Journal of Emergency Nursing最新文献

英文中文

Paradoxical Motion of the Chest Wall 胸壁的矛盾运动。

IF 1.8 4区医学 Q2 EMERGENCY MEDICINE

Journal of Emergency Nursing

Pub Date : 2025-01-01 DOI: 10.1016/j.jen.2024.09.009

Chun-Jen Wu MD, Chen-Yu Lai RN, Yi-Ling Ting RN, NP, Chih-Jung Chang MD

引用次数: 0

Establishing Triage Competencies and Verification Processes: A Survey Study 建立分流能力和验证流程：调查研究。

IF 1.8 4区医学 Q2 EMERGENCY MEDICINE

Journal of Emergency Nursing

Pub Date : 2025-01-01 DOI: 10.1016/j.jen.2024.09.005

Lisa Wolf PhD, RN, CEN, FAEN, FAAN, Altair Delao MPH, Claire Simon ScD, DNP, RN, Francine M. Jodelka BS

Introduction

Although the ED triage function is a critical means of ensuring patient safety, core competencies for ED triage are not well defined in the literature. The purpose of the study was to identify and validate emergency triage nursing competencies and to develop a competency verification process.

Methods

A sample of 1181 emergency nurses evenly divided between roles with oversight of triage training and competency assessment (manager-level and staff nurses performing triage) completed an online survey evaluating competency elements that comprised the following in terms of frequency and importance, training modalities, and evaluation methods: expert assessment, clinical judgment, management of medical resources, communication, and timely decisions.

Results

Both manager-level and triage nurses agreed on the importance of the identified competencies. Gaps in training and evaluation were reported by both staff nurses and manager-level nurses. Triage nurses reported less training offered and less competency evaluation compared with manager-level nurses. Triage nurses reported performing all competencies more frequently and at higher level of competency than manager-level nurses reporting on triage nurse performance.

Discussion

This study provides both a standard set of triage competencies and a method by which to evaluate them. Managers and educators might consider this standard to establish initial triage role competency and periodic competency assessment per institutional guidelines. The gap in perceived education and evaluation suggests that standard education and evaluation processes be adopted across emergency departments.

导言：尽管急诊室分诊功能是确保患者安全的重要手段，但文献中并未对急诊室分诊的核心能力做出明确定义。本研究旨在确定和验证急诊分诊护理能力，并制定能力验证流程：方法：1181 名急诊护士完成了一项在线调查，对能力要素进行评估，这些能力要素包括以下方面的频率和重要性、培训模式和评估方法：专家评估、临床判断、医疗资源管理、沟通和及时决策：结果：主管级护士和分诊护士都认同所确定能力的重要性。员工级护士和管理级护士都报告了培训和评估方面的差距。与经理级护士相比，分诊护士的培训和能力评估较少。与经理级护士相比，分诊护士在报告分诊护士表现时更频繁地报告了所有能力，能力水平也更高：本研究提供了一套标准的分诊能力和评估方法。管理者和教育者可以考虑采用这一标准来建立分诊角色的初始能力，并根据机构指南定期进行能力评估。教育和评估方面的差距表明，急诊科应采用标准的教育和评估流程。

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引用次数: 0

Psychological Distress and the Needs of Family Members of Critically Ill Patients in Emergency Departments During the COVID-19 Pandemic: A Cross-Sectional Study COVID-19 大流行期间急诊科重症患者家属的心理压力和需求：一项横断面研究

IF 1.8 4区医学 Q2 EMERGENCY MEDICINE

Journal of Emergency Nursing

Pub Date : 2025-01-01 DOI: 10.1016/j.jen.2024.07.005

Li-Rong Wu RN, MSN, Jun-Yu Fan PhD, RN, FAAN, Tse-Hsuan Su MD, MS, Chin-Yen Han PhD, RN

Introduction

The literature highlights the importance of the needs of family members of critical patients in emergency departments. Understanding these needs helps to alleviate psychological distress and contribute to the patients’ recoveries. This study aimed to examine the psychological distress and needs of family members of critical patients in emergency departments.

Methods

A cross-sectional design was used to collect data using the Depression, Anxiety, and Stress Scale-21, the Critical Care Family Needs Inventory for the Emergency Department, and the Needs Met Inventory questionnaire from a convenience sample of 170 family members of critical patients. Descriptive analysis and importance-performance analysis were applied to analyze the data.

Results

The results showed that 52.4% of family members reported mild to extremely severe levels of depression, 60% reported mild to extremely severe levels of anxiety, and 53.5% had mild to extremely severe levels of stress. Anxiety showed a significant negative correlation with comfort needs (r = −0.17) and support needs being met (r = −0.16). The importance-performance analysis showed that the coordinates for support needs were in quadrant IV, signifying a higher level of importance perceived by family members but a lower level of the needs being met.

Conclusion

Providing the assessment and necessary support to alleviate psychological distress will help enhance the ability of the emergency department to meet families’ needs.

导言：文献强调了急诊科危重病人家属需求的重要性。了解这些需求有助于减轻患者的心理压力，促进患者康复。本研究旨在探讨急诊科危重病人家属的心理困扰和需求：方法：采用横断面设计，使用抑郁、焦虑和压力量表-21、急诊科危重病人家属需求量表和需求满足量表问卷收集数据，样本为 170 名危重病人家属。数据分析采用了描述性分析和重要性表现分析：结果显示，52.4%的家属有轻度到极重度抑郁，60%的家属有轻度到极重度焦虑，53.5%的家属有轻度到极重度压力。焦虑与舒适需求（r = -0.17）和支持需求得到满足（r = -0.16）呈显著负相关。重要性-绩效分析表明，支持需求的坐标位于第四象限，表明家庭成员认为其重要性较高，但需求得到满足的程度较低：结论：提供评估和必要的支持以缓解心理压力，将有助于提高急诊科满足家属需求的能力。

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引用次数: 0

Methanol Poisoning: A Growing Concern in the COVID-19 Pandemic Era 甲醇中毒：COVID-19大流行时代日益关注的问题。

IF 1.8 4区医学 Q2 EMERGENCY MEDICINE

Journal of Emergency Nursing

Pub Date : 2025-01-01 DOI: 10.1016/j.jen.2024.10.001

引用次数: 0

Information for Readers

IF 1.8 4区医学 Q2 EMERGENCY MEDICINE

Journal of Emergency Nursing

Pub Date : 2025-01-01 DOI: 10.1016/S0099-1767(24)00343-X

引用次数: 0

Acute Generalized Exanthematous Pustulosis Induced by Hyaluronic Acid Knee Injection: A Case Report 透明质酸膝关节注射致急性全身性脓疱病1例。

IF 1.8 4区医学 Q2 EMERGENCY MEDICINE

Journal of Emergency Nursing

Pub Date : 2025-01-01 DOI: 10.1016/j.jen.2024.08.005

Niki Ntavari MD, Georgios Mavrovounis MD, Agoritsa Gravani MD, Vasiliki Syrmou MD, Angeliki-Viktoria Roussaki MD, PhD, Efterpi Zafiriou MD, PhD, Ioannis Pantazopoulos MD, PhD

Acute generalized exanthematous pustulosis is a severe cutaneous adverse reaction characterized by the rapid onset of nonfollicular, sterile pustules on an erythematous base, typically accompanied by fever (≥38 °C), neutrophilia (7.0 × 10⁹/L), and characteristic histopathological features. This case report presents the first documented instance of acute generalized exanthematous pustulosis after hyaluronic acid viscosupplementation.

A 61-year-old female developed a pruritic, erythematous rash that rapidly evolved into generalized erythroderma with systemic manifestations after receiving intra-articular hyaluronic acid injections for knee osteoarthritis. Initial physical examination and diagnostic workup, including biopsy and blood tests, were performed to exclude other differential diagnoses such as generalized pustular psoriasis, subcorneal pustular dermatosis, and immunoglobulin A pemphigus.

The temporal association with hyaluronic acid injections and the patient’s positive response to treatment with systemic corticosteroids and antihistamines supported the definitive diagnosis of drug-induced acute generalized exanthematous pustulosis. The patient was managed with the withdrawal of the offending agent, and supportive care was provided. She did not require rehabilitation and experienced no adverse events during the recovery period. Follow-up visits confirmed the absence of recurrence and complete resolution of symptoms, with no lasting sequelae.

This case underscores the importance of recognizing acute generalized exanthematous pustulosis’ acute manifestations and potential triggers, even with treatments generally considered safe. ED personnel, including advanced practice registered nurses and other clinicians, must include acute generalized exanthematous pustulosis in their differential diagnoses of severe cutaneous disorders to initiate prompt and appropriate management. The development of atrial fibrillation during hospitalization in this patient raises questions about the systemic effects of acute generalized exanthematous pustulosis, suggesting an area for further research.

Early detection and treatment of acute generalized exanthematous pustulosis are crucial for favorable outcomes, illustrating the vital role ED personnel play in managing this condition. Awareness of rare triggers such as hyaluronic acid is essential for preventing and effectively treating such severe adverse reactions.

急性泛发性脓疱病是一种严重的皮肤不良反应，其特征是在红斑基础上迅速出现非滤泡性、无菌脓疱，通常伴有发热（≥38°C）、中性粒细胞增多（7.0 × 10⁹/L）和特征性组织病理学特征。这个病例报告提出了第一个记录的病例急性全身性脓疱病后透明质酸粘胶补充。一名61岁女性因膝骨关节炎接受关节内透明质酸注射后出现瘙痒性红斑皮疹，并迅速发展为全身性红皮病。初步体格检查和诊断检查，包括活检和血液检查，以排除其他鉴别诊断，如全身性脓疱性银屑病、角膜下脓疱性皮肤病和免疫球蛋白A天疱疮。与透明质酸注射的时间相关性以及患者对全身皮质类固醇和抗组胺药治疗的积极反应支持了药物性急性全身性脓疱病的明确诊断。对患者进行了治疗，停用了违规药物，并提供了支持性护理。患者不需要康复治疗，康复期间无不良事件发生。随访证实无复发，症状完全消退，无持久后遗症。该病例强调了认识急性全发性脓疱病的急性表现和潜在诱因的重要性，即使通常认为治疗是安全的。急诊科人员，包括高级执业注册护士和其他临床医生，必须在严重皮肤病的鉴别诊断中包括急性全身性脓疱病，以便及时和适当地进行治疗。该患者住院期间房颤的发生，对急性全身性脓疱病的全身性影响提出了疑问，提示了一个有待进一步研究的领域。急性全身性脓疱病的早期发现和治疗对于良好的预后至关重要，这表明急诊科人员在治疗这种疾病中发挥着至关重要的作用。了解罕见的触发因素，如透明质酸，对于预防和有效治疗这种严重的不良反应至关重要。

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引用次数: 0

Addressing Bias in the Care of Geriatric Emergency Department Patients 解决老年急诊科患者护理中的偏见。

IF 1.8 4区医学 Q2 EMERGENCY MEDICINE

Journal of Emergency Nursing

Pub Date : 2025-01-01 DOI: 10.1016/j.jen.2024.10.018

Altair M. Delao MPH

引用次数: 0

Reaching Out to Our Fellow Emergency Nurses 向急救护士同行伸出援手。

IF 1.8 4区医学 Q2 EMERGENCY MEDICINE

Journal of Emergency Nursing

Pub Date : 2025-01-01 DOI: 10.1016/j.jen.2024.10.013

Ryan Oglesby PhD, MHA, RN, CEN, CFRN, NEA-BC

引用次数: 0

The Role of Emergency Nurses in Emergency Preparedness and Response 急诊护士在应急准备和响应中的作用。

IF 1.8 4区医学 Q2 EMERGENCY MEDICINE

Journal of Emergency Nursing

Pub Date : 2025-01-01 DOI: 10.1016/j.jen.2024.08.004

Nancy J. Denke DNP, ACNP-BC, FNP-BC, FAEN, CEN, CCRN

引用次数: 0

Adult Patients’ Experiences of Closed Reduction Treatment for Distal Radius Fracture in the Emergency Department ‐ A Qualitative Descriptive Study 成人患者在急诊室接受桡骨远端骨折闭合复位治疗的经历--一项定性描述性研究。

IF 1.8 4区医学 Q2 EMERGENCY MEDICINE

Journal of Emergency Nursing

Pub Date : 2025-01-01 DOI: 10.1016/j.jen.2024.08.010

Charlotte M. Jensen PhD, MEd, RN, Christina Østervang PhD, MScN, RN, Kai H.W. Lange PhD, MD, Anders K. Nørskov PhD, MD, Bjarke Viberg PhD, MD, Charlotte Abrahamsen PhD, MSc, RN

Introduction

Distal radius fractures are common injuries managed frequently in emergency departments. While numerous studies focus on the surgical treatment of distal radius fractures, there is a lack of research about non-surgically treated patients' early experiences post-injury. The objective of this study was to explore adult patients' initial experiences following closed reduction treatment of distal radius fracture in the emergency department.

Methods

This qualitative study involved semi-structured telephone interviews with 21 patients who underwent closed-reduction treatment at 2 hospitals in Southern Denmark. Interviews were conducted within the first week following ED treatment and analyzed thematically.

Results

Patients were aged 42 to 91, and 3 were men. Three major themes emerged: (1) Pain Management: Patients reported significant pain during waiting periods and treatment, indicating a need for improved pain management strategies; (2) Information Dissemination: Participants expressed a need for clearer, continuous communication about their treatment and recovery expectations; and (3) Beyond the fracture: Patients were anxious about future functional abilities, especially those with dominant hand fractures, underscoring the need for holistic patient care that addresses psychological and social dimensions.

Discussion

Effective pain management, both pharmacological and non-pharmacological, as well as comprehensive, clear communication, is crucial in the initial treatment phase of distal radius fracture. Acknowledging patients' broader concerns can enhance the quality of care and support improved recovery outcomes. These findings imply that future emergency nursing practice should prioritize swift and effective pain management, clear and empathetic communication, and a holistic approach to patient care to optimize recovery outcomes.

简介桡骨远端骨折是急诊科经常处理的常见损伤。虽然许多研究都集中在桡骨远端骨折的手术治疗上，但对非手术治疗患者受伤后的早期经历却缺乏研究。本研究旨在探讨成年患者在急诊科接受桡骨远端骨折闭合复位治疗后的初期经历：这项定性研究对丹麦南部两家医院的 21 名接受闭合复位治疗的患者进行了半结构化电话访谈。访谈在急诊科治疗后的第一周内进行，并进行了专题分析：患者年龄在 42 岁至 91 岁之间，其中 3 人为男性。出现了三大主题：（1）疼痛管理：患者表示在等待和治疗期间有明显的疼痛感，这表明需要改进疼痛管理策略；（2）信息传播：参与者表示需要就他们的治疗和康复期望进行更清晰、持续的沟通；(3) 骨折之后：患者对未来的功能能力感到焦虑，尤其是那些显性手部骨折的患者，这突出表明需要对患者进行整体护理，以解决心理和社会方面的问题：讨论：在桡骨远端骨折的初期治疗阶段，有效的疼痛管理（包括药物和非药物治疗）以及全面、清晰的沟通至关重要。承认患者更广泛的关切可提高护理质量，有助于改善康复效果。这些研究结果表明，未来的急诊护理实践应优先考虑迅速有效的疼痛管理、清晰和富于同情心的沟通，以及全面的患者护理方法，以优化康复效果。

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全部 ACS Publications Elsevier ieeexplore Springer The Royal Society of Chemistry Wiley

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Journal of Emergency Nursing

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