International Emergency Nursing最新文献_第3页

Comments on: “Artificial intelligence improves survival decision-making in diabetic emergencies: A cross-sectional study” 评论：“人工智能改善糖尿病紧急情况下的生存决策：一项横断面研究”。

IF 1.8 4区医学 Q2 NURSING

International Emergency Nursing

Pub Date : 2025-12-16 DOI: 10.1016/j.ienj.2025.101737

Xiaozhu Huang , Zhiwei Hu

引用次数: 0

Verbal and visual information exchange in EMS-to-ED patient handovers: An observational and attitudinal study ems - ed病人交接中的语言和视觉信息交换：一项观察性和态度性研究。

IF 1.8 4区医学 Q2 NURSING

International Emergency Nursing

Pub Date : 2025-12-15 DOI: 10.1016/j.ienj.2025.101735

Ariel Braverman , Amit Frenkel , Dan Schwarzfuchs , Eli Jaffe , Yuval Bitan

Background

Although effective information exchange during emergency medical services (EMS)-to-emergency department (ED) patient handovers is critical for care continuity and patient safety, handover communication patterns and information gaps remain poorly characterized.

Objective

To characterize verbal and visual information exchange patterns in EMS-to-ED handovers while comparing EMS and ED staff perceptions of handover quality.

Methods

This was a dual-methods study conducted at a tertiary medical center in Israel (June–November 2024) in which 83 EMS-to-ED handovers [35 advanced life support (ALS), 48 basic life support (BLS)] were directly observed. We documented information elements, duration, and communication patterns via a structured checklist. In addition, an electronic survey (Qualtrics) of 103 participants (62 EMS, 41 ED staff) was used to assess perceptions with 6-point Likert scales. Statistical analyses utilized Mann-Whitney U tests, effect sizes (Cohen’s d), and 95 % confidence intervals (CIs).

Results

The handovers were dominated by verbal communication (97.6 %, 95 % CI: 91.6–99.3 %) of brief duration [ALS: Median = 40 s, interquartile range (IQR) 35–45; BLS: Median = 25 s, IQR 25–35]. Significant information gaps included: pre-hospital treatment details, which were absent in 36.1 % of the handovers (95 % CI: 26.6–46.9 %), allergy details in 55.4 %, and demographic details in 61.4 %. The ALS teams provided more complete information than did BLS teams (treatment: 94 % vs. 46 %, p < 0.001; allergies: 60 % vs. 33 %, p = 0.02). EMS documentation was available in only 7.2 % of handovers (95 % CI: 3.4–14.9 %). Patient background documents were valued more by ED staff than by EMS personnel (Median = 4.84 vs. 3.44, p < 0.001, d = 0.98), and they reported higher confidence in using received information (Median = 4.12 vs. 3.15, p < 0.001, d = 0.78).

Conclusions

Because EMS-to-ED handovers rely almost exclusively on brief verbal communication, they are vulnerable to information loss. Critical safety-relevant information (allergies, medications) is frequently omitted, with BLS teams showing greater gaps than ALS teams. Structured handover protocols may improve information completeness and continuity of care by incorporating digital tools to complement verbal communication.

背景：虽然在紧急医疗服务（EMS）到急诊科（ED）患者移交过程中有效的信息交换对护理连续性和患者安全至关重要，但移交沟通模式和信息差距仍然缺乏特征。目的：比较EMS和ED员工对交接质量的感知，探讨EMS和ED员工在交接过程中的语言和视觉信息交换模式。方法：本研究是一项双方法研究，于2024年6月至11月在以色列一家三级医疗中心进行，直接观察83例ems - ed切换[35例高级生命支持（ALS）， 48例基本生命支持（BLS）]。我们通过结构化检查表记录了信息元素、持续时间和通信模式。此外，103名参与者（62名EMS员工，41名ED员工）的电子调查（质量）被用来评估6分李克特量表的看法。统计分析采用Mann-Whitney U检验、效应量（Cohen’s d）和95%置信区间（ci）。结果：短时移交以言语交际为主（97.6%,95% CI: 91.6 ~ 99.3%） [ALS：中位数= 40 s，四分位间距（IQR） 35 ~ 45；BLS: Median = 25 s, IQR 25-35]。重要的信息缺口包括：院前治疗细节，36.1%的移交患者没有这些细节（95% CI: 26.6- 46.9%）， 55.4%的患者没有过敏细节，61.4%的患者没有人口统计学细节。ALS小组比BLS小组提供了更完整的信息(治疗：94%对46%，p结论：因为ems到ed的移交几乎完全依赖于简短的口头交流，他们很容易丢失信息。关键的安全相关信息（过敏，药物）经常被忽略，BLS团队比ALS团队显示出更大的差距。结构化的交接协议可以通过结合数字工具来补充口头沟通，从而提高信息的完整性和护理的连续性。

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引用次数: 0

Letter to the Editor: Methodological and practice insights on emergency nurses’ experiences of caring for critically ill patients requiring intensive care in the emergency department 致编辑的信：急诊护士在急诊科护理需要重症监护的危重病人的经验的方法和实践见解

IF 1.8 4区医学 Q2 NURSING

International Emergency Nursing

Pub Date : 2025-12-10 DOI: 10.1016/j.ienj.2025.101736

Oscar Fidel Antunez Martinez

引用次数: 0

Perception and experience of patients in the emergency department in Edmonton, Canada: A qualitative study 加拿大埃德蒙顿急诊科患者的感知和经验：一项定性研究。

IF 1.8 4区医学 Q2 NURSING

International Emergency Nursing

Pub Date : 2025-12-09 DOI: 10.1016/j.ienj.2025.101731

Moutasem A. Zakkar , Fariba Kolahdooz , Kate Kerber , Farzad Akbaryan , Adrian Wagg , Debbie DeLancey , André Corriveau , Sangita Sharma

Introduction

Patient experiences in emergency departments (EDs) may be suboptimal due to increasing patient volumes and constrained hospital resources. This study explores patient experiences in EDs in Edmonton, Alberta, Canada.

Methods

This study reports findings from a qualitative descriptive study conducted as part of the CARE project. Individuals experiencing socioeconomic disadvantages and having visited an ED in Edmonton within the past 12 months were recruited from two distinct settings—one hospital ED and four community organizations—using purposive sampling.

Quantitative data from closed-ended questions were used to describe participant characteristics and healthcare access, while qualitative data were analyzed thematically. The study adhered to the Consolidated Criteria for Reporting Qualitative Research.

Results

The study included 192 participants: 120 were interviewed in a hospital ED (46.7% women, 37.5% Indigenous, 60% unemployed), and 72 were interviewed in community-based organizations (59.7% women, 68.1% Indigenous, 94.4% unemployed). While most participants reported satisfactory experiences, others described unsatisfactory encounters. Positive experiences were linked to perceptions of health needs being met, while negative ones were associated with racism, accessibility barriers, long wait times, and poor communication. Quantitative data also revealed limited availability of primary care services and access to needed healthcare professionals. Suggestions for improvement included enhancing communication and expanding primary care capacity.

Conclusions

Wait times, communication, service accessibility, availability, and discrimination are key challenges affecting ED experiences. Addressing these issues requires strategic investments in primary care, ED staffing, and culturally safe care practices to improve equity, responsiveness, and patient experience.

简介：由于患者数量的增加和医院资源的限制，急诊科（EDs）的患者体验可能不是最佳的。本研究探讨了加拿大艾伯塔省埃德蒙顿急诊科的患者体验。方法：本研究报告了一项定性描述性研究的结果，该研究是CARE项目的一部分。在过去的12个月里，在埃德蒙顿经历社会经济劣势和访问过急诊科的个人从两个不同的环境中招募——一个医院急诊科和四个社区组织——使用有目的的抽样。来自封闭式问题的定量数据用于描述参与者特征和医疗保健获取情况，而定性数据则按主题进行分析。该研究遵循了报告定性研究的统一标准。结果：该研究包括192名参与者：120人在医院急诊科接受采访（46.7%为女性，37.5%为土著居民，60%为失业者），72人在社区组织接受采访（59.7%为女性，68.1%为土著居民，94.4%为失业者）。虽然大多数参与者报告了满意的经历，但也有人描述了不满意的经历。积极的经历与健康需求得到满足的感觉有关，而消极的经历与种族主义、无障碍障碍、漫长的等待时间和沟通不畅有关。定量数据还显示，初级保健服务的可用性和获得所需保健专业人员的机会有限。改善建议包括加强沟通和扩大初级保健能力。结论：等待时间、沟通、服务可及性、可获得性和歧视是影响ED体验的关键挑战。解决这些问题需要在初级保健、急诊科人员配置和文化安全护理实践方面进行战略投资，以提高公平性、响应能力和患者体验。

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引用次数: 0

Enhancing quality and efficiency: The impact of patient experience officers on teamwork and staff experience in Australian emergency departments 提高质量和效率：病人体验官对澳大利亚急诊科团队合作和工作人员经验的影响。

IF 1.8 4区医学 Q2 NURSING

International Emergency Nursing

Pub Date : 2025-12-09 DOI: 10.1016/j.ienj.2025.101718

Jodie Brabin , Sharon Laver , Rosemary Phillips , Rachel Rossiter , Samantha Jakimowicz

Background

The Patient Experience Officer (PEO) position was implemented into Emergency Department (ED) waiting rooms to address increased rates of occupational aggression and improve patient experience.

Rising ED presentations have lengthened patient wait times, increased risk of clinical deterioration and aggression and violence towards ED staff.

Methods

This study used a mixed-methods approach including staff surveys, focus groups and semi-structured interviews with a range of ED staff. Data was analysed using content analysis and descriptive statistics.

Results

Staff benefit from the PEO’s presence in the waiting room through improved communication with patients, fewer disruptions and humanising the atmosphere within the traditionally chaotic ED environment.

Workflow and teamwork is improved through preparing patients for treatment, supporting ED clinicians in managing the waiting room and streamlining processes.

The PEO position improves patient safety for those in the waiting room through proactive escalation of possible deterioration and early communication with patients, which decreases aggression and anxiety.

Conclusion

Based on this evaluation, the PEO position contributes to improving the safety of staff and patients by providing an important point of contact, a calming presence for patients and, supporting ED staff through improved communication, and escalation of care needs.

背景：急诊科（ED）候诊室设立患者体验官（PEO）职位，以解决职业攻击率上升的问题，改善患者体验。越来越多的急诊科报告延长了病人的等待时间，增加了临床恶化的风险，以及对急诊科工作人员的攻击和暴力。方法：本研究采用混合方法，包括员工调查、焦点小组和对一系列急诊科员工的半结构化访谈。数据分析采用内容分析和描述性统计。结果：员工受益于PEO在候诊室的存在，通过改善与患者的沟通，减少干扰，并使传统混乱的急诊科环境中的气氛人性化。通过为患者准备治疗，支持急诊科临床医生管理等候室和简化流程，工作流程和团队合作得到改善。PEO姿势通过主动升级可能的病情恶化和与患者的早期沟通，减少了攻击和焦虑，提高了候诊室患者的安全。结论：基于这一评估，PEO职位有助于提高工作人员和患者的安全性，因为它提供了一个重要的接触点，为患者提供了一个平静的存在，并通过改善沟通和增加护理需求来支持ED工作人员。

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引用次数: 0

Interventions according to patient severity in an emergency department based short stay unit: Nursing intervention classification and social network analysis 急诊短住院部病人严重程度干预：护理干预分类及社会网络分析。

IF 1.8 4区医学 Q2 NURSING

International Emergency Nursing

Pub Date : 2025-12-08 DOI: 10.1016/j.ienj.2025.101730

Dain Lee , Soyoung Kim , Jaehoon Kim , Joohee Chung , Sunhee Yun , Yeonhee Lee , Il Hyun Lee , Hanjong Park

Purpose

To examine the operational performance of a short stay unit (SSU) and emergency department (ED) and identify the patterns of nursing interventions provided simultaneously to critically ill patients according to the severity of illness in the SSU using the Nursing Intervention Classification System and social network analysis.

Methods

This is a retrospective descriptive study. Data were collected from the electronic medical records of critically ill patients admitted to the SSU and ED of a university-affiliated tertiary general hospital between 1 June 2020 and 31 May 2022.

Results

Among the 48,985 ED visits for medical treatment before the SSU was launched, 2,289 (4.7 %) were hospitalised with severe illnesses. Among the 50,650 ED visits for medical treatment after the launch of the SSU, 2820 (5.5 %) were hospitalised with severe illnesses. A total of 551 patients with severe illnesses were admitted to the SSU via the ED during the study period. The respective occupancy rates of the SSU and ED were 25.2 % and 111.3 %. The median length of stays in the ED before and after the launch of the SSU were 8.05 h and 8.75 h. The SSU helped buffer the ED from receiving 531 more patients with severe illnesses without meaningfully increasing ED crowding. As patient severity increased, so did the need for complex physiological care, increasing from 48.3% in Class I to 56.9% in Class IV. Meanwhile, safety and health system-related interventions were more frequently provided to less severe patients, rising from 11.8 % and 8.5 %. in Class IV to 17.6 % and 14.7 % in Class I, respectively. Social network analysis showed that the clustering of emergency care was consistently centralised, regardless of severity, with ventilatory support and metabolic interventions becoming more prominent as patient severity increased.

Conclusions

This study provided a comprehensive understanding of the evolving priorities of nursing interventions across patient severity levels at the SSU of a tertiary general hospital. This study can serve as a reference to enable nurses to efficiently provide complex and interrelated nursing interventions for patients, ultimately improving patient outcomes in acute care settings. These insights may help other general hospitals refine their acute care models and guide future research on best practices for managing critically ill patients outside traditional ICU settings.

目的：运用护理干预分类系统和社会网络分析方法，考察短期住院病房（SSU）和急诊科（ED）的业务绩效，并根据急诊科重症重症患者的病情严重程度，确定对急诊科重症患者同时进行护理干预的模式。方法：回顾性描述性研究。数据收集自2020年6月1日至2022年5月31日期间某大学附属三级综合医院SSU和急诊科收治的危重患者的电子病历。结果：在推行“全民健康服务”前的48,985宗急诊科求诊中，有2,289宗（4.7%）因严重疾病住院。在推行特别支援计划后的50,650宗求诊个案中，有2820宗（5.5%）因重病住院。在研究期间，共有551名重症患者通过急诊科进入SSU。特别服务小组及教育署的入住率分别为25.2%及11.3%。在SSU推出前后，急诊科的平均住院时间分别为8.05小时和8.75小时。SSU帮助急诊科减少了531名重症患者，而没有明显增加急诊科的拥挤程度。随着患者严重程度的增加，对复杂生理护理的需求也在增加，从第一类的48.3%增加到第IV类的56.9%。同时，向较轻的患者提供安全和卫生系统相关干预的频率也在增加，从11.8%和8.5%上升。第四类为17.6%，第一类为14.7%。社会网络分析显示，无论严重程度如何，急诊护理的聚类始终是集中的，随着患者严重程度的增加，呼吸支持和代谢干预变得更加突出。结论：本研究对一家三级综合医院SSU患者严重程度的护理干预优先级的演变提供了全面的了解。本研究可为护士有效地为患者提供复杂且相互关联的护理干预提供参考，最终改善急性护理环境中患者的预后。这些见解可能有助于其他综合医院改进其急性护理模式，并指导未来在传统ICU设置之外管理危重患者的最佳实践研究。

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引用次数: 0

Emergency nurses’ experiences following resuscitation care: When the adrenaline wears off 急救护士在复苏护理后的经验：当肾上腺素消退时。

IF 1.8 4区医学 Q2 NURSING

International Emergency Nursing

Pub Date : 2025-12-07 DOI: 10.1016/j.ienj.2025.101732

Andrea Toews , Donna Martin , Wanda Chernomas , Kendiss Olafson

Aim

To explore emergency nurses’ experiences following in-hospital resuscitation events in an adult emergency department and their desired resources for coping. Limited research has been done in this area.

Design

Qualitative exploratory design using Lazarus and Folkman’s Transactional Theory of Stress and Coping as a guiding framework.

Methods

Digitally recorded, semi-structured interviews conducted by the first author with emergency nurses who volunteered to participate. Digital recordings were transcribed verbatim. Transcripts and the first author’s reflective journals were iteratively read and analyzed using content analysis. The research setting was an adult emergency department in a Western Canadian city.

Data sources

Short demographic survey, verbatim transcripts, and the first author’s reflective journals.

Results

Eight emergency nurses participated. Most participants were women, employed part-time with an average number of 20 resuscitation events in the previous six months. Three themes were identified: (1) emergency nurses’ experiences of resuscitation – ‘The adrenaline rush,’ (2) emergency nurses’ experiences post-resuscitation – ‘When the adrenaline wears off’ and (3) emergency nurses’ recommendations for policies and resources. Participants described psychological consequences of providing resuscitation care, with profound effects on their personal and professional lives. Moral distress and secondary trauma stress were discussed with recommendations for future policies and resources to support healthcare teams. Improved staffing resources, a mentorship program, and multidisciplinary education for resuscitation teams were recommended.

Conclusion

Participants experienced significant moral distress and secondary trauma stress following resuscitation care. Participants provided recommendations for organizational policies and resources to support emergency nurses and resuscitation teams.

目的：探讨成人急诊科急诊护士应对院内复苏事件的经验及所需资源。这方面的研究还很有限。设计：使用Lazarus和Folkman的压力和应对的交易理论作为指导框架的定性探索性设计。方法：由第一作者与自愿参加的急诊护士进行数字记录的半结构化访谈。数字录音被逐字抄录。使用内容分析反复阅读和分析成绩单和第一作者的反思日志。研究地点是加拿大西部一个城市的成人急诊科。数据来源：简短的人口调查，逐字记录，和第一作者的反思日志。结果：共有8名急诊护士参与。大多数参与者是兼职女性，在过去六个月中平均有20次复苏事件。确定了三个主题：(1)急救护士在复苏中的经历——“肾上腺素激增”；(2)急救护士在复苏后的经历——“当肾上腺素消退”；(3)急救护士对政策和资源的建议。参与者描述了提供复苏护理的心理后果，对他们的个人和职业生活产生了深远的影响。讨论了道德痛苦和继发性创伤压力，并就支持医疗团队的未来政策和资源提出了建议。建议改善人员资源、指导计划和复苏小组的多学科教育。结论：参与者在复苏护理后经历了显著的道德困扰和继发性创伤应激。与会者就支持急诊护士和复苏小组的组织政策和资源提出了建议。

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引用次数: 0

Interventions to reduce overcrowding in emergency departments: An umbrella review 减少急诊科过度拥挤的干预措施：概括性审查

IF 1.8 4区医学 Q2 NURSING

International Emergency Nursing

Pub Date : 2025-12-05 DOI: 10.1016/j.ienj.2025.101729

Eduardo Santos , Ana Carolina Brito , Luana Fonseca , Margarida Figueiredo , Matilde Esteves , Diana Santos

Objective

To identify and evaluate the effectiveness of interventions and/or strategies to reduce overcrowding in Emergency Departments (EDs).

Method

An umbrella review was performed using the JBI method. Eight search resources were considered. Two independent reviewers carried out the selection of studies, quality assessment, data extraction, and synthesis.

Results

Twenty systematic reviews were included, which identified several interventions to reduce overcrowding in EDs, such as: joint triage (physicians and nurses); creation of fast tracks; introduction of Rapid Assessment Units; request for auxiliary diagnostic tests by nurses; streaming; collaboration with Primary Health Care (PHC) for referral of non-urgent cases; allocation of PHC units within or adjacent to EDs; triage by PHC professionals; extension of PHC hours; increase in hospital capacity; creation of full capacity protocols; hiring of specialist professionals; lean thinking; reverse triage. The most effective interventions and/or strategies were: joint triage; creation of fast-track routes; introduction of rapid assessment units; request for auxiliary diagnostic tests by nurses; streaming; and collaboration with PHC for referral of non-urgent cases.

Conclusion

The combination of effective triage, appropriate flow management, and proactive action by the team appears to be key to mitigating overcrowding in the EDs. Joint triage and fast-track routes are the most effective measures. The expanded role of nurses − including their ability to request examinations and manage rapid assessment units − is also crucial to speeding up care.

目的确定和评估减少急诊科过度拥挤的干预措施和/或策略的有效性。方法采用JBI方法进行综述。考虑了8种搜索资源。两名独立审稿人进行了研究选择、质量评估、数据提取和综合。结果纳入了20项系统评价，确定了几种缓解急诊科人满为患的干预措施，如：联合分诊（医生和护士）；建立快速通道；引入快速评估小组；要求护士进行辅助诊断测试；流媒体;与初级保健机构合作，转诊非紧急病例；在急诊科内或邻近地区分配初级保健单位；由初级保健专业人员分诊；延长初级保健时间；增加医院容量；制定满负荷协议；聘用专业人员；精益思想;反向分流。最有效的干预措施和/或策略是：联合分诊；建立快速通道；引进快速评估单位；要求护士进行辅助诊断测试；流媒体;并与初级保健中心合作转诊非紧急病例。结论有效的分诊、适当的流量管理和团队的积极行动相结合是缓解急诊科过度拥挤的关键。联合分流和快速通道是最有效的措施。扩大护士的作用——包括她们要求检查和管理快速评估单元的能力——对加快护理速度也至关重要。

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引用次数: 0

A response to “A systematic review of suction-based airway clearance devices for foreign body airway obstruction” 对“吸痰式气道清除装置治疗异物气道阻塞的系统综述”的回应

IF 1.8 4区医学 Q2 NURSING

International Emergency Nursing

Pub Date : 2025-11-25 DOI: 10.1016/j.ienj.2025.101707

Simon John Gould

引用次数: 0

An examination of how nurses’ use of the Broselow tape affects patient safety during peripheral intravenous catheterization 检查护士如何使用Broselow胶带影响患者安全在周围静脉留置

IF 1.8 4区医学 Q2 NURSING

International Emergency Nursing

Pub Date : 2025-11-25 DOI: 10.1016/j.ienj.2025.101712

Aslı Alaca , Hatice Yıldırım Sarı

Background

Peripheral intravenous catheter insertion is one of the most common procedures in pediatric emergency departments. Inappropriate placement of a peripheral intravenous catheter and the associated management can lead to patient harm, which is considered a patient safety issue. The patient’s safety could be compromised if a peripheral intravenous catheter is not properly placed and managed.

Purpose

This study was conducted to examine how nurses’ use of the Broselow tape affects patient safety during peripheral intravenous catheterization.

Materials and methods

In this study, the selection of peripheral intravenous catheters was based on a randomized controlled trial. The study was registered on ClinicalTrials.gov under the registration number NCT06165003. Using the Stepped Wedge design, data from the control group were collected first, followed by data from the experimental group. The two groups were compared on a variety of criteria, including the number of attempts, extravasation, accidental dislodgement, dwell time of catheter, and reasons for removal of catheter.

Results

The study found no significant difference between the experimental and control groups in terms of “the nurses’ success in performing the procedure” and “catheter dwell time” during peripheral intravenous catheterization. The patients’ estimated weights in the experimental group were found to be consistent with both the Broselow tape estimates and parents’ weight estimates.

Conclusions

The study indicates that using the Broselow tape for cannula selection during peripheral intravenous catheterization could serve as a novel alternative method.

背景：外周静脉置管是儿科急诊科最常见的手术之一。外周静脉导管的不当放置和相关管理可能导致患者伤害，这被认为是一个患者安全问题。如果外周静脉导管放置和管理不当，可能会危及患者的安全。目的本研究旨在探讨护士在周围静脉置管过程中使用Broselow胶带对患者安全的影响。材料与方法本研究采用随机对照试验的方法选择外周静脉留置管。该研究已在ClinicalTrials.gov注册，注册号为NCT06165003。采用阶梯楔形设计，先收集对照组数据，后收集实验组数据。比较两组的各种标准，包括尝试次数、外渗、意外移位、导管停留时间和拔出导管的原因。结果外周静脉留置时，实验组与对照组在“护士操作成功率”和“留置时间”方面无显著差异。研究发现，实验组患者的体重估计值与Broselow胶带估计值和父母的体重估计值一致。结论外周静脉置管时使用Broselow胶带选择套管是一种新颖的替代方法。

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引用次数: 0