Pub Date : 2024-05-14DOI: 10.1016/j.ienj.2024.101458
Aisha Amzaidy M. Assiry , Nathan J. Brown , Sarah Hazelwood , Anna-Lisa Lyrstedt , Rajeev Jarugula , Lee Jones , Kevin Chu , James A. Hughes
{"title":"The use and outcomes of non-pharmacological analgesia in the adult emergency department","authors":"Aisha Amzaidy M. Assiry , Nathan J. Brown , Sarah Hazelwood , Anna-Lisa Lyrstedt , Rajeev Jarugula , Lee Jones , Kevin Chu , James A. Hughes","doi":"10.1016/j.ienj.2024.101458","DOIUrl":"10.1016/j.ienj.2024.101458","url":null,"abstract":"","PeriodicalId":48914,"journal":{"name":"International Emergency Nursing","volume":"74 ","pages":"Article 101458"},"PeriodicalIF":1.8,"publicationDate":"2024-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1755599X24000533/pdfft?md5=29e7ddd890161e9f387d8a7c7587be97&pid=1-s2.0-S1755599X24000533-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140946180","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-05-13DOI: 10.1016/j.ienj.2024.101457
Ellen Benjamin
Introduction
The current crisis of emergency department overcrowding demands novel approaches. Despite a growing body of patient flow literature, there is little understanding of the work of emergency nurses. This study explored how emergency nurses perform patient flow management.
Methods
Constructivist grounded theory and situational analysis methodologies were used to examine the work of emergency nurses. Twenty-nine focus groups and interviews of 27 participants and 64 hours of participant observation across four emergency departments were conducted between August 2022 and February 2023. Data were analyzed using coding, constant comparative analysis, and memo-writing to identify emergent themes and develop a substantive theory.
Findings
Patient flow management is the work of balancing department resources and patient care to promote collective patient safety. Patient safety arises when care is ethical, efficient, and appropriately weighs care timeliness and comprehensiveness. Emergency nurses use numerous patient flow management strategies that can be organized into five tasks: information gathering, continuous triage, resource management, throughput management, and care oversight.
Conclusion
Patient flow management is complex, cognitively demanding work. The central contribution of this paper is a theoretical model that reflects emergency nurses’conceptualizations, discourse, and priorities. This model lays the foundation for knowledge sharing, training, and practice improvement
{"title":"The work of patient flow management: A grounded theory study of emergency nurses","authors":"Ellen Benjamin","doi":"10.1016/j.ienj.2024.101457","DOIUrl":"https://doi.org/10.1016/j.ienj.2024.101457","url":null,"abstract":"<div><h3>Introduction</h3><p>The current crisis of emergency department overcrowding demands novel approaches. Despite a growing body of patient flow literature, there is little understanding of the work of emergency nurses. This study explored how emergency nurses perform patient flow management.</p></div><div><h3>Methods</h3><p>Constructivist grounded theory and situational analysis methodologies were used to examine the work of emergency nurses. Twenty-nine focus groups and interviews of 27 participants and 64 hours of participant observation across four emergency departments were conducted between August 2022 and February 2023. Data were analyzed using coding, constant comparative analysis, and memo-writing to identify emergent themes and develop a substantive theory.</p></div><div><h3>Findings</h3><p>Patient flow management is the work of balancing department resources and patient care to promote collective patient safety. Patient safety arises when care is ethical, efficient, and appropriately weighs care timeliness and comprehensiveness. Emergency nurses use numerous patient flow management strategies that can be organized into five tasks: information gathering, continuous triage, resource management, throughput management, and care oversight.</p></div><div><h3>Conclusion</h3><p>Patient flow management is complex, cognitively demanding work. The central contribution of this paper is a theoretical model that reflects emergency nurses’conceptualizations, discourse, and priorities. This model lays the foundation for knowledge sharing, training, and practice improvement</p></div>","PeriodicalId":48914,"journal":{"name":"International Emergency Nursing","volume":"74 ","pages":"Article 101457"},"PeriodicalIF":1.8,"publicationDate":"2024-05-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1755599X24000521/pdfft?md5=cbde2c8b6d57446fbda89145e9fc3645&pid=1-s2.0-S1755599X24000521-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140914064","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Parents often take their children to the Paediatric Accident and Emergency Department (A&E) for non-urgent consultations rather than using community-based primary care services. This study describes the use of primary care services in parents taking their children to the A&E for non-urgent consultations.
Methods
A cross-sectional study was conducted from July 2018 to June 2019, in a second-level Italian paediatric A&E of a tertiary-level children’s academic research and hub hospital. Parents of children aged between 3 months and 6 years assigned with a white code at the triage were asked to complete a paper-and-pencil 40-item questionnaire after accessing the A&E for a non-urgent consultation.
Results
The questionnaire was completed by the parents of 237 children (males 58 %; median age = 2.3 years). Overall, 48.1 % (n = 114) of the parents reported consulting ‘often/always’ the primary care paediatrician, mainly when their child was sick and for check-ups (n = 182, 76.8 %). However, only 7.2 % (n = 17) of the parents ‘often/always’ used any other health service in the community. Most of them (n = 191, 82 %) did not even know where the community health centre was located.
Conclusion
Parents accessing the A&E for non-urgent consultations should be better informed/educated on how to use community health services.
{"title":"Children accessing accident and emergency department for non-urgent consultations: A cross-sectional study about parents’ use of primary care services","authors":"Immacolata Dall’Oglio , Valentina Biagioli , Alessandra Pol , Orsola Gawronski , Claudia Carlin , Luisa Cirulli , Simone Piga , Rocco Stelitano , Caterina Offidani , Umberto Raucci , Antonino Reale , Emanuela Tiozzo , Alberto Villani , Massimiliano Raponi","doi":"10.1016/j.ienj.2024.101436","DOIUrl":"https://doi.org/10.1016/j.ienj.2024.101436","url":null,"abstract":"<div><h3>Introduction</h3><p>Parents often take their children to the Paediatric Accident and Emergency Department (A&E) for non-urgent consultations rather than using community-based primary care services. This study describes the use of primary care services in parents taking their children to the A&E for non-urgent consultations.</p></div><div><h3>Methods</h3><p>A cross-sectional study was conducted from July 2018 to June 2019, in a second-level Italian paediatric A&E of a tertiary-level children’s academic research and hub hospital. Parents of children aged between 3 months and 6 years assigned with a white code at the triage were asked to complete a paper-and-pencil 40-item questionnaire after accessing the A&E for a non-urgent consultation.</p></div><div><h3>Results</h3><p>The questionnaire was completed by the parents of 237 children (males 58 %; median age = 2.3 years). Overall, 48.1 % (n = 114) of the parents reported consulting ‘often/always’ the primary care paediatrician, mainly when their child was sick and for check-ups (n = 182, 76.8 %). However, only 7.2 % (n = 17) of the parents ‘often/always’ used any other health service in the community. Most of them (n = 191, 82 %) did not even know where the community health centre was located.</p></div><div><h3>Conclusion</h3><p>Parents accessing the A&E for non-urgent consultations should be better informed/educated on how to use community health services.</p></div>","PeriodicalId":48914,"journal":{"name":"International Emergency Nursing","volume":"74 ","pages":"Article 101436"},"PeriodicalIF":1.8,"publicationDate":"2024-05-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140917959","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}
Pub Date : 2024-05-03DOI: 10.1016/j.ienj.2024.101448
Ben Lawson, Brett Williams
Introduction
Organ donation is a life-saving intervention that provides hope for patients with end-stage organ failure, improving their longevity and quality of life. However, the demand for organs far exceeds the supply, leading to a significant disparity between patients on transplant waiting lists and the availability of suitable organs. To address this issue, innovative strategies, such as uncontrolled donation after circulatory death (uDCD) programs, have been proposed to expand the donor pool to the prehospital setting.
Aim
This study aimed to systematically map the literature and comprehensively evaluate the involvement of prehospital healthcare professionals in identifying potential organ donors, as well as the barriers and systems impacting this process.
Methods
A scoping literature review was conducted guided by the PRISMA Extension for Scoping Reviews. Four electronic databases and grey literature were searched for articles examining the participation of prehospital healthcare professionals in the organ or tissue donation process. Relevant data were extracted, organised into narrative and tabular formats, and presented.
Results
A total of 33 articles were included for analysis, predominantly focusing on uDCD programs. The review identified a limited evidence-base regarding the role of prehospital healthcare professionals in organ donation. Four common themes emerged: discrepancies in criteria, decision-making processes, bridging strategies, and ethical considerations.
Conclusion
This scoping literature review highlights the significant role of prehospital healthcare professionals in identifying and recruiting organ donors from non-traditional settings. Established uDCD systems show promise in alleviating the burden on transplant waitlists. However, there is a lack of consensus on enrolment criteria, transportation, and ethical considerations for uDCD. Further research is needed to address these gaps, establish evidence-based guidelines, and ensure the efficient and ethical utilisation of potential organ donors from unconventional settings.
{"title":"Identifying organ donors attended by prehospital healthcare professionals – A scoping review","authors":"Ben Lawson, Brett Williams","doi":"10.1016/j.ienj.2024.101448","DOIUrl":"https://doi.org/10.1016/j.ienj.2024.101448","url":null,"abstract":"<div><h3>Introduction</h3><p>Organ donation is a life-saving intervention that provides hope for patients with end-stage organ failure, improving their longevity and quality of life. However, the demand for organs far exceeds the supply, leading to a significant disparity between patients on transplant waiting lists and the availability of suitable organs. To address this issue, innovative strategies, such as uncontrolled donation after circulatory death (uDCD) programs, have been proposed to expand the donor pool to the prehospital setting.</p></div><div><h3>Aim</h3><p>This study aimed to systematically map the literature and comprehensively evaluate the involvement of prehospital healthcare professionals in identifying potential organ donors, as well as the barriers and systems impacting this process.</p></div><div><h3>Methods</h3><p>A scoping literature review was conducted guided by the PRISMA Extension for Scoping Reviews. Four electronic databases and grey literature were searched for articles examining the participation of prehospital healthcare professionals in the organ or tissue donation process. Relevant data were extracted, organised into narrative and tabular formats, and presented.</p></div><div><h3>Results</h3><p>A total of 33 articles were included for analysis, predominantly focusing on uDCD programs. The review identified a limited evidence-base regarding the role of prehospital healthcare professionals in organ donation. Four common themes emerged: discrepancies in criteria, decision-making processes, bridging strategies, and ethical considerations.</p></div><div><h3>Conclusion</h3><p>This scoping literature review highlights the significant role of prehospital healthcare professionals in identifying and recruiting organ donors from non-traditional settings. Established uDCD systems show promise in alleviating the burden on transplant waitlists. However, there is a lack of consensus on enrolment criteria, transportation, and ethical considerations for uDCD. Further research is needed to address these gaps, establish evidence-based guidelines, and ensure the efficient and ethical utilisation of potential organ donors from unconventional settings.</p></div>","PeriodicalId":48914,"journal":{"name":"International Emergency Nursing","volume":"74 ","pages":"Article 101448"},"PeriodicalIF":1.8,"publicationDate":"2024-05-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1755599X24000430/pdfft?md5=e1c6f229986c6edc42a1a9b63271849a&pid=1-s2.0-S1755599X24000430-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140822404","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-04-29DOI: 10.1016/j.ienj.2024.101450
Manuel Pons Claramonte , Sergio Nieto Caballero , Damián Escribano Tortosa , Maria Dolores Contreras-Aguilar , Jose Joaquin Ceron Madrigal , Juan José Hernández Morante , Ana Nicolas Carrillo , Manuel Pardo Rios , Esther Chicharro-Luna
Introduction
Stress, described as an adaptation of the body to an event, is a considerable problem among health workers, especially for those who work in emergency situations, as they very often have to face complex situations. It has been proven that stress affects the performance of health professionals, which is why it is interesting to measure it in these situations, to be able to know what methods to implement to reduce it in future events. Despite having previous measurements in healthcare personnel during clinical simulations, this study is relevant because stress has never before been measured in EMS professionals when performing their work.
Objective
To determine the acute stress experienced by professionals in an Emergency Medical Service (EMS) when handling five types of clinical emergencies. As secondary objectives, to determine if there were differences in the increases in stress in relation to sex, age, profession, team, and above all, type of emergency handled.
Method
The following were measured for the analysis: physiological (mean heart rate (HR), systolic (SBP) and diastolic (DBP) blood pressure), and biochemical (salivary alpha amylase (sAA) activity) markers, before (Basal) and after (Post-Stress) the interventions of 27 professionals from an EMS.
Results
In general, the results obtained showed significant differences between the baseline measurement of physiological and biochemical markers versus the post-exposure measurement. Some of the differences in stress levels in relation to sex and professional role are striking.
Conclusion
The determination of acute stress experienced by professionals from an EMS in a real emergency showed significant increases in the sAA enzymatic marker of acute stress. These results are the first data published in this regard, and could be used as a reference to follow in clinical simulation in the training of students and the training of nursing professionals.
Implications for clinical practice
Evidence based studies are needed to improve the education and training of emergency and intensive care professionals. The results from are a great step in the analysis of the real stress that professionals are subjected to when they handle different emergencies.
{"title":"The stress experienced in an emergency medical service (EMS): A descriptive study","authors":"Manuel Pons Claramonte , Sergio Nieto Caballero , Damián Escribano Tortosa , Maria Dolores Contreras-Aguilar , Jose Joaquin Ceron Madrigal , Juan José Hernández Morante , Ana Nicolas Carrillo , Manuel Pardo Rios , Esther Chicharro-Luna","doi":"10.1016/j.ienj.2024.101450","DOIUrl":"https://doi.org/10.1016/j.ienj.2024.101450","url":null,"abstract":"<div><h3>Introduction</h3><p>Stress, described as an adaptation of the body to an event, is a considerable problem among health workers, especially for those who work in emergency situations, as they very often have to face complex situations. It has been proven that stress affects the performance of health professionals, which is why it is interesting to measure it in these situations, to be able to know what methods to implement to reduce it in future events. Despite having previous measurements in healthcare personnel during clinical simulations, this study is relevant because stress has never before been measured in EMS professionals when performing their work.</p></div><div><h3>Objective</h3><p>To determine the acute stress experienced by professionals in an Emergency Medical Service (EMS) when handling five types of clinical emergencies. As secondary objectives, to determine if there were differences in the increases in stress in relation to sex, age, profession, team, and above all, type of emergency handled.</p></div><div><h3>Method</h3><p>The following were measured for the analysis: physiological (mean heart rate (HR), systolic (SBP) and diastolic (DBP) blood pressure), and biochemical (salivary alpha amylase (sAA) activity) markers, before (Basal) and after (Post-Stress) the interventions of 27 professionals from an EMS.</p></div><div><h3>Results</h3><p>In general, the results obtained showed significant differences between the baseline measurement of physiological and biochemical markers versus the post-exposure measurement. Some of the differences in stress levels in relation to sex and professional role are striking.</p></div><div><h3>Conclusion</h3><p>The determination of acute stress experienced by professionals from an EMS in a real emergency showed significant increases in the sAA enzymatic marker of acute stress. These results are the first data published in this regard, and could be used as a reference to follow in clinical simulation in the training of students and the training of nursing professionals.</p></div><div><h3>Implications for clinical practice</h3><p>Evidence based studies are needed to improve the education and training of emergency and intensive care professionals. The results from are a great step in the analysis of the real stress that professionals are subjected to when they handle different emergencies.</p></div>","PeriodicalId":48914,"journal":{"name":"International Emergency Nursing","volume":"74 ","pages":"Article 101450"},"PeriodicalIF":1.8,"publicationDate":"2024-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140807826","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}
Understanding moral distress and resilience is crucial for supporting the well-being of emergency nursing staff and improving patient care. However, there is limited research specifically examining moral distress and resilience among emergency nursing staff in ARAR city hospitals.
Aims
This study aims to examine moral distress and resilience levels among emergency nursing staff in ARAR city hospitals. Specifically, the study seeks to determine the correlation between moral distress and resilience among emergency nursing staff and examine differences in the levels of moral distress and resilience among different demographic and occupational characteristics.
Methods
A cross-sectional study design was employed, involving a non-probability stratified sample of emergency nursing staff from two hospitals in ARAR city. The participants completed a Brazilian Moral Distress Scale in Nurses (MDSN-BR) and Rushton Moral Resilience Scale in Nurses (RMRS). Statistical analyses, including descriptive statistics and one-way- ANOVA, were conducted to analyze the data.
Results
The study found that emergency nursing had a moderate level of moral distress, with a mean frequency of 2.70 (SD = 1.02) and a mean intensity of 2.79 (SD = 1.04). The overall self-reported moral resilience was also moderate, with a mean score of 2.48 (SD = 0.77). Significant positive correlations were observed between resilience and both moral distress frequency (r = 0.48, p = 0.001) and intensity (r = 0.48, p = 0.001). Educational levels and nursing positions were associated with variations in moral distress and resilience. Postgraduate diploma emergency nursing reported the highest levels of moral distress frequency (3.12, SD = 1.14) and intensity (3.21, SD = 1.16). A bachelor's degree in nursing exhibited higher levels of personal integrity (3.06, SD = 0.87), while a master's degree in nursing showed higher levels of moral efficacy (2.88, SD = 1.09). Head nurses experienced higher levels of moral distress compared to other positions (3.08, SD = 1.37 for frequency; 3.18, SD = 1.29 for intensity).
Conclusion
The study revealed that emergency nursing experienced relatively moderate levels of moral distress, which could be attributed to insufficient multidisciplinary teams and unprepared actions. The findings also highlighted moderate levels of moral resilience, particularly in relational integrity. Educational levels and nursing positions were found to influence moral distress and resilience. These results underscore the need for targeted interventions to support the well-being of emergency nurses and enhance ethical decision-making.
{"title":"The moral distress and resilience among emergency nurses in Arar city: Saudi Arabia","authors":"Arwa Jazzaa Alruwaili , Mohannad Jamil Alkuwaisi , Eman Jazzaa Alruwaili","doi":"10.1016/j.ienj.2024.101447","DOIUrl":"https://doi.org/10.1016/j.ienj.2024.101447","url":null,"abstract":"<div><h3>Background</h3><p>Understanding moral distress and resilience is crucial for supporting the well-being of emergency nursing staff and improving patient care. However, there is limited research specifically examining moral distress and resilience among emergency nursing staff in ARAR city hospitals.</p></div><div><h3>Aims</h3><p>This study aims to examine moral distress and resilience levels among emergency nursing staff in ARAR city hospitals. Specifically, the study seeks to determine the correlation between moral distress and resilience among emergency nursing staff and examine differences in the levels of moral distress and resilience among different demographic and occupational characteristics.</p></div><div><h3>Methods</h3><p>A cross-sectional study design was employed, involving a non-probability stratified sample of emergency nursing staff from two hospitals in ARAR city. The participants completed a Brazilian Moral Distress Scale in Nurses (MDSN-BR) and Rushton Moral Resilience Scale in Nurses (RMRS). Statistical analyses, including descriptive statistics and one-way- ANOVA, were conducted to analyze the data.</p></div><div><h3>Results</h3><p>The study found that emergency nursing had a moderate level of moral distress, with a mean frequency of 2.70 (SD = 1.02) and a mean intensity of 2.79 (SD = 1.04). The overall self-reported moral resilience was also moderate, with a mean score of 2.48 (SD = 0.77). Significant positive correlations were observed between resilience and both moral distress frequency (r = 0.48, p = 0.001) and intensity (r = 0.48, p = 0.001). Educational levels and nursing positions were associated with variations in moral distress and resilience. Postgraduate diploma emergency nursing reported the highest levels of moral distress frequency (3.12, SD = 1.14) and intensity (3.21, SD = 1.16). A bachelor's degree in nursing exhibited higher levels of personal integrity (3.06, SD = 0.87), while a master's degree in nursing showed higher levels of moral efficacy (2.88, SD = 1.09). Head nurses experienced higher levels of moral distress compared to other positions (3.08, SD = 1.37 for frequency; 3.18, SD = 1.29 for intensity).</p></div><div><h3>Conclusion</h3><p>The study revealed that emergency nursing experienced relatively moderate levels of moral distress, which could be attributed to insufficient multidisciplinary teams and unprepared actions. The findings also highlighted moderate levels of moral resilience, particularly in relational integrity. Educational levels and nursing positions were found to influence moral distress and resilience. These results underscore the need for targeted interventions to support the well-being of emergency nurses and enhance ethical decision-making.</p></div>","PeriodicalId":48914,"journal":{"name":"International Emergency Nursing","volume":"74 ","pages":"Article 101447"},"PeriodicalIF":1.8,"publicationDate":"2024-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140813348","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}
This study aimed to assess the proficiency of nurses in interpreting electrocardiogram within the adult emergency units of Addis Ababa, Ethiopia, during the year 2021.
Methods
This institutional-based descriptive, cross-sectional study involved 175 nurses from five randomly selected hospitals' adult emergency units. Semi-structured, self-administered questionnaires were used for data collection. Data were entered into Epi-Data and analyzed using SPSS version 26. Fisher's exact test identified statistical significance between dependent and independent variables at a p-value < 0.05.
Results
Out of 203 respondents, 175 participated actively, yielding a response rate of 86.2%. Among these nurses, 159 (90.9%) were deemed not competent (scoring < 65%), with a mean score of 6.82 ± 3.65 SD.
Patient or Public Contribution
No patient or public contribution was included in this study.
Conclusion
The overall competency level in electrocardiogram interpretation among nurses is significantly poor. This indicates that most nurses in the emergency units are unable to accurately interpret ECG monitoring, potentially leading to the failure to recognize signs of arrhythmias, electrolyte disturbances, and other cardiac abnormalities. Consequently, this may result in inappropriate patient care and increased mortality rates. Education and training were identified as key factors in enhancing their competency.
{"title":"Nurses’ competency on electrocardiography interpretation in adult emergency room: Addis Ababa, Ethiopia, 2021. Multicenter cross-sectional study","authors":"Yegremew Haimanot Belay , Demmelash Gezahegn , Birhanu Melaku , Ousman Adal","doi":"10.1016/j.ienj.2024.101453","DOIUrl":"https://doi.org/10.1016/j.ienj.2024.101453","url":null,"abstract":"<div><h3>Aim</h3><p>This study aimed to assess the proficiency of nurses in interpreting electrocardiogram within the adult emergency units of Addis Ababa, Ethiopia, during the year 2021.</p></div><div><h3>Methods</h3><p>This institutional-based descriptive, cross-sectional study involved 175 nurses from five randomly selected hospitals' adult emergency units. Semi-structured, self-administered questionnaires were used for data collection. Data were entered into Epi-Data and analyzed using SPSS version 26. Fisher's exact test identified statistical significance between dependent and independent variables at a p-value < 0.05.</p></div><div><h3>Results</h3><p>Out of 203 respondents, 175 participated actively, yielding a response rate of 86.2%. Among these nurses, 159 (90.9%) were deemed not competent (scoring < 65%), with a mean score of 6.82 ± 3.65 SD.</p></div><div><h3>Patient or Public Contribution</h3><p>No patient or public contribution was included in this study.</p></div><div><h3>Conclusion</h3><p>The overall competency level in electrocardiogram interpretation among nurses is significantly poor. This indicates that most nurses in the emergency units are unable to accurately interpret ECG monitoring, potentially leading to the failure to recognize signs of arrhythmias, electrolyte disturbances, and other cardiac abnormalities. Consequently, this may result in inappropriate patient care and increased mortality rates. Education and training were identified as key factors in enhancing their competency.</p></div>","PeriodicalId":48914,"journal":{"name":"International Emergency Nursing","volume":"74 ","pages":"Article 101453"},"PeriodicalIF":1.8,"publicationDate":"2024-04-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140650046","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}
Pub Date : 2024-04-26DOI: 10.1016/j.ienj.2024.101454
Andrew Rixon , Elizabeth Elder , Claudia Bull , Julia Crilly OAM , Christina Østervan , Hayley Frieslich , Shaun Robertson , Ed Pink , Samuel Wilson
Background
The Emergency Department (ED) is a setting where teamwork and leadership is imperative, however, the literature to date is mostly discipline (nursing or medical) specific. This scoping review aimed to map what is known about nurses’ and physicians’ conceptions of leadership in the ED to understand similarities, differences, and opportunities for leadership development and research.
Method
Guided by the Joanna Briggs Institute approach, and Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) Guidelines, a systematic search of three electronic databases was performed. The Mixed Methods Assessment Tool was used for quality appraisal of included articles.
Results
In total, 37 articles were included. Four key findings emerged: 1) leadership was rarely explicitly defined; 2) nurse leaders tended to be characterised as agents of continuity whilst physician leaders tended to be characterised as agents of change and continuity; 3) the clarification of expectations from nurse leaders was more evident than expectations from physician leaders; and 4) leadership discourse tended to be traditional rather than contemporary.
Conclusion
Despite the proliferation of studies into ED nurse, physician and interprofessional leadership, opportunities exist to integrate learnings from other sectors to strengthen the development of current and next generation of ED leaders.
{"title":"Leadership conceptions of nurses and physicians in emergency care: A scoping review","authors":"Andrew Rixon , Elizabeth Elder , Claudia Bull , Julia Crilly OAM , Christina Østervan , Hayley Frieslich , Shaun Robertson , Ed Pink , Samuel Wilson","doi":"10.1016/j.ienj.2024.101454","DOIUrl":"https://doi.org/10.1016/j.ienj.2024.101454","url":null,"abstract":"<div><h3>Background</h3><p>The Emergency Department (ED) is a setting where teamwork and leadership is imperative, however, the literature to date is mostly discipline (nursing or medical) specific. This scoping review aimed to map what is known about nurses’ and physicians’ conceptions of leadership in the ED to understand similarities, differences, and opportunities for leadership development and research.</p></div><div><h3>Method</h3><p>Guided by the Joanna Briggs Institute approach, and Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) Guidelines, a systematic search of three electronic databases was performed. The Mixed Methods Assessment Tool was used for quality appraisal of included articles.</p></div><div><h3>Results</h3><p>In total, 37 articles were included. Four key findings emerged: 1) leadership was rarely explicitly defined; 2) nurse leaders tended to be characterised as agents of continuity whilst physician leaders tended to be characterised as agents of change and continuity; 3) the clarification of expectations from nurse leaders was more evident than expectations from physician leaders; and 4) leadership discourse tended to be traditional rather than contemporary.</p></div><div><h3>Conclusion</h3><p>Despite the proliferation of studies into ED nurse, physician and interprofessional leadership, opportunities exist to integrate learnings from other sectors to strengthen the development of current and next generation of ED leaders.</p></div>","PeriodicalId":48914,"journal":{"name":"International Emergency Nursing","volume":"74 ","pages":"Article 101454"},"PeriodicalIF":1.8,"publicationDate":"2024-04-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1755599X24000491/pdfft?md5=14720e399e6b74aefd1737cefd454db0&pid=1-s2.0-S1755599X24000491-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140650045","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-04-26DOI: 10.1016/j.ienj.2024.101446
Santel de Lange, Tanya Heyns, Celia Filmalter
Background
Transfer of patients from the prehospital to the in-hospital environment is a frequent occurrence requiring a handover process. Habitually, emergency care practitioners and healthcare professionals focus on patient care activities, not prioritising person-centred handover practices and not initiating person-centred care.
Aim
The aim of this concept analysis was to define the concept person centred handover practices.
Methods
The eight steps for Walker and Avant’s method of concept analysis.
Results
Thirty-one articles were included for final review including qualitative and quantitative studies, literature reviews and audits. This concept analysis guided the development of an concept definition of person-centred handover practices between emergency care practitioners and healthcare professionals in the emergency department as person- centred handover practices are those handovers being performed while including all identified defining attributes such as structure, verbal, and written information transfer, interprofessional process, inclusion of the patient and/ or family, occurs at the bedside, without interruption.
Conclusions
Results suggested that person-centred handover practices involve verbal and non– verbal interprofessional communication within a specific location in the emergency department. It requires mutual respect from all professionals involved, experience and training, and the participation of the patient and / or family to improve patient outcomes and quality patient care. A definition for the concept may encourage the implementation of person-centred handover practices in emergency departments.
背景病人从院前环境转入院内环境是经常发生的事情，需要一个交接过程。本概念分析旨在定义以人为本的交接实践概念。方法采用 Walker 和 Avant 的概念分析方法的八个步骤。在概念分析的指导下，我们对急诊科中急诊从业人员和医护人员之间以人为本的交接班实践进行了概念定义：以人为本的交接班实践是指在进行交接班时，包括所有已确定的定义属性，如结构、口头和书面信息传递、跨专业流程、病人和/或家属的参与、在床边进行且无中断。这需要所有相关专业人员的相互尊重、经验和培训，以及病人和/或家属的参与，以改善病人的治疗效果和病人护理质量。对这一概念进行定义可鼓励在急诊科实施以人为本的交接班实践。
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