Pub Date : 2025-08-29DOI: 10.1016/j.ienj.2025.101666
Atiye Erbaş , Selin Keskin Kiziltepe , Ümit Kiliç
Introduction
Effective handover skills play a crucial role in communication between pre-hospital and hospital staff. However, nursing and paramedic students rarely have the opportunity to practice them.
Objective
Our study aimed to evaluate the effectiveness of the Situation-Background-Assessment-Recommendation (SBAR) method in emergency settings using simulation-based education for nursing and paramedic students.
Methods
We conducted a single-group quasi-experimental study involving 39 nursing and 42 paramedic students. The students’ patient handover skills were evaluated through simulation-based training using a structured handover method. Data were collected using the Personal Data Form, Patient Handover Information Form, Patient Handover Skill Evaluation Form, and Video Observation and Evaluation Form. For data analysis, we used the Mann–Whitney U test, the Friedman test, the Cohen’s kappa coefficient, and the Pearson correlation test.
Results
The knowledge scores of nursing (N) and paramedic (P) students (N: 16 [11–20]; P: 15 [10–19] pre-training) increased post-training (N: 18 [15–20]; P: 18 [10–21]), post-simulation (N: 18 [14–21]; P: 17 [13–20]), and one-month after the post-simulation (N: 18 [14–21]; P: 17 [14–20]). The group participants, 50%, received scores between 12.50 and 16.25 and acquired medium handover skills.
Conclusion
We found that theoretical education and simulation-based applications were effective in enhancing students’ knowledge level of handover processes, which are critical for patient safety, and that simulation supported their learning. It is recommended that patient handover training be conducted using simulation-based methods with different student groups, integrated into educational curricula, and updated regularly.
{"title":"Effectiveness of the Situation-Background-Assessment-Recommendation method in emergencies with simulation-based education for nursing and paramedic students","authors":"Atiye Erbaş , Selin Keskin Kiziltepe , Ümit Kiliç","doi":"10.1016/j.ienj.2025.101666","DOIUrl":"10.1016/j.ienj.2025.101666","url":null,"abstract":"<div><h3>Introduction</h3><div>Effective handover skills play a crucial role in communication between pre-hospital and hospital staff. However, nursing and paramedic students rarely have the opportunity to practice them.</div></div><div><h3>Objective</h3><div>Our study aimed to evaluate the effectiveness of the Situation-Background-Assessment-Recommendation (SBAR) method in emergency settings using simulation-based education for nursing and paramedic students.</div></div><div><h3>Methods</h3><div>We conducted a single-group quasi-experimental study involving 39 nursing and 42 paramedic students. The students’ patient handover skills were evaluated through simulation-based training using a structured handover method. Data were collected using the Personal Data Form, Patient Handover Information Form, Patient Handover Skill Evaluation Form, and Video Observation and Evaluation Form. For data analysis, we used the Mann–Whitney <em>U</em> test, the Friedman test, the Cohen’s kappa coefficient, and the Pearson correlation test.</div></div><div><h3>Results</h3><div>The knowledge scores of nursing (N) and paramedic (P) students (N: 16 [11–20]; P: 15 [10–19] pre-training) increased post-training (N: 18 [15–20]; P: 18 [10–21]), post-simulation (N: 18 [14–21]; P: 17 [13–20]), and one-month after the post-simulation (N: 18 [14–21]; P: 17 [14–20]). The group participants, 50%, received scores between 12.50 and 16.25 and acquired medium handover skills.</div></div><div><h3>Conclusion</h3><div>We found that theoretical education and simulation-based applications were effective in enhancing students’ knowledge level of handover processes, which are critical for patient safety, and that simulation supported their learning. It is recommended that patient handover training be conducted using simulation-based methods with different student groups, integrated into educational curricula, and updated regularly.</div></div>","PeriodicalId":48914,"journal":{"name":"International Emergency Nursing","volume":"82 ","pages":"Article 101666"},"PeriodicalIF":1.8,"publicationDate":"2025-08-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144912207","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 : 2025-08-27DOI: 10.1016/j.ienj.2025.101668
Ramazan Aslan , Süleyman Yıldırım
The globally increasing incidence of obesity and the growing need for emergency health services among obese patients necessitate a better understanding of the impact of this issue on healthcare professionals. It is thought that the negative attitudes and beliefs of Emergency Medical Services (EMS) workers toward obese patients may reduce the quality of care provided and create barriers to treatment access for these patients. In this context, the aim of this study is to assess the beliefs and attitudes of EMS workers in Adana province towards obesity and to explore how these attitudes are shaped by demographic and professional factors.
The research was conducted using a cross-sectional design on EMS workers employed at the Adana Provincial Ambulance Service. A convenience sampling method was utilized, and data were collected from 450 on EMS workers via a survey. The survey form included questions to determine the demographic characteristics of the participants, as well as two scales designed to assess their beliefs and attitudes towards obesity. Validity and reliability analyses of the scales were conducted, and the data were evaluated using One-Way ANOVA, independent samples t-test, and Pearson’s correlation analyses.
The findings of the research, consistent with the literature, reveal that EMS workers generally hold negative attitudes and beliefs towards obese patients. It was determined that participants’ attitudes were influenced by demographic factors such as age, professional experience, education level, and economic status. Male participants generally had more positive attitudes compared to females, and healthcare workers who frequently encountered obese patients also exhibited more positive attitudes.
The study highlights the need for improvement in EMS workers’ attitudes and beliefs towards obese patients. These attitudes can affect the quality of healthcare services and pose significant barriers to access for obese patients. It is believed that awareness and empathy training for EMS workers could change negative beliefs about obesity and reduce negative attitudes.
{"title":"Determination of the beliefs and attitudes of pre-hospital emergency health service workers towards obese individuals as a vulnerable group: The case of Adana Provincial Ambulance Service","authors":"Ramazan Aslan , Süleyman Yıldırım","doi":"10.1016/j.ienj.2025.101668","DOIUrl":"10.1016/j.ienj.2025.101668","url":null,"abstract":"<div><div>The globally increasing incidence of obesity and the growing need for emergency health services among obese patients necessitate a better understanding of the impact of this issue on healthcare professionals. It is thought that the negative attitudes and beliefs of Emergency Medical Services (EMS) workers toward obese patients may reduce the quality of care provided and create barriers to treatment access for these patients. In this context, the aim of this study is to assess the beliefs and attitudes of EMS workers in Adana province towards obesity and to explore how these attitudes are shaped by demographic and professional factors.</div><div>The research was conducted using a cross-sectional design on EMS workers employed at the Adana Provincial Ambulance Service. A convenience sampling method was utilized, and data were collected from 450 on EMS workers via a survey. The survey form included questions to determine the demographic characteristics of the participants, as well as two scales designed to assess their beliefs and attitudes towards obesity. Validity and reliability analyses of the scales were conducted, and the data were evaluated using One-Way ANOVA, independent samples <em>t</em>-test, and Pearson’s correlation analyses.</div><div>The findings of the research, consistent with the literature, reveal that EMS workers generally hold negative attitudes and beliefs towards obese patients. It was determined that participants’ attitudes were influenced by demographic factors such as age, professional experience, education level, and economic status. Male participants generally had more positive attitudes compared to females, and healthcare workers who frequently encountered obese patients also exhibited more positive attitudes.</div><div>The study highlights the need for improvement in EMS workers’ attitudes and beliefs towards obese patients. These attitudes can affect the quality of healthcare services and pose significant barriers to access for obese patients. It is believed that awareness and empathy training for EMS workers could change negative beliefs about obesity and reduce negative attitudes.</div></div>","PeriodicalId":48914,"journal":{"name":"International Emergency Nursing","volume":"82 ","pages":"Article 101668"},"PeriodicalIF":1.8,"publicationDate":"2025-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144908676","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}
Trauma accounts for 11 % of the total global burden of disease and is the leading cause of death in individuals under 40 years of age. Ethiopia faces a substantial task in establishing well-equipped and sufficiently staffed emergency departments. Moreover, current research in Ethiopia concentrates on trauma epidemiology and specific trauma types to guide evidence-based intervention strategies rather than emphasising trauma care features. Thus, this study aims to explore the trauma care process and investigate the predictors of ED mortality at a single-centre trauma hospital in Ethiopia.
Methods
We conducted a single-centre prospective observational study at Addis Ababa Burn Emergency and Trauma Hospital in Ethiopia. Observations were conducted from November 30, 2022, to May 24, 2023. The study included patients admitted with reported major injuries during the study period. Descriptive statistics and multivariate logistic regression were applied to explore predictors of ED mortality.
Results
The cohort consisted of 425 patients, 73.4 % were male, and the median age was 32 years. Of the patients, 188 (44.4 %) met the criteria for trauma team activation, but none received treatment from such teams. Among the patients in need of emergency procedures, 22.6 % experienced delays within 48 h of observation. Epidural or subdural haematoma was diagnosed in 37.1 % of patients, but fewer patients underwent a craniotomy procedure. A small percentage of patients stayed in the ED for less than 24 h (13.4 %), while ED mortality was 10.4 %. Lower Glasgow Coma Scale, haematoma presence and shorter length of ED stay were associated with increased odds of ED mortality.
Conclusions
Close to half of the participants met the criteria for trauma team activation, but none received treatment from such teams.
{"title":"Trauma care and predictors of mortality at a single-centre trauma hospital in Ethiopia: A prospective observational study","authors":"Helina Bogale Abayneh , Stine Engebretsen , Kristin Halvorsen , Stein Ove Danielsen","doi":"10.1016/j.ienj.2025.101665","DOIUrl":"10.1016/j.ienj.2025.101665","url":null,"abstract":"<div><h3>Introduction</h3><div>Trauma accounts for 11 % of the total global burden of disease and is the leading cause of death in individuals under 40 years of age. Ethiopia faces a substantial task in establishing well-equipped and sufficiently staffed emergency departments. Moreover, current research in Ethiopia concentrates on trauma epidemiology and specific trauma types to guide evidence-based intervention strategies rather than emphasising trauma care features. Thus, this study aims to explore the trauma care process and investigate the predictors of ED mortality at a single-centre trauma hospital in Ethiopia.</div></div><div><h3>Methods</h3><div>We conducted a single-centre prospective observational study at Addis Ababa Burn Emergency and Trauma Hospital in Ethiopia. Observations were conducted from November 30, 2022, to May 24, 2023. The study included patients admitted with reported major injuries during the study period. Descriptive statistics and multivariate logistic regression were applied to explore predictors of ED mortality.</div></div><div><h3>Results</h3><div>The cohort consisted of 425 patients, 73.4 % were male, and the median age was 32 years. Of the patients, 188 (44.4 %) met the criteria for trauma team activation, but none received treatment from such teams. Among the patients in need of emergency procedures, 22.6 % experienced delays within 48 h of observation. Epidural or subdural haematoma was diagnosed in 37.1 % of patients, but fewer patients underwent a craniotomy procedure. A small percentage of patients stayed in the ED for less than 24 h (13.4 %), while ED mortality was 10.4 %. Lower Glasgow Coma Scale, haematoma presence and shorter length of ED stay were associated with increased odds of ED mortality.</div></div><div><h3>Conclusions</h3><div>Close to half of the participants met the criteria for trauma team activation, but none received treatment from such teams.</div></div>","PeriodicalId":48914,"journal":{"name":"International Emergency Nursing","volume":"82 ","pages":"Article 101665"},"PeriodicalIF":1.8,"publicationDate":"2025-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144904516","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 : 2025-08-20DOI: 10.1016/j.ienj.2025.101661
Nicola Ramacciati, Sara Morales Palomares
Background
Workplace violence (WPV) in emergency departments (EDs) remains a growing concern worldwide, necessitating updated theoretical perspectives. A 2018 review identified 24 frameworks, but ongoing healthcare challenges, particularly the COVID-19 pandemic, warrant a re-examination and expansion of these models.
Methods
A narrative review was conducted using PubMed/Medline, CINAHL, Scopus, and ProQuest databases for studies published from 2017 onward, focusing on theoretical frameworks explaining WPV in EDs.
Results
The 18 included studies in this review introduce novel or refined theories addressing psychosocial, organizational, and environmental factors that trigger or mitigate WPV. Frameworks range from physiological deterioration and psychosocial moderation to architectural design and resilience-based models. These comprehensive approaches reflect a growing consensus on the need for integrated, multilevel interventions.
Conclusions
Contemporary theories underscore WPV as a multifactorial issue requiring solutions that go beyond single-factor models. By examining the broader interplay among patients, staff, organizational, and environmental determinants, these frameworks offer valuable insights for more effective, holistic WPV prevention and management strategies in EDs.
{"title":"Violence towards emergency nurses: an update of a narrative review of theories and frameworks","authors":"Nicola Ramacciati, Sara Morales Palomares","doi":"10.1016/j.ienj.2025.101661","DOIUrl":"10.1016/j.ienj.2025.101661","url":null,"abstract":"<div><h3>Background</h3><div>Workplace violence (WPV) in emergency departments (EDs) remains a growing concern worldwide, necessitating updated theoretical perspectives. A 2018 review identified 24 frameworks, but ongoing healthcare challenges, particularly the COVID-19 pandemic, warrant a re-examination and expansion of these models.</div></div><div><h3>Methods</h3><div>A narrative review was conducted using PubMed/Medline, CINAHL, Scopus, and ProQuest databases for studies published from 2017 onward, focusing on theoretical frameworks explaining WPV in EDs.</div></div><div><h3>Results</h3><div>The 18 included studies in this review introduce novel or refined theories addressing psychosocial, organizational, and environmental factors that trigger or mitigate WPV. Frameworks range from physiological deterioration and psychosocial moderation to architectural design and resilience-based models. These comprehensive approaches reflect a growing consensus on the need for integrated, multilevel interventions.</div></div><div><h3>Conclusions</h3><div>Contemporary theories underscore WPV as a multifactorial issue requiring solutions that go beyond single-factor models. By examining the broader interplay among patients, staff, organizational, and environmental determinants, these frameworks offer valuable insights for more effective, holistic WPV prevention and management strategies in EDs.</div></div>","PeriodicalId":48914,"journal":{"name":"International Emergency Nursing","volume":"82 ","pages":"Article 101661"},"PeriodicalIF":1.8,"publicationDate":"2025-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144863603","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 : 2025-08-20DOI: 10.1016/j.ienj.2025.101662
Khitam Alsaqer , Saeed Hussein Alhmoud
Background
Emergency preparedness in hospitals for disasters is unexpectedly required. Disasters, however, are rarely encountered clinically, making it ideal for simulation, such as Virtual Reality (VR).
Objective
To examine the impact of an immersive VR disaster training program on disaster preparedness and self-efficacy in emergency (ER) nurses.
Methods
A quasi-experimental design with one-group repeated measures. 90 ER nurses were recruited to receive disaster training through immersive VR. Nurses’ Perceptions of Disaster Core Competencies (NPDCC) and Disaster Response Self-Efficacy (DRSES) were collected before, immediately, and one month after the training.
Results
Paired t-tests revealed significant improvements in both NPDCC and DRSES scores from pre-test to post-test (NPDCC: t (89) = -12.45, p < 0.001; DRSES: t (89) = -10.65, p < 0.001). The follow-up scores showed a slight decrease compared to post-test scores but remained significantly higher than pre-test scores (NPDCC: t (89) = -6.72, p < 0.001; DRSES: t (89) = -4.99, p < 0.001).
Conclusion
This study provides compelling evidence for the efficacy of immersive VR disaster training in enhancing disaster preparedness and self-efficacy among emergency nurses. Healthcare institutions and nursing education programs should incorporate VR training modules into their curricula and ongoing professional development.
医院对灾害的应急准备是出乎意料的需要。然而，灾难在临床上很少遇到，这使其成为模拟的理想选择，例如虚拟现实（VR）。目的探讨沉浸式虚拟现实灾害培训对急诊护士备灾和自我效能感的影响。方法采用准实验设计，单组重复测量。招募90名急诊室护士通过沉浸式VR进行灾难培训。在培训前、培训后和培训后一个月分别收集护士对灾难核心能力（NPDCC）和灾难应对自我效能感（DRSES）的感知。结果西班牙t检验显示，NPDCC和DRSES评分从测试前到测试后均有显著改善(NPDCC: t (89) = -12.45, p < 0.001；DRSES: t (89) = -10.65, p < 0.001)。随访得分与测试后得分相比略有下降，但仍显著高于测试前得分(NPDCC: t (89) = -6.72, p < 0.001；DRSES: t (89) = -4.99, p < 0.001)。结论沉浸式虚拟现实灾害训练对提高急诊护士的备灾能力和自我效能感有较好的效果。医疗机构和护理教育项目应将VR培训模块纳入其课程和持续的专业发展中。
{"title":"Impact of virtual reality training on nurses’ preparedness and self-efficacy in emergencies and disasters: A quasi-experimental study","authors":"Khitam Alsaqer , Saeed Hussein Alhmoud","doi":"10.1016/j.ienj.2025.101662","DOIUrl":"10.1016/j.ienj.2025.101662","url":null,"abstract":"<div><h3>Background</h3><div>Emergency preparedness in hospitals for disasters is unexpectedly required. Disasters, however, are rarely encountered clinically, making it ideal for simulation, such as Virtual Reality (VR).</div></div><div><h3>Objective</h3><div>To examine the impact of an immersive VR disaster training program on disaster preparedness and self-efficacy in emergency (ER) nurses.</div></div><div><h3>Methods</h3><div>A quasi-experimental design with one-group repeated measures. 90 ER nurses were recruited to receive disaster training through immersive VR. Nurses’ Perceptions of Disaster Core Competencies (NPDCC) and Disaster Response Self-Efficacy (DRSES) were collected before, immediately, and one month after the training.</div></div><div><h3>Results</h3><div>Paired t-tests revealed significant improvements in both NPDCC and DRSES scores from pre-test to post-test (NPDCC: t (89) = -12.45, p < 0.001; DRSES: t (89) = -10.65, p < 0.001). The follow-up scores showed a slight decrease compared to post-test scores but remained significantly higher than pre-test scores (NPDCC: t (89) = -6.72, p < 0.001; DRSES: t (89) = -4.99, p < 0.001).</div></div><div><h3>Conclusion</h3><div>This study provides compelling evidence for the efficacy of immersive VR disaster training in enhancing disaster preparedness and self-efficacy among emergency nurses. Healthcare institutions and nursing education programs should incorporate VR training modules into their curricula and ongoing professional development.</div></div>","PeriodicalId":48914,"journal":{"name":"International Emergency Nursing","volume":"82 ","pages":"Article 101662"},"PeriodicalIF":1.8,"publicationDate":"2025-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144863602","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 : 2025-08-05DOI: 10.1016/j.ienj.2025.101660
Jane O’Donnell , Georgia Doyle , Michaela Fletcher , Chantelle Maria Dick
Background
Globally, emergency department (ED) nurses routinely care for patients requiring respiratory support; this support may include nasal high flow (NHF) therapy.
Objective
The study objective was to profile and evaluate the outcomes of ED patients receiving NHF respiratory support compared to those receiving all other forms of respiratory support.
Methods
A prospective, observational, multicenter method was used to capture real-time, real-world epidemiological data at four New Zealand EDs for two 12-hour periods in April and May 2023. N = 898 patients presented to the participating EDs; the minority, n = 76 (8.46 %), received respiratory support, with a subset of these (n = 12, 15.7 %) receiving NHF.
Results
Most of those receiving NHF were male (n = 8, 66 %), of New Zealand European ethnicity (n = 4, 33 %), with a mean age of 69.91 years (SD 18.93). These participants had a mean triage score of 2.66 (SD 0.65) and a mean modified early warning score of 7.58 (SD 3.32). ‘Respiratory’ was the most common participant diagnostic category (n = 5, 41.5 %). The most common reason for NHF delivery was ‘oxygenation improvement’ (n = 4, 33.3 %).
Those receiving NHF appeared to require less escalation of respiratory support versus those receiving other forms of respiratory support (n = 1, 8.3 %, versus n = 21, 32.8 %). No significant difference in treatment effect was seen for escalation to NHF versus other forms of respiratory support (RR 0.31, 95 % CI 0.04 to 2.12, P = 0.23, NNT (benefit) 5.87, 95 % CI 2.43 to 14.07). The median overall length of stay for those admitted to the hospital was eight days (4–15). This was seen to be significantly higher for those receiving NHF in the ED (Mann-Whitney U, 183, P = 0.004).
Conclusion
Given the methods used, all findings must be viewed with caution. The study reports that a minority of ED patients requiring respiratory support receive NHF. However, these patients appear to have high acuities, a high need for hospitalization, and an increased length of stay (LOS). Collectively, these data suggest that these patients are high consumers of healthcare resources. These New Zealand study findings may have implications for research and care planning across health sectors, including the ED.
Contribution to Emergency Nursing Practice
What is already known about this topic? Nasal high-flow therapy, which provides respiratory support, is provided in the emergency department to patients with many conditions.
What does this paper add to the currently published literature? This description of the epidemiology of emergency department patients provided nasal high flow here may inform benchmarking for future ED clinical practice and
在全球范围内，急诊科（ED）护士通常护理需要呼吸支持的患者；这种支持可能包括鼻高流量（NHF）治疗。该研究的目的是分析和评估接受NHF呼吸支持的ED患者与接受所有其他形式呼吸支持的患者的结果。方法采用前瞻性、观察性、多中心方法，于2023年4月和5月2个12小时时段，在新西兰4个急诊科采集实时、真实的流行病学数据。N = 898例患者就诊于参与急诊科；少数患者（n = 76, 8.46%）接受了呼吸支持，其中一部分患者（n = 12, 15.7%）接受了NHF。结果接受NHF的患者以男性居多（n = 8, 66%），新西兰欧裔（n = 4, 33%），平均年龄69.91岁（SD 18.93）。这些参与者的平均分诊评分为2.66 (SD 0.65)，平均修正预警评分为7.58 （SD 3.32）。“呼吸”是最常见的参与者诊断类别（n = 5, 41.5%）。提供NHF的最常见原因是“氧合改善”（n = 4, 33.3%）。与接受其他形式呼吸支持的患者相比，接受NHF的患者似乎需要更少的呼吸支持升级（n = 1,8.3%, n = 21,32.8%）。与其他形式的呼吸支持相比，升级至NHF的治疗效果无显著差异（RR 0.31, 95% CI 0.04至2.12,P = 0.23， NNT（获益）5.87,95% CI 2.43至14.07）。入院患者的平均总住院时间为8天（4-15天）。在急诊科接受NHF的患者中，这一比例明显更高（Mann-Whitney U, 183, P = 0.004）。结论鉴于所采用的方法，所有的结果都必须谨慎看待。该研究报告称，少数需要呼吸支持的ED患者接受了NHF。然而，这些患者似乎具有高视力，高住院需求和住院时间（LOS）的增加。总的来说，这些数据表明这些患者是医疗资源的高消费人群。这些新西兰的研究结果可能对整个卫生部门的研究和护理计划产生影响，包括ed对急诊护理实践的贡献。关于这个主题我们已经知道什么？鼻高流量治疗，提供呼吸支持，是在急诊科提供给病人的许多条件。这篇论文对目前发表的文献有何补充？本文对急诊科患者的流行病学描述提供了鼻高流量，可以为未来的急诊科临床实践和研究提供基准。对临床急诊护理实践最重要的启示是什么？本研究中的患者易受伤害，具有高敏锐度，需要有针对性的呼吸支持来改善其预后。
{"title":"Nasal high flow therapy in the emergency department – A prospective study","authors":"Jane O’Donnell , Georgia Doyle , Michaela Fletcher , Chantelle Maria Dick","doi":"10.1016/j.ienj.2025.101660","DOIUrl":"10.1016/j.ienj.2025.101660","url":null,"abstract":"<div><h3>Background</h3><div>Globally, emergency department (ED) nurses routinely care for patients requiring respiratory support; this support may include nasal high flow (NHF) therapy.</div></div><div><h3>Objective</h3><div>The study objective was to profile and evaluate the outcomes of ED patients receiving NHF respiratory support compared to those receiving all other forms of respiratory support.</div></div><div><h3>Methods</h3><div>A prospective, observational, multicenter method was used to capture real-time, real-world epidemiological data at four New Zealand EDs for two 12-hour periods in April and May 2023. N = 898 patients presented to the participating EDs; the minority, n = 76 (8.46 %), received respiratory support, with a subset of these (<em>n</em> = 12, 15.7 %) receiving NHF.</div></div><div><h3>Results</h3><div>Most of those receiving NHF were male (<em>n</em> = 8, 66 %), of New Zealand European ethnicity (<em>n</em> = 4, 33 %), with a mean age of 69.91 years (SD 18.93). These participants had a mean triage score of 2.66 (SD 0.65) and a mean modified early warning score of 7.58 (SD 3.32). ‘Respiratory’ was the most common participant diagnostic category (<em>n</em> = 5, 41.5 %). The most common reason for NHF delivery was ‘oxygenation improvement’ (<em>n</em> = 4, 33.3 %).</div><div>Those receiving NHF appeared to require less escalation of respiratory support versus those receiving other forms of respiratory support (<em>n</em> = 1, 8.3 %, versus <em>n</em> = 21, 32.8 %). No significant difference in treatment effect was seen for escalation to NHF versus other forms of respiratory support (RR 0.31, 95 % CI 0.04 to 2.12, <em>P</em> = 0.23, NNT (benefit) 5.87, 95 % CI 2.43 to 14.07). The median overall length of stay for those admitted to the hospital was eight days (4–15). This was seen to be significantly higher for those receiving NHF in the ED (Mann-Whitney U, 183, <em>P</em> = 0.004).</div></div><div><h3>Conclusion</h3><div>Given the methods used, all findings must be viewed with caution. The study reports that a minority of ED patients requiring respiratory support receive NHF. However, these patients appear to have high acuities, a high need for hospitalization, and an increased length of stay (LOS). Collectively, these data suggest that these patients are high consumers of healthcare resources. These New Zealand study findings may have implications for research and care planning across health sectors, including the ED.</div></div><div><h3>Contribution to Emergency Nursing Practice</h3><div><strong>What is already known about this topic?</strong> Nasal high-flow therapy, which provides respiratory support, is provided in the emergency department to patients with many conditions.</div><div><strong>What does this paper add to the currently published literature?</strong> This description of the epidemiology of emergency department patients provided nasal high flow here may inform benchmarking for future ED clinical practice and","PeriodicalId":48914,"journal":{"name":"International Emergency Nursing","volume":"82 ","pages":"Article 101660"},"PeriodicalIF":1.8,"publicationDate":"2025-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144772263","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 : 2025-07-25DOI: 10.1016/j.ienj.2025.101659
Liang Wang , Xue Wang
Aims
This meta-analysis aims to assess the efficacy and safety of adjunctive therapies in patients with organophosphate poisoning.
Methods
A comprehensive literature search was performed in PubMed, EMBASE, Cochrane Library, and Web of Science from database inception to August 21, 2024. Prospective randomized controlled trials (RCTs) evaluating emergency interventions for organophosphate poisoning were included in the analysis. Clinical outcomes including mortality, duration of mechanical ventilation, length of stay (LOS) and need for mechanical ventilation were collected.
Results
Compared with atropine alone, the atropine plus pralidoxime group showed a significantly higher risk of mortality (P = 0.020) and a longer LOS (P < 0.001), while no significant differences were observed in the need for mechanical ventilation or its duration. For the atropine plus FFP group, no significant differences were found in outcomes including mortality, LOS, or ventilatory parameters. Hemopurification combined with atropine significantly reduced both mortality (P = 0.020) and LOS (P = 0.001). NAC showed a trend towards reduced LOS, although the result was not statistically significant. MgSO4 and glycopyrrolate exhibited potential benefits in reducing LOS, although the results were not statistically significant. NaHCO3 significantly reduced LOS (P = 0.05).
Conclusion
The use of pralidoxime may be associated with an increased risk of adverse outcomes, calling into question its routine application in organophosphate poisoning. In contrast, hemopurification was associated with a significant reduction in mortality and may represent a promising adjunctive therapeutic strategy.
{"title":"Emergency adjunctive therapy for organophosphate poisoning: A meta-analysis","authors":"Liang Wang , Xue Wang","doi":"10.1016/j.ienj.2025.101659","DOIUrl":"10.1016/j.ienj.2025.101659","url":null,"abstract":"<div><h3>Aims</h3><div>This <em>meta</em>-analysis aims to assess the efficacy and safety of adjunctive therapies in patients with organophosphate poisoning.</div></div><div><h3>Methods</h3><div>A comprehensive literature search was performed in PubMed, EMBASE, Cochrane Library, and Web of Science from database inception to August 21, 2024. Prospective randomized controlled trials (RCTs) evaluating emergency interventions for organophosphate poisoning were included in the analysis. Clinical outcomes including mortality, duration of mechanical ventilation, length of stay (LOS) and need for mechanical ventilation were collected.</div></div><div><h3>Results</h3><div>Compared with atropine alone, the atropine plus pralidoxime group showed a significantly higher risk of mortality (P = 0.020) and a longer LOS (P < 0.001), while no significant differences were observed in the need for mechanical ventilation or its duration. For the atropine plus FFP group, no significant differences were found in outcomes including mortality, LOS, or ventilatory parameters. Hemopurification combined with atropine significantly reduced both mortality (P = 0.020) and LOS (P = 0.001). NAC showed a trend towards reduced LOS, although the result was not statistically significant. MgSO<sub>4</sub> and glycopyrrolate exhibited potential benefits in reducing LOS, although the results were not statistically significant. NaHCO<sub>3</sub> significantly reduced LOS (P = 0.05).</div></div><div><h3>Conclusion</h3><div>The use of pralidoxime may be associated with an increased risk of adverse outcomes, calling into question its routine application in organophosphate poisoning. In contrast, hemopurification was associated with a significant reduction in mortality and may represent a promising adjunctive therapeutic strategy.</div></div>","PeriodicalId":48914,"journal":{"name":"International Emergency Nursing","volume":"82 ","pages":"Article 101659"},"PeriodicalIF":1.8,"publicationDate":"2025-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144702277","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 : 2025-07-17DOI: 10.1016/j.ienj.2025.101648
Tjitske D. Groenveld , Roeland A.L. Arpots , Marjan de Vries , Regina L.M. van Boekel , Evelien van Eeten , Harry van Goor , Vincent M.A Stirler
Background
Assessing factors related to patients and clinicians, particularly nurses, along with pain scores and their association with opioid administration is important before introducing non-pharmacological innovations in the emergency department.
Methods
A prospective cross-sectional study was conducted using multivariable logistic regression analysis. The primary outcome was the association of opioid administration with patient’s age, sex, pain acceptability, pain location, pre-hospital use of analgesics, baseline numeric rating scale (NRS) pain score at rest, desire for analgesics, and the nurses’ perception of the reported pain score. Secondary outcomes included NRS anxiety, analgesics use and prescription, patient satisfaction, and the patient’s definition of pain acceptability. Cut-off NRS pain scores for pain acceptability and desire for analgesics were calculated. Patient definitions of pain acceptability were determined using thematic analysis.
Results
Data from 236 patients were analyzed. Factors associated with administering opioids included nurse-perceived adequate pain score, higher baseline NRS pain scores, pre-hospital opioid use, and unacceptable pain. The cut-off NRS pain scores were 7 for pain acceptability and 6 for the desire for analgesics. Patients related pain acceptability to pain characteristics and situational context.
Conclusions
Nurse perception of the patient-reported pain score and pain acceptability are important determinants for administering analgesics. The insufficient discriminative power of a cut-off NRS pain score highlights that pain management should go beyond pain scores alone. These findings could enhance selecting patients with acute pain who may benefit from non-pharmacological interventions in the emergency department.
{"title":"Understanding the need for and use of analgesics in the emergency department","authors":"Tjitske D. Groenveld , Roeland A.L. Arpots , Marjan de Vries , Regina L.M. van Boekel , Evelien van Eeten , Harry van Goor , Vincent M.A Stirler","doi":"10.1016/j.ienj.2025.101648","DOIUrl":"10.1016/j.ienj.2025.101648","url":null,"abstract":"<div><h3>Background</h3><div>Assessing factors related to patients and clinicians, particularly nurses, along with pain scores and their association with opioid administration is important before introducing non-pharmacological innovations in the emergency department.</div></div><div><h3>Methods</h3><div>A prospective cross-sectional study was conducted using multivariable logistic regression analysis. The primary outcome was the association of opioid administration with patient’s age, sex, pain acceptability, pain location, pre-hospital use of analgesics, baseline numeric rating scale (NRS) pain score at rest, desire for analgesics, and the nurses’ perception of the reported pain score. Secondary outcomes included NRS anxiety, analgesics use and prescription, patient satisfaction, and the patient’s definition of pain acceptability. Cut-off NRS pain scores for pain acceptability and desire for analgesics were calculated. Patient definitions of pain acceptability were determined using thematic analysis.</div></div><div><h3>Results</h3><div>Data from 236 patients were analyzed. Factors associated with administering opioids included nurse-perceived adequate pain score, higher baseline NRS pain scores, pre-hospital opioid use, and unacceptable pain. The cut-off NRS pain scores were 7 for pain acceptability and 6 for the desire for analgesics. Patients related pain acceptability to pain characteristics and situational context.</div></div><div><h3>Conclusions</h3><div>Nurse perception of the patient-reported pain score and pain acceptability are important determinants for administering analgesics. The insufficient discriminative power of a cut-off NRS pain score highlights that pain management should go beyond pain scores alone. These findings could enhance selecting patients with acute pain who may benefit from non-pharmacological interventions in the emergency department.</div></div>","PeriodicalId":48914,"journal":{"name":"International Emergency Nursing","volume":"82 ","pages":"Article 101648"},"PeriodicalIF":1.8,"publicationDate":"2025-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144653933","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 : 2025-07-12DOI: 10.1016/j.ienj.2025.101658
Fatma Tok, Naile Canıtez, Tuğba Aydemir
Background
Paramedics must apply appropriate body mechanics principles when providing emergency care, actively engaging their bodies to prevent physical injuries and protect patients from falls and harm. The aim of this study is to investigate the effectiveness of a occupational musculoskeletal injury prevention program provided to paramedic students on their level of knowledge regarding body mechanics principles and their performance in patient transport practices.
Methods
This semi-experimental study employs a pretest–posttest single-group design. The study population consisted of 60 paramedic program students at a university’s health services vocational school during the 2022–2023 academic year’s fall semester. Students received theoretical and practical training on body mechanics, following the Body Mechanics Training Guide. Data were analyzed using IBM SPSS 24.
Results
The mean age of the students was 20.40 ± 1.65 years, with 58.3 % in their second year, and 76.7 % female. Significant differences were found in Body Mechanics Knowledge Form scores across pre-training, post-training, and follow-up assessments. A statistically significant improvement was also observed in Observational Checklist scores, with 95.0 % of students failing the pre-test but all succeeding in the post-training assessment.
Conclusion
This study concluded that the occupational injury prevention training program improved the knowledge levels and performance in patient transport practices of paramedic students.
{"title":"Assessing the effectiveness of an occupational musculoskeletal ınjury prevention program for paramedic students: A quasi-experimental, pretest–posttest study","authors":"Fatma Tok, Naile Canıtez, Tuğba Aydemir","doi":"10.1016/j.ienj.2025.101658","DOIUrl":"10.1016/j.ienj.2025.101658","url":null,"abstract":"<div><h3>Background</h3><div>Paramedics must apply appropriate body mechanics principles when providing emergency care, actively engaging their bodies to prevent physical injuries and protect patients from falls and harm. The aim of this study is to investigate the effectiveness of a occupational musculoskeletal injury prevention program provided to paramedic students on their level of knowledge regarding body mechanics principles and their performance in patient transport practices.</div></div><div><h3>Methods</h3><div>This semi-experimental study employs a pretest–posttest single-group design. The study population consisted of 60 paramedic program students at a university’s health services vocational school during the 2022–2023 academic year’s fall semester. Students received theoretical and practical training on body mechanics, following the Body Mechanics Training Guide. Data were analyzed using IBM SPSS 24.</div></div><div><h3>Results</h3><div>The mean age of the students was 20.40 ± 1.65 years, with 58.3 % in their second year, and 76.7 % female. Significant differences were found in Body Mechanics Knowledge Form scores across pre-training, post-training, and follow-up assessments. A statistically significant improvement was also observed in Observational Checklist scores, with 95.0 % of students failing the pre-test but all succeeding in the post-training assessment.</div></div><div><h3>Conclusion</h3><div>This study concluded that the occupational injury prevention training program improved the knowledge levels and performance in patient transport practices of paramedic students.</div></div>","PeriodicalId":48914,"journal":{"name":"International Emergency Nursing","volume":"82 ","pages":"Article 101658"},"PeriodicalIF":1.8,"publicationDate":"2025-07-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144605124","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 : 2025-07-12DOI: 10.1016/j.ienj.2025.101657
C.M. Edwards , S. Veenje , E. Visser , D. Dammers , M.I. de Haan-Lauteslager , H. Lameijer
Introduction
Frequent use of the term ’pain’ in clinical settings has been associated with the nocebo effect, potentially leading to increased pain perception and unnecessary analgesic use. This study aimed to explore the impact of cognitive reframing, employing comfort scores (CS) instead of pain scores (PS), on analgesic desire and usage in adults presenting to the emergency department (ED) with abdominal pain.
Methods
In this randomized controlled trial, ED patients with abdominal pain were assigned to either the PS group (assessing pain using a pain score) or CS group (assessing comfort using an inverted pain score). In the CS group, explicit references to ’pain’ or ’discomfort’ were avoided. Desire for and use of analgesia were assessed at triage, 1 h post-entry, and at ED discharge. Statistical analyses included the Mann-Whitney U test for CS vs. PS and the Chi-squared test for analgesia desire and patient satisfaction.
Results
Among the 496 included patients (36 % male, median age 52 (IQR 31–67) years), CS and PS groups showed similar characteristics and prehospital analgesic use. The PS group required slightly less morphine in dosage (PS: 0.05 mg/kg (0.03–0.07) vs. CS: 0.07 mg/kg (0.04–0.10), p = 0.03). CS scores were lower than PS scores, but only significant at 1 h post-entry (CS median (IQR): 5 (4–6) vs. PS 6 (4–7), p = 0.03). Baseline analgesic desire was lower in the CS group (45 % vs. 54 %, p = 0.06), with no differences in administered analgesic types. Treatment satisfaction did not differ between groups.
Conclusion
In this study using CS as opposed to PS did not affect the desire for or the use of opioids or other analgesia in adult patients with abdominal pain presenting at the ED. Although CS may be potentially useful, using it instead of PS as a tool for cognitive reframing is currently not supported in the uncontrolled clinical setting of the ED.
在临床环境中频繁使用“疼痛”一词与反安慰剂效应有关，可能导致疼痛感增加和不必要的止痛药使用。本研究旨在探讨认知重构的影响，采用舒适评分（CS）代替疼痛评分（PS），对成人腹痛急诊科（ED）的镇痛欲望和使用。方法在这项随机对照试验中，伴有腹痛的ED患者被分为PS组（使用疼痛评分评估疼痛）和CS组（使用反向疼痛评分评估舒适度）。在CS组，明确提到“疼痛”或“不适”是避免的。在分诊、入院后1小时和急诊科出院时评估镇痛的愿望和使用情况。统计分析包括CS与PS的Mann-Whitney U检验和镇痛欲望与患者满意度的卡方检验。结果纳入的496例患者（36%为男性，中位年龄52岁（IQR 31-67）岁）中，CS组和PS组在院前镇痛使用方面表现相似。PS组吗啡用量略低于CS组（0.05 mg/kg (0.04 ~ 0.10), p = 0.03）。CS评分低于PS评分，但仅在入组后1小时显著(CS中位数（IQR）： 5 （4-6) vs PS 6 (4-7), p = 0.03）。CS组的基线镇痛欲望较低（45% vs. 54%, p = 0.06），给药类型无差异。治疗满意度在两组间无差异。结论：在本研究中，在急诊科出现腹痛的成年患者中，使用CS而不是PS并不会影响对阿片类药物或其他镇痛药物的使用。尽管CS可能有潜在的用途，但在急诊科不受控制的临床环境中，目前尚不支持使用CS代替PS作为认知重构的工具。
{"title":"Comfort scores instead of pain scores as a possible tool for pain and analgesia reduction in the emergency department: A randomized controlled clinical trial","authors":"C.M. Edwards , S. Veenje , E. Visser , D. Dammers , M.I. de Haan-Lauteslager , H. Lameijer","doi":"10.1016/j.ienj.2025.101657","DOIUrl":"10.1016/j.ienj.2025.101657","url":null,"abstract":"<div><h3>Introduction</h3><div>Frequent use of the term ’pain’ in clinical settings has been associated with the nocebo effect, potentially leading to increased pain perception and unnecessary analgesic use. This study aimed to explore the impact of cognitive reframing, employing comfort scores (CS) instead of pain scores (PS), on analgesic desire and usage in adults presenting to the emergency department (ED) with abdominal pain.</div></div><div><h3>Methods</h3><div>In this randomized controlled trial, ED patients with abdominal pain were assigned to either the PS group (assessing pain using a pain score) or CS group (assessing comfort using an inverted pain score). In the CS group, explicit references to ’pain’ or ’discomfort’ were avoided. Desire for and use of analgesia were assessed at triage, 1 h post-entry, and at ED discharge. Statistical analyses included the Mann-Whitney <em>U</em> test for CS vs. PS and the Chi-squared test for analgesia desire and patient satisfaction.</div></div><div><h3>Results</h3><div>Among the 496 included patients (36 % male, median age 52 (IQR 31–67) years), CS and PS groups showed similar characteristics and prehospital analgesic use. The PS group required slightly less morphine in dosage (PS: 0.05 mg/kg (0.03–0.07) vs. CS: 0.07 mg/kg (0.04–0.10), p = 0.03). CS scores were lower than PS scores, but only significant at 1 h post-entry (CS median (IQR): 5 (4–6) vs. PS 6 (4–7), p = 0.03). Baseline analgesic desire was lower in the CS group (45 % vs. 54 %, p = 0.06), with no differences in administered analgesic types. Treatment satisfaction did not differ between groups.</div></div><div><h3>Conclusion</h3><div>In this study using CS as opposed to PS did not affect the desire for or the use of opioids or other analgesia in adult patients with abdominal pain presenting at the ED. Although CS may be potentially useful, using it instead of PS as a tool for cognitive reframing is currently not supported in the uncontrolled clinical setting of the ED.</div></div>","PeriodicalId":48914,"journal":{"name":"International Emergency Nursing","volume":"82 ","pages":"Article 101657"},"PeriodicalIF":1.8,"publicationDate":"2025-07-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144611854","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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