Pub Date : 2025-12-01Epub Date: 2025-10-04DOI: 10.1016/j.ienj.2025.101700
Lintang Arum Nikentari , Heri Kristianto , Laily Yuliatun , Ali Haedar , Paulus Lucky Tirma Irawan
Aims
This study aims to develop and validate an artificial intelligence -driven survival prediction model using the Random Forest algorithm to support clinical decision-making in diabetic emergency cases. The model is designed to assist emergency nurses in triage prioritization and resource allocation to improve patient outcomes.
Methods
A retrospective cross-sectional study was conducted using medical records of 1,047 diabetic emergency patients treated at regional hospital in Indonesia, from 2019 to 2024. Key clinical variables, including age, gender, blood glucose levels, Glasgow Coma Scale, triage classification, and insulin use, were analyzed. Logistic regression identified significant survival predictors, and random forest model was developed for survival prediction. Model performance was evaluated using accuracy, sensitivity, specificity, and the area under the receiver operating characteristic AUC (Area Under Curve).
Results
The random forest model identified GCS and triage classification as the most significant predictors of survival. Patients with higher GCS scores and immediate triage classification (P1) had a greater likelihood of survival. The model demonstrated high predictive performance, achieving an accuracy of 94.9 %, sensitivity of 95.6 %, specificity of 93.7 %, and an AUC of 0.96.
Conclusion
The AI-based random forest model demonstrated excellent predictive accuracy, supporting its integration into emergency nursing workflows. Implementing AI-driven decision-support systems in emergency departments may enhance triage accuracy, to improve survival outcomes in diabetic emergencies, future studies should focus on external validation and the integration of additional clinical parameters to further refine model performance.
{"title":"Artificial intelligence for improved decision-making in diabetic emergency survival: A cross-sectional study","authors":"Lintang Arum Nikentari , Heri Kristianto , Laily Yuliatun , Ali Haedar , Paulus Lucky Tirma Irawan","doi":"10.1016/j.ienj.2025.101700","DOIUrl":"10.1016/j.ienj.2025.101700","url":null,"abstract":"<div><h3>Aims</h3><div>This study aims to develop and validate an artificial intelligence -driven survival prediction model using the Random Forest algorithm to support clinical decision-making in diabetic emergency cases. The model is designed to assist emergency nurses in triage prioritization and resource allocation to improve patient outcomes.</div></div><div><h3>Methods</h3><div>A retrospective cross-sectional study was conducted using medical records of 1,047 diabetic emergency patients treated at regional hospital in Indonesia, from 2019 to 2024. Key clinical variables, including age, gender, blood glucose levels, Glasgow Coma Scale, triage classification, and insulin use, were analyzed. Logistic regression identified significant survival predictors, and random forest model was developed for survival prediction. Model performance was evaluated using accuracy, sensitivity, specificity, and the area under the receiver operating characteristic AUC (Area Under Curve).</div></div><div><h3>Results</h3><div>The random forest model identified GCS and triage classification as the most significant predictors of survival. Patients with higher GCS scores and immediate triage classification (P1) had a greater likelihood of survival. The model demonstrated high predictive performance, achieving an accuracy of 94.9 %, sensitivity of 95.6 %, specificity of 93.7 %, and an AUC of 0.96.</div></div><div><h3>Conclusion</h3><div>The AI-based random forest model demonstrated excellent predictive accuracy, supporting its integration into emergency nursing workflows. Implementing AI-driven decision-support systems in emergency departments may enhance triage accuracy, to improve survival outcomes in diabetic emergencies, future studies should focus on external validation and the integration of additional clinical parameters to further refine model performance.</div></div>","PeriodicalId":48914,"journal":{"name":"International Emergency Nursing","volume":"83 ","pages":"Article 101700"},"PeriodicalIF":1.8,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145220937","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 : 2025-12-01Epub Date: 2025-10-03DOI: 10.1016/j.ienj.2025.101682
Luke Molloy , Hadwan Aldahmashi , Tammy Tran Merrick , Kelly Lewer , Faisal Khalaf Alanazi , Louise Doyle , Brian Keogh , Timothy Wand
Background
Self-harm is a significant public health issue and a key focus of health policies globally. Emergency departments (EDs) often see self-harm cases, with emergency nurses playing a crucial role. However, care is inconsistent and substandard due to a lack of evidence-based practices and mixed attitudes among nurses.
Objective
To understand the social context of emergency nurses’ practice with self-harm patients by synthesising qualitative research findings.
Method
Noblit and Hare’s meta-ethnography method was used to synthesise qualitative studies. Three databases (PsychINFO, CINAHL, and MEDLINE) were searched for relevant studies over the period October 2013 to July 2025. Five studies with rich qualitative data were included.
Results
Nurses often feel discomfort and uncertainty when caring for self-harm patients due to a lack of knowledge and confidence. Emotional responses like frustration and anger can negatively impact care quality. Service barriers, including time constraints, lack of privacy, and inadequate guidelines, further hinder optimal care. However, with experience and education, nurses develop greater comfort and skills. The presence of mental health specialists in EDs enhances nurses’ confidence and care quality. Focused education and training are crucial for changing attitudes and improving care for self-harm patients.
Conclusion
The meta-ethnography highlights the need for improved education and training for ED nurses in mental health care. Enhancing the physical environment of EDs and fostering a culture of shared responsibility for mental health care can improve service users’ outcomes and professional satisfaction for nurses.
{"title":"Emergency nurses and the care of people who have self-harmed: A meta-ethnography","authors":"Luke Molloy , Hadwan Aldahmashi , Tammy Tran Merrick , Kelly Lewer , Faisal Khalaf Alanazi , Louise Doyle , Brian Keogh , Timothy Wand","doi":"10.1016/j.ienj.2025.101682","DOIUrl":"10.1016/j.ienj.2025.101682","url":null,"abstract":"<div><h3>Background</h3><div>Self-harm is a significant public health issue and a key focus of health policies globally. Emergency departments (EDs) often see self-harm cases, with emergency nurses playing a crucial role. However, care is inconsistent and substandard due to a lack of evidence-based practices and mixed attitudes among nurses.</div></div><div><h3>Objective</h3><div>To understand the social context of emergency nurses’ practice with self-harm patients by synthesising qualitative research findings.</div></div><div><h3>Method</h3><div>Noblit and Hare’s <em>meta</em>-ethnography method was used to synthesise qualitative studies. Three databases (PsychINFO, CINAHL, and MEDLINE) were searched for relevant studies over the period October 2013 to July 2025. Five studies with rich qualitative data were included.</div></div><div><h3>Results</h3><div>Nurses often feel discomfort and uncertainty when caring for self-harm patients due to a lack of knowledge and confidence. Emotional responses like frustration and anger can negatively impact care quality. Service barriers, including time constraints, lack of privacy, and inadequate guidelines, further hinder optimal care. However, with experience and education, nurses develop greater comfort and skills. The presence of mental health specialists in EDs enhances nurses’ confidence and care quality. Focused education and training are crucial for changing attitudes and improving care for self-harm patients.</div></div><div><h3>Conclusion</h3><div>The <em>meta</em>-ethnography highlights the need for improved education and training for ED nurses in mental health care. Enhancing the physical environment of EDs and fostering a culture of shared responsibility for mental health care can improve service users’ outcomes and professional satisfaction for nurses.</div></div>","PeriodicalId":48914,"journal":{"name":"International Emergency Nursing","volume":"83 ","pages":"Article 101682"},"PeriodicalIF":1.8,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145220938","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 : 2025-12-01Epub Date: 2025-10-16DOI: 10.1016/j.ienj.2025.101693
Baylie Trostian , Kate Curtis , Sameer Dikshit , Simon Binks , Anne Smith , Belinda Munroe , Geoff Hicks , Andrea McCloughen
Background
Women with early pregnancy bleeding experience care variations. We developed a guideline based on best available evidence to guide Emergency Department (ED) management.
Aim
To identify the barriers and enablers to the use of an evidence-based guideline for initial management of women with early pregnancy bleeding in the ED.
Methods
A mixed methods survey was distributed to 476 staff from four EDs and one Urgent Care Centre, across a health district. Quantitative data were analysed using jamovi (version 2.3.28) and qualitative data were coded and grouped into subcategories and categories. Enablers and barriers were identified, and quantitative and qualitative results were integrated.
Findings
One hundred and four staff completed the survey (response rate 21.8%). Two barriers to evidence-based practice were identified: knowledge and training gap; and ED resources and workload. Two enablers: ED clinician belief about appropriateness of care; and women are willing to stay, wait and/or request care. Two functioned as both enablers and barriers: guideline is available, however elements are absent or not applicable; and ED clinicians are confident in some but not all aspects of care.
Conclusion
Multiple enablers and barriers were identified that may affect the implementation of evidence-based practice for the management of early pregnancy bleeding.
{"title":"Barriers and enablers to evidence-based practice for the initial management of women with early pregnancy bleeding in the Emergency Department","authors":"Baylie Trostian , Kate Curtis , Sameer Dikshit , Simon Binks , Anne Smith , Belinda Munroe , Geoff Hicks , Andrea McCloughen","doi":"10.1016/j.ienj.2025.101693","DOIUrl":"10.1016/j.ienj.2025.101693","url":null,"abstract":"<div><h3>Background</h3><div>Women with early pregnancy bleeding experience care variations. We developed a guideline based on best available evidence to guide Emergency Department (ED) management.</div></div><div><h3>Aim</h3><div>To identify the barriers and enablers to the use of an evidence-based guideline for initial management of women with early pregnancy bleeding in the ED.</div></div><div><h3>Methods</h3><div>A mixed methods survey was distributed to 476 staff from four EDs and one Urgent Care Centre, across a health district. Quantitative data were analysed using jamovi (version 2.3.28) and qualitative data were coded and grouped into subcategories and categories. Enablers and barriers were identified, and quantitative and qualitative results were integrated.</div></div><div><h3>Findings</h3><div>One hundred and four staff completed the survey (response rate 21.8%). Two barriers to evidence-based practice were identified: knowledge and training gap; and ED resources and workload. Two enablers: ED clinician belief about appropriateness of care; and women are willing to stay, wait and/or request care. Two functioned as both enablers and barriers: guideline is available, however elements are absent or not applicable; and ED clinicians are confident in some but not all aspects of care.</div></div><div><h3>Conclusion</h3><div>Multiple enablers and barriers were identified that may affect the implementation of evidence-based practice for the management of early pregnancy bleeding.</div></div>","PeriodicalId":48914,"journal":{"name":"International Emergency Nursing","volume":"83 ","pages":"Article 101693"},"PeriodicalIF":1.8,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145313921","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 : 2025-12-01Epub Date: 2025-09-08DOI: 10.1016/j.ienj.2025.101677
Amina Yasser Al Balushi , Lin Zhao , Karen Livesay
<div><h3>Background</h3><div>ST-segment elevation myocardial infarction (STEMI) demands aggressive and rapid medical intervention. Delays in Door-to-balloon time (DTB) of more than 90 min cause progressive damage to the cardiac tissue and require immediate medical intervention, including percutaneous coronary intervention (PCI). Nurses and doctors in STEMI management face several challenges that result in a delay in DTB time.</div></div><div><h3>Aim</h3><div>To investigate challenges nurses and doctors encounter in managing Door to Balloon (DTB) time for ST-elevation Myocardial Infarction (STEMI) patients.</div></div><div><h3>Method</h3><div>An online survey using Qualtrics software was distributed to all nurses and doctors working in the Emergency Room and Cardiac Catheterization Laboratory at the study site, which included a total of 150 staff members. The survey was conducted in August 2023 and lasted for one month. The questionnaire online link was sent to the participants and filled out by them through their smartphones.</div></div><div><h3>Results</h3><div>A total of 83 nurses and doctors responded to the questionnaire. The survey revealed several challenges encountered by nurses and doctors in STEMI management from highest to lowest based on response items in the Likert scale. In ER, the reported challenges related to the ECG interpretation (mean = 33, 47.8 %), followed by Process (mean = 31.5, 45.6 %), Resources (mean = 30.0, 43.5 %), Communication (mean = 28.8, 41.7 %), and Healthcare setting (28, 40.6 %). In CCL, the most reported challenges were related to Communication (mean = 10, 71.4 %). Followed by Resources (mean = 7.5, 53.5 %), and Healthcare setting (mean = 28, 40.6 %).</div><div>The primary outcomes showed no statistically significant association of predictable variables of Age groups with a p value of 0.612 (21–30 years, mean 3.31 ± 0.95, 31–40 years, mean 3.62 ± 1.17, 41–50 years, mean 3.7 ± 1.22), Educational groups with a p value of 0.481(Diploma 3.60 ± 1.23, Bachelor 3.33 ± 0.97, Postgraduate 3.79 ± 1.18), Years of experience groups with a p value of 0.659, two-tailed (10 years of experience 3.65 ± 1.23, and More than 10 years of experience 3.65 ± 1.23), and groups of certified with an ECG interpretation course with a p value of 0.583, two-tailed (Certified with an ECG interpretation course 3.62 ± 1.16 and not Certified with an ECG interpretation course 3.42 ± 1.08) on the Knowledge variable. Similarly, the outcomes showed no statistically significant association of predictable variables of Age with a p value of 0.615 (21–30 years, mean 31.91 ± 5.43, 31–40 years, mean 32.61 ± 6.38, 41–50 years, mean 30.31 ± 8.08) Educational groups with a p value of 0.325(Diploma 29.87 ± 7.75, Bachelor 31.93 ± 5.95, Postgraduate 33.41 ± 6.02), Years of experience groups with a p value of 0.813, two-tailed (10 years of experience 32 ± 6.283, and More than 10 years of experience 31.53 ± 7.27), certified with an ECG interpretation course with
{"title":"Challenges encountered by healthcare workers in managing door-to-balloon time of myocardial infarction: A survey","authors":"Amina Yasser Al Balushi , Lin Zhao , Karen Livesay","doi":"10.1016/j.ienj.2025.101677","DOIUrl":"10.1016/j.ienj.2025.101677","url":null,"abstract":"<div><h3>Background</h3><div>ST-segment elevation myocardial infarction (STEMI) demands aggressive and rapid medical intervention. Delays in Door-to-balloon time (DTB) of more than 90 min cause progressive damage to the cardiac tissue and require immediate medical intervention, including percutaneous coronary intervention (PCI). Nurses and doctors in STEMI management face several challenges that result in a delay in DTB time.</div></div><div><h3>Aim</h3><div>To investigate challenges nurses and doctors encounter in managing Door to Balloon (DTB) time for ST-elevation Myocardial Infarction (STEMI) patients.</div></div><div><h3>Method</h3><div>An online survey using Qualtrics software was distributed to all nurses and doctors working in the Emergency Room and Cardiac Catheterization Laboratory at the study site, which included a total of 150 staff members. The survey was conducted in August 2023 and lasted for one month. The questionnaire online link was sent to the participants and filled out by them through their smartphones.</div></div><div><h3>Results</h3><div>A total of 83 nurses and doctors responded to the questionnaire. The survey revealed several challenges encountered by nurses and doctors in STEMI management from highest to lowest based on response items in the Likert scale. In ER, the reported challenges related to the ECG interpretation (mean = 33, 47.8 %), followed by Process (mean = 31.5, 45.6 %), Resources (mean = 30.0, 43.5 %), Communication (mean = 28.8, 41.7 %), and Healthcare setting (28, 40.6 %). In CCL, the most reported challenges were related to Communication (mean = 10, 71.4 %). Followed by Resources (mean = 7.5, 53.5 %), and Healthcare setting (mean = 28, 40.6 %).</div><div>The primary outcomes showed no statistically significant association of predictable variables of Age groups with a p value of 0.612 (21–30 years, mean 3.31 ± 0.95, 31–40 years, mean 3.62 ± 1.17, 41–50 years, mean 3.7 ± 1.22), Educational groups with a p value of 0.481(Diploma 3.60 ± 1.23, Bachelor 3.33 ± 0.97, Postgraduate 3.79 ± 1.18), Years of experience groups with a p value of 0.659, two-tailed (10 years of experience 3.65 ± 1.23, and More than 10 years of experience 3.65 ± 1.23), and groups of certified with an ECG interpretation course with a p value of 0.583, two-tailed (Certified with an ECG interpretation course 3.62 ± 1.16 and not Certified with an ECG interpretation course 3.42 ± 1.08) on the Knowledge variable. Similarly, the outcomes showed no statistically significant association of predictable variables of Age with a p value of 0.615 (21–30 years, mean 31.91 ± 5.43, 31–40 years, mean 32.61 ± 6.38, 41–50 years, mean 30.31 ± 8.08) Educational groups with a p value of 0.325(Diploma 29.87 ± 7.75, Bachelor 31.93 ± 5.95, Postgraduate 33.41 ± 6.02), Years of experience groups with a p value of 0.813, two-tailed (10 years of experience 32 ± 6.283, and More than 10 years of experience 31.53 ± 7.27), certified with an ECG interpretation course with","PeriodicalId":48914,"journal":{"name":"International Emergency Nursing","volume":"83 ","pages":"Article 101677"},"PeriodicalIF":1.8,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145020657","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 : 2025-12-01Epub Date: 2025-11-17DOI: 10.1016/j.ienj.2025.101711
Hesam Seyedin , Shandiz Moslehi , Sajjad Narimani
Introduction
Emergency nurses face significant challenges in crisis response, including cognitive overload and institutional barriers, which compromise patient outcomes. This quality improvement (QI) initiative aimed to enhance crisis preparedness through evidence-based interventions, addressing gaps in risk perception, decision-making, and self-efficacy.
Method
A pre/post-intervention study was conducted at two academic medical centers (Level I trauma centers)150 emergency nurses. Interventions included simulation-based training, AI-driven decision-support tools, and protocol reforms. Data were collected at baseline, post-intervention, and six-month follow-up. Primary outcomes included risk perception accuracy, decision latency, and self-efficacy, which were analyzed using paired t-tests, repeated measures ANCOVA, control charts, and chi-square tests.
Results
Post-intervention, nurses demonstrated a 32 % improvement in risk perception accuracy (p < 0.01) and a 26 % reduction in decision-making time (p < 0.05). Self-efficacy scores nearly doubled, rising from 45 % to 89 %. ED-specific process outcomes included a 40 % reduction in triage errors and a 35 % decrease in missed deteriorations with AI support. Improvements were sustained at the 6-month follow-up.
Discussion
The multimodal approach yielded statistically and clinically significant improvements, surpassing single-intervention studies. Sustainable implementation requires institutional support for technology integration and policy reforms. These findings advocate for widespread adoption of combined simulation, AI, and protocol strategies to empower nurses in crisis response.
{"title":"Empowering emergency nurses in crisis response – A quality improvement framework for enhanced preparedness and decision-making","authors":"Hesam Seyedin , Shandiz Moslehi , Sajjad Narimani","doi":"10.1016/j.ienj.2025.101711","DOIUrl":"10.1016/j.ienj.2025.101711","url":null,"abstract":"<div><h3>Introduction</h3><div>Emergency nurses face significant challenges in crisis response, including cognitive overload and institutional barriers, which compromise patient outcomes. This quality improvement (QI) initiative aimed to enhance crisis preparedness through evidence-based interventions, addressing gaps in risk perception, decision-making, and self-efficacy.</div></div><div><h3>Method</h3><div>A pre/post-intervention study was conducted at two academic medical centers (Level I trauma centers)150 emergency nurses. Interventions included simulation-based training, AI-driven decision-support tools, and protocol reforms. Data were collected at baseline, post-intervention, and six-month follow-up. Primary outcomes included risk perception accuracy, decision latency, and self-efficacy, which were analyzed using paired t-tests, repeated measures ANCOVA, control charts, and chi-square tests.</div></div><div><h3>Results</h3><div>Post-intervention, nurses demonstrated a 32 % improvement in risk perception accuracy (p < 0.01) and a 26 % reduction in decision-making time (p < 0.05). Self-efficacy scores nearly doubled, rising from 45 % to 89 %. <strong>ED-specific process outcomes</strong> <!-->included a 40 % reduction in triage errors and a 35 % decrease in missed deteriorations with AI support. Improvements were sustained at the 6-month follow-up.</div></div><div><h3>Discussion</h3><div>The multimodal approach yielded statistically and clinically significant improvements, surpassing single-intervention studies. Sustainable implementation requires institutional support for technology integration and policy reforms. These findings advocate for widespread adoption of combined simulation, AI, and protocol strategies to empower nurses in crisis response.</div></div>","PeriodicalId":48914,"journal":{"name":"International Emergency Nursing","volume":"83 ","pages":"Article 101711"},"PeriodicalIF":1.8,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145551502","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 : 2025-12-01Epub Date: 2025-10-27DOI: 10.1016/j.ienj.2025.101704
Ted J. Andrews , Jill Fennell , Brian H. Wrotniak , Heather Territo
Objectives
Phlebotomy is an important source of self-reported pain in the pediatric emergency department. The purpose of this study was to compare the effectiveness of Buzzy®, a vibrating cold device, to vapocoolant and control in reducing child-reported and parent-perceived pain during IV placement in the pediatric emergency department.
Methods
Patients ages 6–18 years who required IV insertion in the emergency department were randomized to Buzzy, vapocoolant or control groups. The Faces Pain Scale – Revised was used to assess both patient pain and parent perceived pain.
Results
171 patients were randomized into the 3 groups: 56 in the Buzzy group, 57 in the vapocoolant group and 58 in the control group. Patient-reported FACES pain scores decreased significantly from pre- to post-intervention in the Buzzy group (5.41 ± 2.90 to 3.58 ± 2.87, p < 0.01) but not in the vapocoolant group (4.54 ± 2.65 to 3.84 ± 3.12, not significant), or the control group (5.03 ± 3.01 to 4.57 ± 3.43, not significant). Guardian-reported pain scores also showed significant reductions in the Buzzy group (3.46 ± 2.88 to 1.69 ± 2.28, p < 0.01) and vapocoolant group (3.06 ± 2.93 to 2.24 ± 2.56, p < 0.05), with no significant change in the control group (2.86 ± 2.85 to 2.79 ± 2.84).
Conclusions
This study supports the utility of Buzzy® as a clinically effective resource in the management of phlebotomy related pain and demonstrates that it is as good or better than vapocoolant in the pediatric emergency department.
{"title":"The effectiveness of a gate channel device on pain in the pediatric emergency department: A randomized controlled trial","authors":"Ted J. Andrews , Jill Fennell , Brian H. Wrotniak , Heather Territo","doi":"10.1016/j.ienj.2025.101704","DOIUrl":"10.1016/j.ienj.2025.101704","url":null,"abstract":"<div><h3>Objectives</h3><div>Phlebotomy is an important source of self-reported pain in the pediatric emergency department. The purpose of this study was to compare the effectiveness of Buzzy®, a vibrating cold device, to vapocoolant and control in reducing child-reported and parent-perceived pain during IV placement in the pediatric emergency department.</div></div><div><h3>Methods</h3><div>Patients ages 6–18 years who required IV insertion in the emergency department were randomized to Buzzy, vapocoolant or control groups. The Faces Pain Scale – Revised was used to assess both patient pain and parent perceived pain.</div></div><div><h3>Results</h3><div>171 patients were randomized into the 3 groups: 56 in the Buzzy group, 57 in the vapocoolant group and 58 in the control group. Patient-reported FACES pain scores decreased significantly from pre- to post-intervention in the Buzzy group (5.41 ± 2.90 to 3.58 ± 2.87, p < 0.01) but not in the vapocoolant group (4.54 ± 2.65 to 3.84 ± 3.12, not significant), or the control group (5.03 ± 3.01 to 4.57 ± 3.43, not significant). Guardian-reported pain scores also showed significant reductions in the Buzzy group (3.46 ± 2.88 to 1.69 ± 2.28, p < 0.01) and vapocoolant group (3.06 ± 2.93 to 2.24 ± 2.56, p < 0.05), with no significant change in the control group (2.86 ± 2.85 to 2.79 ± 2.84).</div></div><div><h3>Conclusions</h3><div>This study supports the utility of Buzzy® as a clinically effective resource in the management of phlebotomy related pain and demonstrates that it is as good or better than vapocoolant in the pediatric emergency department.</div></div>","PeriodicalId":48914,"journal":{"name":"International Emergency Nursing","volume":"83 ","pages":"Article 101704"},"PeriodicalIF":1.8,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145394626","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 : 2025-12-01Epub Date: 2025-10-28DOI: 10.1016/j.ienj.2025.101706
Asuman Şener , Tuğba Çınarlı , Dilan Köse
Background
Considering that patient care is provided for 24 h without interruption in the emergency service, the work roles in this service require a state of full wakefulness. Alarm fatigue is defined as the main cause of clinical alarm management problems. Alarm fatigue, that cannot be managed in a full sense, may make desensitize emergency nurses and may endanger patient safety.
Aim
The aim of the study was to determine the effect of sleep quality on alarm fatigue of emergency nurses.
Methods
This research used the descriptive, cross-sectional and correlational study pattern. The study was completed with 183 emergency nurses from May-November 2023. Data were collected using the Descriptive Information Form, Pittsburgh Sleep Quality Index (PSQI) and the Nurses’ Alarm Fatigue Scale. Data were analyzed using IBM SPSS V26 program.
Results
Of nurses, 96.2 % worked shifts and 38.8 % stated their monthly working hours were more than 240 h. Of those working shifts, 77.6 % slept after their shift, 56.8 % experienced sleep problems and 43.3 % stated they required support to be able to easily fall asleep. The mean scores on the Nurses’ Alarm Fatigue Scale were 24.98 ± 6.16, while mean scores for the PSQI were 9.08 ± 3.48. There was a statistically significant, low level positive correlation between PSQI scores and Alarm Fatigue Scale scores (r = 0.178). Additionally, the simple linear regression model created with the aim of investigating the effect of PSQI scores on Alarm Fatigue Scale scores was identified to be statistically significant (F = 5.897; p = 0.016).
Conclusion
With the aim of empowering nurses working irregular night shifts in institutions providing health services, offering education and teaching programs should be considered. In conclusion, our research will help to create a safer, more effective and encouraging hospital environment for both patients and emergency service nurses.
背景：考虑到急诊服务是24小时不间断地提供患者护理，该服务中的工作角色需要处于完全清醒的状态。报警疲劳被定义为临床报警管理问题的主要原因。警报疲劳如果不能得到充分的管理，可能会使急诊护士变得麻木，危及患者安全。目的：研究睡眠质量对急诊护士报警疲劳的影响。方法：本研究采用描述性、横断面和相关性研究模式。这项研究是在2023年5月至11月期间由183名急诊护士完成的。采用描述性信息表、匹兹堡睡眠质量指数（PSQI）和护士报警疲劳量表收集数据。数据分析采用IBM SPSS V26软件。结果：96.2%的护士轮班工作，38.8%的护士每月工作时间超过240小时。在这些轮班的护士中，77.6%的人在轮班后睡觉，56.8%的人有睡眠问题，43.3%的人表示他们需要帮助才能轻松入睡。护士报警疲劳量表平均得分为24.98±6.16分，PSQI平均得分为9.08±3.48分。PSQI评分与报警疲劳量表评分之间有统计学意义的低水平正相关（r = 0.178）。此外，为了研究PSQI评分对报警疲劳量表评分的影响而建立的简单线性回归模型被发现具有统计学意义（F = 5.897; p = 0.016）。结论：在医疗卫生服务机构中，应考虑为夜班护士提供教育和教学方案。总之，我们的研究将有助于为病人和急救护士创造一个更安全、更有效和鼓舞人心的医院环境。
{"title":"Effect of sleep quality on alarm fatigue among emergency nurses","authors":"Asuman Şener , Tuğba Çınarlı , Dilan Köse","doi":"10.1016/j.ienj.2025.101706","DOIUrl":"10.1016/j.ienj.2025.101706","url":null,"abstract":"<div><h3>Background</h3><div>Considering that patient care is provided for 24 h without interruption in the emergency service, the work roles in this service require a state of full wakefulness. Alarm fatigue is defined as the main cause of clinical alarm management problems. Alarm fatigue, that cannot be managed in a full sense, may make desensitize emergency nurses and may endanger patient safety.</div></div><div><h3>Aim</h3><div>The aim of the study was to determine the effect of sleep quality on alarm fatigue of emergency nurses.</div></div><div><h3>Methods</h3><div>This research used the descriptive, cross-sectional and correlational study pattern. The study was completed with 183 emergency nurses from May-November 2023. Data were collected using the Descriptive Information Form, Pittsburgh Sleep Quality Index (PSQI) and the Nurses’ Alarm Fatigue Scale. Data were analyzed using IBM SPSS V26 program.</div></div><div><h3>Results</h3><div>Of nurses, 96.2 % worked shifts and 38.8 % stated their monthly working hours were more than 240 h. Of those working shifts, 77.6 % slept after their shift, 56.8 % experienced sleep problems and 43.3 % stated they required support to be able to easily fall asleep. The mean scores on the Nurses’ Alarm Fatigue Scale were 24.98 ± 6.16, while mean scores for the PSQI were 9.08 ± 3.48. There was a statistically significant, low level positive correlation between PSQI scores and Alarm Fatigue Scale scores (r = 0.178). Additionally, the simple linear regression model created with the aim of investigating the effect of PSQI scores on Alarm Fatigue Scale scores was identified to be statistically significant (F = 5.897; p = 0.016).</div></div><div><h3>Conclusion</h3><div>With the aim of empowering nurses working irregular night shifts in institutions providing health services, offering education and teaching programs should be considered. In conclusion, our research will help to create a safer, more effective and encouraging hospital environment for both patients and emergency service nurses.</div></div>","PeriodicalId":48914,"journal":{"name":"International Emergency Nursing","volume":"83 ","pages":"Article 101706"},"PeriodicalIF":1.8,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145402520","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 validity, reliability, and cultural adaptation of the Critical Care Family Needs Inventory – Emergency Department (CCFNI-ED) into the Indonesian language.
Methods
The study was conducted in three phases, including the translation and cultural adaptation process, content and face validation by six emergency nursing experts, and construct validity and reliability testing through a cross-sectional survey of 120 family members of patients in three emergency departments in Indonesia. Data analysis included the item-level content validity index (I-CVI), Cronbach’s alpha, item-total correlation, and exploratory factor analysis (EFA).
Results
The results showed a total Cronbach’s alpha value of 0.931, with all subscales having values greater than 0.70. The I-CVI value for all items was 1, indicating excellent content validity. EFA yielded six factors from 24 items, explaining 64.7 % of the total variance, with all items showing loadings ≥ 0.50 and communalities > 0.50. The correlations between subscales were significant (p < 0.01), with the strongest relationship observed between participation and communication (r = 0.720).
Conclusions
The CCFNI-ED instrument is valid and reliable for assessing family needs in patient care within emergency settings. This can enhance the quality of family-centered services in emergency departments.
{"title":"Adaptation and validation of the critical care family needs inventory – Emergency department (CCFNI-ED) in Indonesian emergency care settings","authors":"Rafi Achmad Rukhama , Raditya Bagus Septian , Desy Listyaningrum","doi":"10.1016/j.ienj.2025.101695","DOIUrl":"10.1016/j.ienj.2025.101695","url":null,"abstract":"<div><h3>Objectives</h3><div>This study aimed to assess the validity, reliability, and cultural adaptation of the Critical Care Family Needs Inventory – Emergency Department (CCFNI-ED) into the Indonesian language.</div></div><div><h3>Methods</h3><div>The study was conducted in three phases, including the translation and cultural adaptation process, content and face validation by six emergency nursing experts, and construct validity and reliability testing through a cross-sectional survey of 120 family members of patients in three emergency departments in Indonesia. Data analysis included the item-level content validity index (I-CVI), Cronbach’s alpha, item-total correlation, and exploratory factor analysis (EFA).</div></div><div><h3>Results</h3><div>The results showed a total Cronbach’s alpha value of 0.931, with all subscales having values greater than 0.70. The I-CVI value for all items was 1, indicating excellent content validity. EFA yielded six factors from 24 items, explaining 64.7 % of the total variance, with all items showing loadings ≥ 0.50 and communalities > 0.50. The correlations between subscales were significant (p < 0.01), with the strongest relationship observed between participation and communication (r = 0.720).</div></div><div><h3>Conclusions</h3><div>The CCFNI-ED instrument is valid and reliable for assessing family needs in patient care within emergency settings. This can enhance the quality of family-centered services in emergency departments.</div></div>","PeriodicalId":48914,"journal":{"name":"International Emergency Nursing","volume":"83 ","pages":"Article 101695"},"PeriodicalIF":1.8,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145239845","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}
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