospital to facilitate the integrated transport of critically ill children. The study observed and compared the incidence of transport accidents, nursing quality, and satisfaction with medical team cooperation over four months before and after HFMEA implementation.

Results

The transport accident rate was 35 % in the control group and 6.7 % in the experimental group, demonstrating a significantly lower incidence of transport accidents (P < 0.001). The nursing quality score in the experimental group was 95.8 %, markedly higher than in the control group. Satisfaction with medical team cooperation in the experimental group was 97.5 %, compared to 88.1 % in the control group, a statistically significant difference (P < 0.001).

Conclusion

HFMEA improves the safety of transport for critically ill pediatric patients in emergency settings, thereby enhancing nursing quality.

Implications for Clinical Practice: HFMEA significantly enhances pediatric critical care transport safety, improving nursing quality, efficiency, and multidisciplinary team collaboration.

目的探讨HFMEA在儿科危重病人综合转运中的应用效果。方法自2024年1月起在我院实施HFMEA，方便重症患儿综合转运。本研究对实施HFMEA前后4个月的交通事故发生率、护理质量、医疗团队合作满意度进行了观察和比较。结果对照组交通事故率为35%，实验组交通事故率为6.7%，交通事故率明显低于对照组（P < 0.001）。实验组护理质量评分为95.8%，明显高于对照组。实验组对医疗团队合作的满意度为97.5%，对照组为88.1%，差异有统计学意义（P < 0.001）。结论hfmea提高了儿科危重病人急诊转运的安全性，从而提高了护理质量。对临床实践的影响：HFMEA显著提高了儿科重症监护运输的安全性，提高了护理质量、效率和多学科团队协作。

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引用次数: 0

Evaluating a closed-loop tracking and management model in determining aortic dissection diagnosis rates in a selected emergency department in China: A quality improvement project 评价一个闭环跟踪和管理模式确定主动脉夹层诊断率在中国选定的急诊科：一个质量改进项目。

IF 1.8 4区医学 Q2 NURSING

International Emergency Nursing

Pub Date : 2026-03-01 Epub Date: 2026-02-20 DOI: 10.1016/j.ienj.2026.101770

Xiaorong Lang , Shusheng Li , Jie Xiong , Jing Cheng , Danli Zheng , Yaru Xiao , Sufang Huang , Ying Li

Objective

This study aimed to evaluate the effectiveness of a closed-loop tracking and management model in reducing the rates of missed and misdiagnosed aortic dissection (AD) in the emergency department (ED).

Design

Quality improvement report.

Methods

Using HIRAID as the guiding framework, a quality improvement program was implemented. The quality improvement team developed a closed-loop tracking and management model for AD, which included symptom-based screening and tracking, blood pressure screening of the limbs as an auxiliary method, and a diagnostic and treatment information tracking platform. The closed-loop tracking and management model for AD was applied in the ED of a tertiary hospital in Wuhan. Blood pressure measurements of the extremities were taken when patients presented with risk symptoms of AD for further screening. Additionally, misdiagnosed cases were continuously tracked.

Results

After the application of closed-loop tracking and management model, the rate of misdiagnosed AD decreased from 5.16% in 2019 to 1.23% in 2023.

Conclusion

Closed-loop tracking and management model could help reduce the rates of misdiagnosed AD in the ED.

目的：本研究旨在评估闭环跟踪和管理模式在降低急诊科（ED）主动脉夹层（AD）漏诊和误诊率方面的有效性。设计：质量改进报告。方法：以HIRAID为指导框架，实施质量改进方案。质量改进团队开发了AD的闭环跟踪管理模型，包括基于症状的筛查和跟踪，以肢体血压筛查为辅助方法，以及诊疗信息跟踪平台。将AD闭环跟踪管理模式应用于武汉市某三级医院急诊科。当患者出现阿尔茨海默病的危险症状时，测量四肢血压，以便进一步筛查。此外，对误诊病例进行持续跟踪。结果：应用闭环跟踪管理模式后，AD误诊率由2019年的5.16%降至2023年的1.23%。结论：闭环跟踪管理模式有助于降低急诊科AD的误诊率。

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引用次数: 0