International Emergency Nursing最新文献_第4页

Developing a trauma-informed care graphic narrative educational tool for emergency trauma nurses 为急救创伤护士开发创伤知情护理图形叙事教育工具

IF 1.8 4区医学 Q2 NURSING

International Emergency Nursing

Pub Date : 2024-11-29 DOI: 10.1016/j.ienj.2024.101545

Melissa Wholeben , Robert McCreary , Elvira Carrizal-Dukes , Ronnie Dukes

Background

In the emergency department, communicating therapeutically to optimize health outcomes is crucial when caring for trauma survivors. Graphic narratives are an innovative means of conveying critical nursing concepts to emergency trauma nurses that have the potential to promote enhanced application of trauma-informed care core values to clinical practice.

Purpose

The purpose of this manuscript is to describe the initial step of developing a graphic narrative educational tool depicting clinical scenarios in which trauma-informed care values are employed in an emergency department setting. Content validation by subject matter experts’ approach was taken to create a graphic narrative tool reflective of the core values of trauma-informed care.

Methods

A graphic narrative was created as an educational tool that included examples of nurses using core trauma-informed care values to provide nursing care to trauma survivors. Content Validation by subject matter experts’ approach was used to ensure that the core values of trauma-informed care were reflected in the script and visuals, or graphics, depicted in this tool.

Results

The development of a graphic narrative educational tool, compiled into a study guide, was designed to educate emergency trauma nurses in the specialized knowledge and TIC competencies needed to care for trauma survivors who have experienced acute trauma. The finalized four graphic narratives encompassing the six core values of TIC show nurse-patient interactions that demonstrate how the nurse would apply TIC in specific clinical situations.

Conclusion

The collaborative review process utilized in this study highlights a process of content validation by subject matter experts’ that can be useful for other nurse educators who collaborate with graphic artists to develop graphic narratives. Graphic narratives show through vivid imagery the powerful healing delivered to trauma survivors through trauma-informed care and can move nurses to employ this approach in every patient interaction.

在急诊科，在照顾创伤幸存者时，沟通治疗以优化健康结果是至关重要的。图形叙事是一种创新的手段，传达关键的护理概念，急救创伤护士，有可能促进创伤知情护理核心价值的临床实践的加强应用。目的：本文的目的是描述开发一个图形叙事教育工具的第一步，该工具描绘了在急诊室环境中采用创伤知情护理价值的临床场景。通过主题专家的方法进行内容验证，创建了一个反映创伤知情护理核心价值的图形叙事工具。方法创建了一个图形叙事作为教育工具，其中包括护士使用核心创伤知情护理价值观为创伤幸存者提供护理的例子。采用主题专家的方法进行内容验证，以确保创伤知情护理的核心价值反映在该工具中描述的脚本和视觉效果或图形中。结果设计了一种图形叙事教育工具，编写成学习指南，旨在教育急诊创伤护士护理急性创伤幸存者所需的专业知识和TIC能力。最终确定的四个图形叙述包含了TIC的六个核心价值，展示了护士与患者的互动，展示了护士如何在特定的临床情况下应用TIC。本研究中使用的协作审查过程强调了主题专家对内容进行验证的过程，这对于与图形艺术家合作开发图形叙述的其他护理教育工作者来说是有用的。图形叙述通过生动的图像展示了通过创伤知情护理为创伤幸存者提供的强大治疗，并可以促使护士在每次患者互动中采用这种方法。

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引用次数: 0

Effectiveness of a training program for emergency nurses on pelvic binder application and patient care: A single-group pretest–posttest study 急诊护士骨盆捆绑剂应用和患者护理培训计划的有效性：一项单组前测后测研究

IF 1.8 4区医学 Q2 NURSING

International Emergency Nursing

Pub Date : 2024-11-28 DOI: 10.1016/j.ienj.2024.101528

Perihan Şimşek , İsmail Tayfur , Abdülkadir Gunduz , Burcu Bayramoglu

Aim

Pelvic binder application is one of the life-saving interventions used in pelvic trauma. The aim of this study was to evaluate the effect of a pelvic binder training program on the knowledge, skills, attitudes and competence levels of emergency department nurses.

Methods

The study was conducted with 35 emergency department nurses using a one-group pretest–posttest design. The effectiveness of the training provided to the nurses was evaluated in four stages: immediately before the training, immediately after the training, 20 days after the training, and two months after the training, using forms developed by the researchers. The evaluation assessed knowledge, skills, attitudes, and perceived levels of competence related to the topic.

Results

Attitudes toward pelvic binder application and perceived competence levels in providing care for patients with pelvic binders were significantly higher in all post-training assessments compared to pre-training (p < 0.001). Knowledge levels were significantly higher two months after training compared to other time periods (p < 0.001). It was also found that pelvic binder application training for ED nurses significantly improved nurses’ skills (p < 0.001).

Conclusion

In conclusion, this study shows that the pelvic binder training program is effective in improving the knowledge, skills, attitudes, and competence levels of emergency department nurses. To improve patient care in critical situations such as pelvic trauma, the dissemination and continuity of such training programs will be an important step.

盆腔固定器的应用是盆腔创伤的救命干预措施之一。本研究的目的是评估骨盆捆绑训练计划对急诊科护士的知识、技能、态度和能力水平的影响。方法采用单组前测后测设计，对35名急诊科护士进行研究。采用研究人员编制的表格，分培训前、培训后、培训后20天和培训后2个月四个阶段对护士培训的效果进行评估。该评估评估了与主题相关的知识、技能、态度和感知能力水平。结果在所有训练后评估中，对盆腔粘连剂应用的态度和对盆腔粘连剂患者提供护理的感知能力水平均显著高于训练前(p <；0.001)。与其他时间段相比，培训后两个月的知识水平显著提高(p <；0.001)。我们还发现，对急诊科护士进行盆腔粘合剂应用培训可显著提高护士的技能(p <；0.001)。结论本研究表明，骨盆绑扎训练方案对提高急诊科护士的知识、技能、态度和能力水平是有效的。为了改善骨盆创伤等危急情况下的患者护理，此类培训计划的传播和连续性将是重要的一步。

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引用次数: 0

Relationship between compassion fatigue, conscience stress, and perceived quality of care in emergency nurses 急诊护士同情疲劳、良心压力与感知护理质量的关系

IF 1.8 4区医学 Q2 NURSING

International Emergency Nursing

Pub Date : 2024-11-28 DOI: 10.1016/j.ienj.2024.101543

Semra Kayacan , Simge Coskun Palaz

Background

Examining factors affecting nursing care is vital for enhancing practices, improving care quality, and achieving desired patient outcomes.

Aim

To explore emergency nurses’ perceptions of care quality, compassion fatigue and conscience stress levels; and evaluate the mediating role of conscience stress between compassion fatigue and perception of nursing care quality.

Methods

This cross-sectional and descriptive study was conducted between April 1 and September 1, 2022, with 384 nurses working in emergency departments across Turkey. “Sociodemographic Data Collection Form”, “Compassion Fatigue Scale”, “Stress of Conscience Scale” and “Caring Behaviors Scale” were used to collect data.

Results

The mean total scores for the Caring Behaviors Scale, Compassion Fatigue Scale, and Conscience Stress Scale among emergency nurses were 5.16 ± 0.67, 71.28 ± 25.19, and 100.48 ± 41.97, respectively. The study revealed a positive correlation between Conscience Stress Scale and Compassion Fatigue Scale scores, and no correlation between Caring Behaviors Scale scores. Additionally, a negative correlation was found between Compassion Fatigue Scale and Caring Behaviors Scale scores.

Conclusion

It was found that emergency nurses had high perceptions of care quality, moderate levels of compassion fatigue and stress of conscience, and that stress of conscience did not mediate the relationship between perception of care quality and compassion fatigue.

研究影响护理的因素对于加强实践、提高护理质量和实现预期的患者结果至关重要。目的探讨急诊护士对护理质量的感知、同情疲劳和良心压力水平；评估良心压力在同情疲劳与护理质量感知之间的中介作用。方法横断面描述性研究于2022年4月1日至9月1日进行，共有384名在土耳其急诊科工作的护士参与。采用《社会人口学数据收集表》、《同情疲劳量表》、《良心压力量表》和《关怀行为量表》进行数据收集。结果急诊护士关爱行为量表、同情疲劳量表和良心压力量表的平均总分分别为5.16±0.67、71.28±25.19和100.48±41.97。研究发现，良心压力量表与同情疲劳量表得分呈正相关，关怀行为量表得分无相关。此外，同情疲劳量表与关怀行为量表得分呈负相关。结论急诊护士对护理质量的感知较高，同情疲劳和良心压力处于中等水平，良心压力在护理质量感知与同情疲劳之间没有中介作用。

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引用次数: 0

Determination of the relationship between competencies in disaster nursing management and perceived stress: The intermediary role of resilience 确定灾难护理管理能力与感知压力之间的关系：复原力的中介作用

IF 1.8 4区医学 Q2 NURSING

International Emergency Nursing

Pub Date : 2024-11-25 DOI: 10.1016/j.ienj.2024.101530

Gülnur Akkaya , Yeliz Akkuş , Ayşe Gül Parlak , Yasemin Karacan

Background

Türkiye encounters various natural disasters, foremost earthquakes, and, nurses’ resilience, ability to cope with stress and disaster competence play a significant role in disasters.

Objective

The objective of this study is to establish the intermediary role of resilience in the relation between nurses’ competencies in disaster management and perceived stress.

Method

The sampling of this descriptive and cross-sectional study included 240 nurses from across Türkiye. The socio-demographic characteristics questionnaire, Competencies for Disaster Nursing Management Questionnaire, Brief Resilience Scale, Perceived Stress Scale were utilized in order to collect data. Among the continuous variables of the research, Pearson correlation analysis, linear regression and hierarchical regression analyses regarding the intermediary effect were performed by using PROCESS Model.

Findings

The mean scale scores of nurses were detected to be “CDNMQ” 6.300 ± 2.771 (medium), “BRS” 18.463 ± 4.308 (medium), and “PS” 21.038 ± 6.759 (low), respectively. The relationship between CDNMQ and PS (path c; ß = −0.534) descends in case BRS is added to the model (path c’; ß = −0.429) (p < 0.05). In light of this finding, BRS was determined to be a partial intervening variable between CDNMQ and PS.

Conclusion

In accordance with this study, it is recommended to plan studies to enhance disaster nursing competence, prioritize resilience, and reproduce this study in various nurse groups.

背景土耳其会遇到各种自然灾害，其中最严重的是地震，而护士的抗灾能力、应对压力的能力和应对灾害的能力在灾害中发挥着重要作用。研究目的本研究旨在确定抗灾能力在护士灾害管理能力和感知压力之间的中介作用。研究采用了社会人口学特征问卷、灾害护理管理能力问卷、简明复原力量表和感知压力量表来收集数据。研究结果护士的平均量表得分分别为 "CDNMQ" 6.300 ± 2.771（中）、"BRS" 18.463 ± 4.308（中）和 "PS" 21.038 ± 6.759（低）。如果模型中加入 BRS（路径 c'；ß = -0.429），CDNMQ 与 PS 之间的关系（路径 c；ß = -0.534）会下降（p < 0.05）。根据这一发现，BRS被确定为CDNMQ和PS之间的部分干预变量。结论根据本研究，建议规划提高灾难护理能力的研究，优先考虑抗灾能力，并在不同的护士群体中重复本研究。

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引用次数: 0

Emergency medical service nurses’ experiences and perspectives on a protocol change of pre-hospital preventive immobilization of spinal injuries after trauma: A qualitative study 紧急医疗服务护士对创伤后脊柱损伤院前预防性固定协议变更的经验和观点：定性研究。

IF 1.8 4区医学 Q2 NURSING

International Emergency Nursing

Pub Date : 2024-11-22 DOI: 10.1016/j.ienj.2024.101533

Otto J. van de Breevaart , Nancy E.E. Van Loey , Luke P.H. Leenen , Lisette Schoonhoven , Wietske H.W. Ham

Objective

In 2016, a selective preventive spinal immobilization protocol for emergency medical service (EMS) nurses was introduced in the Netherlands. This protocol leaves more room for autonomous decision-making in the pre-hospital phase regarding preventive spinal immobilization (PSI), compared to the previous strict protocol. In this study, we explored the experiences and perspectives of EMS nurses on decisionmaking about PSI after the change from a strict to a selective PSI protocol. Methods: We used a qualitative design with semi-structured face-to-face interviews. Thematic analysis was applied. The capability-opportunity-motivation-behavior-model was used to interpret the experiences and perspectives. Results: Thirteen EMS nurses from three emergency medical services were interviewed. Respondents appreciated autonomous decision-making as there was more room for patient-centered informed decision-making. However, autonomous decision-making required optimized knowledge and skills and elicited the need to receive feedback on their decision not to apply PSI. When nurses anticipated resistance to selective PSI from receiving hospitals, they were doubtful to apply it. Conclusion: Nurses appreciate the increased autonomy in decision-making, encouraging them to focus on patient-centered care. Increased autonomy also places higher demands on knowledge and skills, calling for training and feedback. Anticipated resistance to receiving hospitals based on mutual protocol discrepancies could lead to PSI application by EMS nurses while not deemed necessary. Recommendations: To enhance PSI procedures, optimizing the knowledge and skills of EMS nurses that facilitate on-scene decision-making may be indicated. A learning loop for feedback between the EMS nurses and the involved hospitals may add to their professional performance. More efforts are needed to create support for the changed Emergency Medical Services strategy in PSI to prevent unnecessary PSI and practice variation.

目的：2016 年，荷兰为急救医疗服务 (EMS) 护士推出了选择性预防性脊柱固定方案。与之前的严格规程相比，该规程在院前阶段为预防性脊柱固定（PSI）的自主决策留出了更多空间。在本研究中，我们探讨了从严格的 PSI 方案转变为选择性 PSI 方案后，急救护士在 PSI 决策方面的经验和观点：方法：我们采用了半结构化面对面访谈的定性设计。采用主题分析法。采用能力-机会-动机-行为模型来解释经验和观点：来自三个紧急医疗服务机构的 13 名急救护士接受了访谈。受访者对自主决策表示赞赏，因为这为以患者为中心的知情决策提供了更大的空间。然而，自主决策需要优化的知识和技能，并需要在决定不使用 PSI 时得到反馈。当护士预料到接收医院对选择性 PSI 的抵制时，她们对应用 PSI 持怀疑态度：结论：护士对决策自主权的增加表示赞赏，这鼓励她们将精力集中在以患者为中心的护理上。自主权的增加也对知识和技能提出了更高的要求，需要培训和反馈。基于双方协议的差异，预计接收医院会有抵触情绪，这可能会导致急救护士在认为没有必要的情况下应用 PSI：建议：为加强 PSI 程序，应优化急救护士的知识和技能，以促进现场决策。在急救护理人员和相关医院之间建立反馈学习回路，可提高他们的专业表现。还需要做出更多努力，为急救医疗服务在 PSI 中改变策略提供支持，以防止不必要的 PSI 和实践差异。

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引用次数: 0

Decreasing hemolysis rates through phlebotomy education 通过抽血疗法教育降低溶血率。

IF 1.8 4区医学 Q2 NURSING

International Emergency Nursing

Pub Date : 2024-11-20 DOI: 10.1016/j.ienj.2024.101534

Mariolina Bartolomeo, Christina Tedesco, LuAnn Etcher

引用次数: 0

What is the optimal outcome for evaluating the triage Systems? Insights from a prospective observational study 评估分流系统的最佳结果是什么？前瞻性观察研究的启示。

IF 1.8 4区医学 Q2 NURSING

International Emergency Nursing

Pub Date : 2024-11-19 DOI: 10.1016/j.ienj.2024.101540

Arian Zaboli , Francesco Brigo , Serena Sibilio , Gloria Brigiari , Magdalena Massar , Marta Parodi , Michael Mian , Norbert Pfeifer , Gianni Turcato

Background

Currently, there is no universally accepted gold standard outcome for assessing the effectiveness of the Triage Systems. This study aimed to comprehensively evaluate and compare various outcomes utilized in triage studies.

Methods

A prospective observational study was conducted at the Emergency Department (ED) of Merano Hospital from June 1 to December 31, 2023. We assessed the predictive capability of the Manchester Triage System (MTS) across multiple outcomes using areas under the receiver operating characteristic curve (AUROC), along with their corresponding 95% confidence intervals (95% CI), and frequency distributions.

Results

The MTS demonstrated strong performance concerning the most objective outcomes, such as mortality (at 72 h: AUROC 0.914; 95 %CI: 0.815–1; at 7 days: 0.845; 95 %CI: 0.729–0.965; at 30 days: 0.794; 95 %CI: 0.706–0.881), admission to the intensive care unit (0.831; 95 %CI: 0.763–0.899), and need for life-saving interventions (0.870; 95 %CI: 0.806–0.934). Additionally, outcomes such as urgency status and clinical priority, as judged by physicians, exhibited excellent performance and optimal frequency distribution.

Conclusions

The performance of the MTS varied significantly depending on the specific outcome under evaluation. Currently, no single outcome appears superior to others, nor does any seem poised to serve as a potential gold standard for the assessment of triage systems. It is advisable for dedicated working groups to convene and reach a consensus on the most effective outcomes for evaluating the performance of MTS and other triage systems. This should be accomplished through a systematic, standardized, and transparent approach, grounded in the best available evidence.

背景：目前，在评估分诊系统的有效性方面还没有公认的金标准结果。本研究旨在全面评估和比较分诊研究中使用的各种结果：一项前瞻性观察研究于 2023 年 6 月 1 日至 12 月 31 日在梅拉诺医院急诊科（ED）进行。我们使用接收者操作特征曲线下面积（AUROC）及其相应的 95% 置信区间（95% CI）和频率分布评估了曼彻斯特分诊系统（MTS）对多种结果的预测能力：结果：MTS 在死亡率等最客观的结果方面表现出色（72 小时内：AUROC 0.914；72 小时后：AUROC 0.914；72 小时后：AUROC 0.914）：AUROC 0.914; 95 %CI: 0.815-1; at 7 days：0.845; 95 %CI: 0.729-0.965; at 30 days：0.794; 95 %CI: 0.706-0.881）、入住重症监护室（0.831; 95 %CI: 0.763-0.899）和救生干预需求（0.870; 95 %CI: 0.806-0.934）。此外，由医生判断的紧急状况和临床优先级等结果也表现出优异的性能和最佳的频率分布：MTS的性能因评估的具体结果不同而有很大差异。目前，没有任何一种结果比其他结果更优越，也没有任何一种结果可以作为评估分流系统的潜在黄金标准。最好由专门的工作组召开会议，就评估 MTS 和其他分流系统性能的最有效结果达成共识。要做到这一点，就必须以现有的最佳证据为基础，采用系统化、标准化和透明的方法。

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引用次数: 0

The Multinational Association for Supportive Care in cancer criteria. An Evaluation and recommendations for the management of neutropenia in the emergency department 多国癌症支持性治疗协会标准。对急诊科中性粒细胞减少症处理的评估和建议。

IF 1.8 4区医学 Q2 NURSING

International Emergency Nursing

Pub Date : 2024-11-19 DOI: 10.1016/j.ienj.2024.101542

Anas Alsharawneh

Objectives

We aimed to evaluate the reproducibility, accuracy, feasibility, and effect of the Multinational Association for Supportive Care in Cancer (MASCC) criteria on emergency clinical decisions, treatment, and health outcomes.

Methods

A retrospective cohort design was used.

Results

The MASCC score was better at correctly detecting the high urgency (70 % of patients with a high urgency were identified as high risk) than the low urgency (only 30 % of patients with a low urgency were identified as low risk). The examination of the MASCC score as a continuous variable could have been more valuable and indicated inferior validity. The likelihood ratios were far from good, which is better for ruling out the high urgency. The observed likelihood ratio of the MASCC range 17 to 20 provided no information for the goodness of the scale (equal to one). The results from multiple linear regression analyses identified that the MASCC original categorization (high vs. low risk) and the investigated new one (multiple ranges of MASCC score) were significantly associated with time to reassessment, time to be seen, time to decide on admission, boarding time until disposition, and length of stay. However, the original categorization nor the new one was predictive of the admission site. Still, both were significantly associated with hospital disposition (mortality) (p < 0.05).

Conclusion

Even though the MASCC score determines the neutropenia treatment pathway, the sensitivity and specificity analysis identified that the scale did not perform well in detecting real clinical urgency.

目的我们旨在评估多国癌症支持性治疗协会（MASCC）标准的可重复性、准确性、可行性以及对急诊临床决策、治疗和健康结果的影响：方法：采用回顾性队列设计：结果：MASCC评分在正确检测高危急症方面（70%的高危急症患者被认定为高危）优于低危急症（仅30%的低危急症患者被认定为低危）。将 MASCC 评分作为一个连续变量进行研究可能更有价值，但其有效性较差。似然比远远不够，这更有利于排除高危急症。观察到的 MASCC 17 至 20 分的似然比没有提供量表好坏的信息（等于 1）。多元线性回归分析结果表明，MASCC 原始分类（高危与低危）和新调查分类（MASCC 评分的多个范围）与重新评估时间、就诊时间、决定入院时间、处置前的住院时间和住院时间有显著相关性。但是，原始分类和新分类都不能预测入院地点。尽管如此，两者都与入院处置（死亡率）有明显相关性（P 结论）：尽管 MASCC 评分决定了中性粒细胞减少症的治疗路径，但敏感性和特异性分析表明，该量表在检测真正的临床紧迫性方面表现不佳。

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引用次数: 0

“It’s about making a difference”: Interplay of professional value formation and sense of coherence in newly graduated Finnish paramedics "与众不同"：新毕业的芬兰辅助医务人员的职业价值观形成与连贯感的相互作用。

IF 1.8 4区医学 Q2 NURSING

International Emergency Nursing

Pub Date : 2024-11-18 DOI: 10.1016/j.ienj.2024.101541

Christoffer R Ericsson , Veronica Lindström , Ann Rudman , Hilla Nordquist

引用次数: 0

Effect of rescue work training in nursing students with a novel device: A quasi-experimental study 使用新型设备对护理专业学生进行抢救工作培训的效果：准实验研究。

IF 1.8 4区医学 Q2 NURSING

International Emergency Nursing

Pub Date : 2024-11-18 DOI: 10.1016/j.ienj.2024.101544

Verónica V. Márquez Hernández , José Miguel Garrido-Molina , Antonio Javier Segura-Fornieles , Mª Carmen Rodríguez-García , Alba García-Viola

Aims

The aim of this study was to analyze the effectiveness of an intervention for the training of nursing students in rescue work of a traumatized patient using the Snaid® device.

Methods

A quasi-experimental one group pretest–posttest study was carried out. A total of 107 nursing students participated. Data on self-efficacy, knowledge, ergonomics and skill were collected. The data were analyzed with SPSS version 29 statistical software.

Results

Statistically significant differences were found between mean self-efficacy score and time of measurement (U = 2090.500; Z = -8.377; p < 0.001). Statistically significant differences were also found between the time of measurement and the knowledge score (U = 373.000; Z = -11.966; p < 0.001). Considering the results on ergonomics, it was found that the mean score given after the intervention was 9.37 (SD = 1.02). Regarding intervention time, the mean time was 47.76 s (SD = 4.74). Finally, considering skill, the mean score was 8.78 (SD = 1.23).

Conclusion

The results of the present study indicate that participants obtained a high level of self-efficacy, knowledge, skill and ergonomics after training in the rescue work of a patient through the Snaid® device. This device may contribute to improve trauma patient care.

目的：本研究旨在分析使用 Snaid® 设备对护理专业学生进行创伤患者抢救工作培训的干预效果：方法：开展了一项前测-后测一组的准实验研究。共有 107 名护理专业学生参加。研究收集了有关自我效能感、知识、人体工程学和技能的数据。数据采用 SPSS 29 版统计软件进行分析：本研究的结果表明，在通过 Snaid® 设备对患者进行抢救工作培训后，参与者获得了较高的自我效能感、知识、技能和人体工程学水平。该设备可能有助于改善创伤患者的护理。

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引用次数: 0