Pub Date : 2024-05-01DOI: 10.1016/j.jen.2024.01.006
Zahide İyi MSc, RN, Nimet Karataş PhD, RN, Ayşegül İşler PhD, RN
Introduction
Pediatric convulsive status epilepticus is one of the most common neurologic emergencies and should be managed by health care professionals as soon as possible based on current guidelines. This study aimed to determine the nursing approaches and management of pediatric convulsive status epilepticus from the perspective of emergency nurses in Turkey.
Methods
A cross-sectional, multicenter study was conducted with 162 emergency nurses working in emergency departments in 35 different provinces in Turkey. The data were collected via an online form. Descriptive statistical methods were used in data analysis.
Results
Most emergency nurses (72.2%) attempted an intravenous access immediately to administer antiseizure medications during the stabilization phase. Approximately half the emergency nurses stated that rectal diazePAM was frequently administered in the initial therapy phase and intravenous diazePAM was administered in the second therapy phase. The emergency nurses had most difficulties attempting intravenous access, determining status epilepticus types, and calming the parents.
Discussion
As health care professionals and important members of the health team, emergency nurses have the responsibility to manage pediatric convulsive status epilepticus in the fastest and the most appropriate way based on current practice guidelines in emergency departments. When intravenous access is not available, nonintravenous benzodiazepines should be considered in the first-line treatment of pediatric convulsive status epilepticus, followed by immediate intravenous access.
{"title":"Management of Pediatric Convulsive Status Epilepticus From the Perspective of Emergency Nurses: A Cross-sectional, Multicenter Study","authors":"Zahide İyi MSc, RN, Nimet Karataş PhD, RN, Ayşegül İşler PhD, RN","doi":"10.1016/j.jen.2024.01.006","DOIUrl":"10.1016/j.jen.2024.01.006","url":null,"abstract":"<div><h3>Introduction</h3><p>Pediatric convulsive status epilepticus is one of the most common neurologic emergencies and should be managed by health care professionals as soon as possible based on current guidelines. This study aimed to determine the nursing approaches and management of pediatric convulsive status epilepticus from the perspective of emergency nurses in Turkey.</p></div><div><h3>Methods</h3><p>A cross-sectional, multicenter study was conducted with 162 emergency nurses working in emergency departments in 35 different provinces in Turkey. The data were collected via an online form. Descriptive statistical methods were used in data analysis.</p></div><div><h3>Results</h3><p>Most emergency nurses (72.2%) attempted an intravenous access immediately to administer antiseizure medications during the stabilization phase. Approximately half the emergency nurses stated that rectal diazePAM was frequently administered in the initial therapy phase and intravenous diazePAM was administered in the second therapy phase. The emergency nurses had most difficulties attempting intravenous access, determining status epilepticus types, and calming the parents.</p></div><div><h3>Discussion</h3><p>As health care professionals and important members of the health team, emergency nurses have the responsibility to manage pediatric convulsive status epilepticus in the fastest and the most appropriate way based on current practice guidelines in emergency departments. When intravenous access is not available, nonintravenous benzodiazepines should be considered in the first-line treatment of pediatric convulsive status epilepticus, followed by immediate intravenous access.</p></div>","PeriodicalId":51082,"journal":{"name":"Journal of Emergency Nursing","volume":"50 3","pages":"Pages 364-372"},"PeriodicalIF":1.7,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140121285","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 : 2024-05-01DOI: 10.1016/j.jen.2024.02.007
Lisa Wolf PhD, RN, CEN, FAEN, FAAN, Altair Delao MPH, Francine M. Jodelka BS, Claire Simon ScD, DNP, RN
Introduction
Freestanding emergency departments (FSEDs) are emergency facilities not connected to inpatient services. The percentage of FSEDs of all EDs grew from 1% in 2001 to 12% in 2017, making FSEDs a substantial subset of US emergency care. The purpose of this study was to describe the individual attributes and environmental conditions of registered nurses working in FSEDs in the US.
Methods
A quantitative descriptive exploratory design with cross-sectional survey methodology.
Results
A total of 364 emergency nurses responded to the survey. Most reported their FSED was open 24 hours/day (99.5%), with board-certified emergency physicians onsite (91.5%) and a mean of 3.6 RNs working per shift. Resources immediately available in more than 50% of FSEDs included laboratory and imaging services, and in fewer than 30% of FSEDs included behavioral health care, MRI, obstetric care, orthopedic care, neurologic care, and surgical consult care. Respiratory therapy was reported by 39.6% of respondents as being immediately available. A significant minority of respondents expressed concerns about adequacy of resources and training and the effect on patient care in both survey (30% of respondents) and open-ended questions (42.5% of respondents).
Discussion
The practice environment of emergency nurses in FSEDs was reported as having positive elements; however, a substantial subpopulation reported serious concerns. FSEDs adhere to some of the standards put forward by the American College of Emergency Physicians, with notable exceptions in the areas of staffing RNs, staffing ancillary staff, and availability of some resources.
{"title":"Individual Attributes and Environmental Conditions of Registered Nurses Working in Freestanding Emergency Departments in the United States: A Descriptive Exploratory Study","authors":"Lisa Wolf PhD, RN, CEN, FAEN, FAAN, Altair Delao MPH, Francine M. Jodelka BS, Claire Simon ScD, DNP, RN","doi":"10.1016/j.jen.2024.02.007","DOIUrl":"10.1016/j.jen.2024.02.007","url":null,"abstract":"<div><h3>Introduction</h3><p>Freestanding emergency departments (FSEDs) are emergency facilities not connected to inpatient services. The percentage of FSEDs of all EDs grew from 1% in 2001 to 12% in 2017, making FSEDs a substantial subset of US emergency care. The purpose of this study was to describe the individual attributes and environmental conditions of registered nurses working in FSEDs in the US.</p></div><div><h3>Methods</h3><p>A quantitative descriptive exploratory design with cross-sectional survey methodology.</p></div><div><h3>Results</h3><p>A total of 364 emergency nurses responded to the survey. Most reported their FSED was open 24 hours/day (99.5%), with board-certified emergency physicians onsite (91.5%) and a mean of 3.6 RNs working per shift. Resources immediately available in more than 50% of FSEDs included laboratory and imaging services, and in fewer than 30% of FSEDs included behavioral health care, MRI, obstetric care, orthopedic care, neurologic care, and surgical consult care. Respiratory therapy was reported by 39.6% of respondents as being immediately available. A significant minority of respondents expressed concerns about adequacy of resources and training and the effect on patient care in both survey (30% of respondents) and open-ended questions (42.5% of respondents).</p></div><div><h3>Discussion</h3><p>The practice environment of emergency nurses in FSEDs was reported as having positive elements; however, a substantial subpopulation reported serious concerns. FSEDs adhere to some of the standards put forward by the American College of Emergency Physicians, with notable exceptions in the areas of staffing RNs, staffing ancillary staff, and availability of some resources.</p></div>","PeriodicalId":51082,"journal":{"name":"Journal of Emergency Nursing","volume":"50 3","pages":"Pages 381-391.e2"},"PeriodicalIF":1.7,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140177628","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 : 2024-05-01DOI: 10.1016/j.jen.2024.02.006
Chris Dellinger MBA, BSN, RN, FAEN
{"title":"The Leader Behind. How Can Someone Who Is Behind Lead Effectively, You Ask? Well, Let Us Chat","authors":"Chris Dellinger MBA, BSN, RN, FAEN","doi":"10.1016/j.jen.2024.02.006","DOIUrl":"https://doi.org/10.1016/j.jen.2024.02.006","url":null,"abstract":"","PeriodicalId":51082,"journal":{"name":"Journal of Emergency Nursing","volume":"50 3","pages":"Page 321"},"PeriodicalIF":1.7,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140822791","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}
The Individual Earthquake Resilience Scale was developed with the aim of measuring individual resilience in the context of earthquake disasters. The purpose of this study was to adapt the Individual Earthquake Resilience Scale into Turkish and examine its psychometric properties.
Methods
A total of 419 adult individuals (65.2% females, median age = 43.35) participated in the study. The psychometric properties of the scale were examined in terms of content validity, face validity, construct validity, criterion-related validity, and reliability. Translation and back-translation processes were conducted.
Results
Confirmatory factor analyses revealed that the scale has a 4-factor structure. In terms of criterion-related validity, a positive relationship was found between Individual Earthquake Resilience and the Short Psychological Resilience Scale. The reliability of the scale was assessed using Cronbach’s alpha coefficient. The total scale had a Cronbach’s alpha score of 0.892. The Individual Earthquake Resilience Questionnaire subscales had Cronbach’s alpha scores of 0.620, 0.817, 0.776, and 0.692, respectively.
Discussion
The study confirmed that the 4-factor structure of the Individual Earthquake Resilience Scale met the required standards for validity and reliability at an acceptable level. This validates its use in assessing individual resilience within the context of earthquakes in a Turkish-speaking population.
{"title":"Individual Earthquake Resilience Scale: Psychometric Properties of the Turkish Version","authors":"Bilge Kalanlar PhD, RN, Nilgün Kuru Alıcı PhD, RN, Mücahide Öner PhD, RN","doi":"10.1016/j.jen.2024.01.002","DOIUrl":"10.1016/j.jen.2024.01.002","url":null,"abstract":"<div><h3>Introduction</h3><p>The Individual Earthquake Resilience Scale was developed with the aim of measuring individual resilience in the context of earthquake disasters. The purpose of this study was to adapt the Individual Earthquake Resilience Scale into Turkish and examine its psychometric properties.</p></div><div><h3>Methods</h3><p>A total of 419 adult individuals (65.2% females, median age = 43.35) participated in the study. The psychometric properties of the scale were examined in terms of content validity, face validity, construct validity, criterion-related validity, and reliability. Translation and back-translation processes were conducted.</p></div><div><h3>Results</h3><p>Confirmatory factor analyses revealed that the scale has a 4-factor structure. In terms of criterion-related validity, a positive relationship was found between Individual Earthquake Resilience and the Short Psychological Resilience Scale. The reliability of the scale was assessed using Cronbach’s alpha coefficient. The total scale had a Cronbach’s alpha score of 0.892. The Individual Earthquake Resilience Questionnaire subscales had Cronbach’s alpha scores of 0.620, 0.817, 0.776, and 0.692, respectively.</p></div><div><h3>Discussion</h3><p>The study confirmed that the 4-factor structure of the Individual Earthquake Resilience Scale met the required standards for validity and reliability at an acceptable level. This validates its use in assessing individual resilience within the context of earthquakes in a Turkish-speaking population.</p></div>","PeriodicalId":51082,"journal":{"name":"Journal of Emergency Nursing","volume":"50 3","pages":"Pages 436-443"},"PeriodicalIF":1.7,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139944609","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 : 2024-05-01DOI: 10.1016/S0099-1767(24)00086-2
{"title":"Board of Directors","authors":"","doi":"10.1016/S0099-1767(24)00086-2","DOIUrl":"https://doi.org/10.1016/S0099-1767(24)00086-2","url":null,"abstract":"","PeriodicalId":51082,"journal":{"name":"Journal of Emergency Nursing","volume":"50 3","pages":"Page A8"},"PeriodicalIF":1.7,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140822719","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 : 2024-05-01DOI: 10.1016/j.jen.2024.01.008
Lauren Do BS, Karen Piper BS, Amanda N. Barczyk PhD, Jeffrey D. Shahidullah PhD, Karla A. Lawson PhD
Introduction
Suicide is the second leading cause of death for youth 12 to 18 years of age. Suicidal ideation can be predictive of suicide attempt, so screening for suicidal ideation by emergency nurses can help identify those at risk and facilitate timely intervention. This study evaluates the use of a universal suicide screening using the Patient Safety Screener 3 and the Columbia Suicide Severity Rating Scale to identify youth ages 12 to 18 years experiencing suicide risk and assess factors predictive of suicide risk level.
Methods
We conducted a retrospective cohort study using data from patients presenting to the emergency department at an acute care hospital that uses a universal screening program for suicide risk. We determined the frequency of positive screens and performed multivariate analyses to identify predictive factors of scoring high on the Columbia Suicide Severity Rating Scale.
Results
Notably, 9.1% of patients were experiencing some level of suicide risk; 10% of those with positive scores had no mental health history and were not presenting for a mental health reason. After controlling for other independent variables, insurance status, mental health presentation, and known mental health history were significantly associated with Columbia Suicide Severity Rating Scale score.
Discussion
Universal screening for suicide risk in pediatric emergency departments by nurses is critical for all patients older than 12 years, given that we identified patients at risk of suicide who presented for non–mental health reasons. These patients may not have been identified or referred to treatment if they were not screened for suicidality increasing risk of future suicide attempt.
{"title":"Universal Suicidality Screening in a Pediatric Emergency Department to Improve Mental Health Safety Risk","authors":"Lauren Do BS, Karen Piper BS, Amanda N. Barczyk PhD, Jeffrey D. Shahidullah PhD, Karla A. Lawson PhD","doi":"10.1016/j.jen.2024.01.008","DOIUrl":"10.1016/j.jen.2024.01.008","url":null,"abstract":"<div><h3>Introduction</h3><p>Suicide is the second leading cause of death for youth 12 to 18 years of age. Suicidal ideation can be predictive of suicide attempt, so screening for suicidal ideation by emergency nurses can help identify those at risk and facilitate timely intervention. This study evaluates the use of a universal suicide screening using the Patient Safety Screener 3 and the Columbia Suicide Severity Rating Scale to identify youth ages 12 to 18 years experiencing suicide risk and assess factors predictive of suicide risk level.</p></div><div><h3>Methods</h3><p>We conducted a retrospective cohort study using data from patients presenting to the emergency department at an acute care hospital that uses a universal screening program for suicide risk. We determined the frequency of positive screens and performed multivariate analyses to identify predictive factors of scoring high on the Columbia Suicide Severity Rating Scale.</p></div><div><h3>Results</h3><p>Notably, 9.1% of patients were experiencing some level of suicide risk; 10% of those with positive scores had no mental health history and were not presenting for a mental health reason. After controlling for other independent variables, insurance status, mental health presentation, and known mental health history were significantly associated with Columbia Suicide Severity Rating Scale score.</p></div><div><h3>Discussion</h3><p>Universal screening for suicide risk in pediatric emergency departments by nurses is critical for all patients older than 12 years, given that we identified patients at risk of suicide who presented for non–mental health reasons. These patients may not have been identified or referred to treatment if they were not screened for suicidality increasing risk of future suicide attempt.</p></div>","PeriodicalId":51082,"journal":{"name":"Journal of Emergency Nursing","volume":"50 3","pages":"Pages 354-363"},"PeriodicalIF":1.7,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140295245","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 : 2024-05-01DOI: 10.1016/S0099-1767(24)00087-4
{"title":"Information for Readers","authors":"","doi":"10.1016/S0099-1767(24)00087-4","DOIUrl":"https://doi.org/10.1016/S0099-1767(24)00087-4","url":null,"abstract":"","PeriodicalId":51082,"journal":{"name":"Journal of Emergency Nursing","volume":"50 3","pages":"Page A10"},"PeriodicalIF":1.7,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140822790","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 : 2024-05-01DOI: 10.1016/j.jen.2023.12.002
Monika Bednarek-Chałuda PhD, Anna Żądło MSc, Natalia Antosz MSc, Patricia Clutter MEd
Introduction
The aim of this study was to assess the impact of the national government initiative Emergency Severity Index version 4.0 validated triage training on triage practitioners’ knowledge and accuracy.
Methods
This pre/post intervention study evaluated the knowledge of triage practitioners, who constituted 30% of employees trained by the national program, in 74 emergency departments across Poland in 2020. Statistical analysis was used to evaluate the impact of the triage training.
Results
No significant differences in triage knowledge were found based on experience, length of ED service, or previous training. Training resulted in increased accuracy (61.3% vs 81.1%) and decreased overtriage and undertriage. Participants significantly reduced errors and improved Emergency Severity Index guideline–based case evaluations, especially for Emergency Severity Index 1-3 cases, with the most notable improvements observed among those without prior triage experience. The training significantly improved interrater reliability.
Discussion
The Emergency Severity Index pilot training demonstrated a significant improvement in the accuracy of triage practitioners. Emergency Severity Index level 4 has been identified as a challenging area to learn, as well as yielding promising results in the acquisition of knowledge across levels 1 and 2, among less experienced practitioners.
{"title":"Polish Perspective: The Influence of National Emergency Severity Index Training on Triage Practitioners’ Knowledge","authors":"Monika Bednarek-Chałuda PhD, Anna Żądło MSc, Natalia Antosz MSc, Patricia Clutter MEd","doi":"10.1016/j.jen.2023.12.002","DOIUrl":"10.1016/j.jen.2023.12.002","url":null,"abstract":"<div><h3>Introduction</h3><p>The aim of this study was to assess the impact of the national government initiative Emergency Severity Index version 4.0 validated triage training on triage practitioners’ knowledge and accuracy.</p></div><div><h3>Methods</h3><p>This pre/post intervention study evaluated the knowledge of triage practitioners, who constituted 30% of employees trained by the national program, in 74 emergency departments across Poland in 2020. Statistical analysis was used to evaluate the impact of the triage training.</p></div><div><h3>Results</h3><p>No significant differences in triage knowledge were found based on experience, length of ED service, or previous training. Training resulted in increased accuracy (61.3% vs 81.1%) and decreased overtriage and undertriage. Participants significantly reduced errors and improved Emergency Severity Index guideline–based case evaluations, especially for Emergency Severity Index 1-3 cases, with the most notable improvements observed among those without prior triage experience. The training significantly improved interrater reliability.</p></div><div><h3>Discussion</h3><p>The Emergency Severity Index pilot training demonstrated a significant improvement in the accuracy of triage practitioners. Emergency Severity Index level 4 has been identified as a challenging area to learn, as well as yielding promising results in the acquisition of knowledge across levels 1 and 2, among less experienced practitioners.</p></div>","PeriodicalId":51082,"journal":{"name":"Journal of Emergency Nursing","volume":"50 3","pages":"Pages 413-424"},"PeriodicalIF":1.7,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0099176723003379/pdfft?md5=7ee37c0b688f1f76613ba7fdc2527fe4&pid=1-s2.0-S0099176723003379-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139724835","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}
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