Journal of Emergency Nursing最新文献

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IF 2.3 4区医学 Q2 EMERGENCY MEDICINE

Journal of Emergency Nursing

Pub Date : 2026-01-01 DOI: 10.1016/S0099-1767(25)00501-X

引用次数: 0

Enhancing the Psychiatric Emergency Department Triage Process to Optimize Patient Care 加强精神科急诊科分诊流程以优化病人护理。

IF 2.3 4区医学 Q2 EMERGENCY MEDICINE

Journal of Emergency Nursing

Pub Date : 2026-01-01 DOI: 10.1016/j.jen.2025.07.018

Kristen Edmunds BSN, RN, PMH-BC, Michelle Olshan-Perlmutter APRN, PMHCNS, FNP, Nicholas Archer MSN, RN, PMH-BC, Marquita Boggess DNP, MHA, FNP-C, PMHNP-BC, Jared Ruggieri DPT, PT, CLSSGB, Jason Roberge PhD, MPH

Introduction

Emergency departments have seen a steady increase in patients presenting with mental health and substance use disorders, leading to overcrowding, prolonged length of stay, patients leaving without being seen, and diminished staff satisfaction. To address these issues, a behavioral health psychiatric emergency department redesigned its triage process to include a fast-track protocol for low-complexity patients, eliminate treatment redundancies, and incorporate a provider in triage to improve patient outcomes and staff satisfaction.

Methods

Using the Plan-Do-Study-Act methodology, a revised triage process was implemented to streamline workflows and reduce waste. Time metrics from pre- and postintervention periods were compared.

Results

Reductions were observed in all phases of the ED encounter. The median total length of stay decreased by 110 minutes (38% reduction; P<.001). Time from rooming to provider was reduced from 98 to 43 minutes (56% reduction; P<.001), and the median time from arrival to provider was halved, from 152 to 76 minutes (52% reduction; P<.001). The leaving without being seen rate dropped from 10.5% to 6.3% (40% reduction; P<.001).

Discussion

The findings suggest that a fast-track triage system, combined with provider in triage, can improve length of stay, reduce leaving without being seen, and enhance staff satisfaction. This model could be beneficial for other emergency departments managing patients with behavioral health concerns.

导读：急诊科出现精神健康和物质使用障碍的患者稳步增加，导致过度拥挤，住院时间延长，患者离开而没有被看到，以及工作人员满意度下降。为了解决这些问题，行为健康精神科急诊科重新设计了其分诊流程，包括针对低复杂性患者的快速通道协议，消除治疗冗余，并将提供者纳入分诊，以提高患者的治疗效果和员工满意度。方法：采用计划-行动-研究-行动方法，实施修订后的分诊流程，以简化工作流程并减少浪费。比较干预前后的时间指标。结果：在ED接触的所有阶段都观察到减少。总住院时间中位数减少了110分钟（减少了38%）。讨论：研究结果表明，快速分诊系统与提供者分诊相结合，可以缩短住院时间，减少未就医就离开的情况，并提高员工满意度。该模型可用于其他急诊科管理行为健康问题患者。

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引用次数: 0

Patients’ and Family Members’ Perspectives on Family Presence During Adult Resuscitation in Asian Hospital Settings: A Scoping Review 亚洲医院成人复苏过程中患者和家庭成员对家庭存在的看法：一项范围综述。

IF 2.3 4区医学 Q2 EMERGENCY MEDICINE

Journal of Emergency Nursing

Pub Date : 2026-01-01 DOI: 10.1016/j.jen.2025.08.019

Mohammad Syafar Sangkala MANP, RN, Diane Chamberlain PhD, RN, FACN, FACCCN, GAICD, Nina Sivertsen PhD, RN, Mulhaeriah Mulhaeriah MN, CNS, RN

Introduction

Family presence during resuscitation has been examined for more than 4 decades. Although many studies describe potential benefits, debate persists regarding its effects on patients, family members, and clinicians. Effective implementation also hinges on cultural and religious norms and contextual features of care settings, which require careful consideration and further study. This scoping review maps the evidence and identifies family presence during resuscitation knowledge gaps in Asian hospital contexts, focusing on studies that enrolled patients and their family members.

Methods

This scoping review adhered to the JBI methodology and is reported in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews guidelines. In August 2024, a total of 11 databases were systematically searched for primary studies conducted in Asian hospital settings. Eligible studies were published in English or Indonesian, which included adult patients and/or family members aged 18 years or older.

Results

Twenty-three articles met the inclusion criteria and were included in the review: 1 focused on patients, and 22 involved family members. Findings from the family member studies were synthesized into 5 themes: support for family presence during resuscitation, neutrality or opposition toward family presence during resuscitation, cultural and spiritual matters, family members’ needs during resuscitation, and recommendations for family presence during resuscitation implementation.

Discussion

Overall, the analysis of reviewed articles found that most family members support family presence during resuscitation. However, patient-derived evidence remains limited, underscoring the need for further research centered on patients’ perspectives.

引言：在复苏过程中的家庭存在已经进行了40多年的研究。尽管许多研究描述了潜在的益处，但关于其对患者、家庭成员和临床医生的影响仍存在争议。有效的实施还取决于文化和宗教规范以及护理环境的背景特征，这些都需要仔细考虑和进一步研究。这篇范围综述绘制了证据图，并确定了亚洲医院背景下复苏知识缺口中的家庭存在，重点是纳入患者及其家庭成员的研究。方法：该范围评价遵循JBI方法，并按照系统评价的首选报告项目和范围评价的元分析扩展指南进行报告。2024年8月，共有11个数据库系统地检索了在亚洲医院环境中进行的初步研究。符合条件的研究以英语或印尼语发表，包括18岁或以上的成年患者和/或家庭成员。结果：23篇文章符合纳入标准，纳入本综述：1篇针对患者，22篇涉及家属。家庭成员研究的结果被综合为5个主题：支持复苏期间的家庭在场，中立或反对复苏期间的家庭在场，文化和精神问题，复苏期间家庭成员的需求，以及实施复苏期间家庭在场的建议。讨论：总体而言，对综述文章的分析发现，大多数家庭成员支持在复苏期间有家人在场。然而，患者来源的证据仍然有限，强调需要进一步研究以患者的观点为中心。

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引用次数: 0

Outcomes of the Use of Intuition in Nurses’ Decision Making for Critical Care Patients: Scoping Review Protocol 在护士对重症病人的决策中使用直觉的结果：范围审查方案。

IF 2.3 4区医学 Q2 EMERGENCY MEDICINE

Journal of Emergency Nursing

Pub Date : 2026-01-01 DOI: 10.1016/j.jen.2025.09.012

Maria Margarida Assis RN, Maria João Lopes RN, Susana Miguel PhD, MSN, RN, Filipa Veludo PhD, MSN, RN

Introduction

Intuition plays a crucial role in nursing decision making, particularly in high-pressure environments such as emergency departments and intensive care units. Nursing decision making, especially in highly complex contexts, such as caring for patients in critical care, may involve intuition as a form of aesthetic knowledge that complements logical reasoning. Intuition enables the recognition of patterns, the anticipation of complications, and prompt action, thereby influencing the quality and safety of the care. Despite growing recognition of its relevance, the outcomes associated with the use of intuition remain insufficiently systematized, highlighting the need to map the available evidence within advanced nursing.

Objective

This study aimed to map the available scientific evidence regarding the outcomes of using intuition in nurses’ decision making for critical care patients.

Methods

This scoping review will be conducted using the JBI methodology. The search will be performed across 5 databases: CINAHL Complete, PubMed/MEDLINE, Web of Science Core Collection (Web of Science), ProQuest Dissertations & Theses Citation Index (Web of Science), and Scopus. No date restriction will be applied. The studies will be screened using Rayyan software by 2 independent blind reviewers, following a 2-stage process: an initial screening of titles and abstracts, followed by full-text reading of potentially eligible articles, based on predefined inclusion and exclusion criteria. The study protocol was registered on the Open Science Framework (DOI 10.17605/OSF.IO/VUZWX).

Discussion

By mapping outcomes linked to the use of intuition in nurses’ decision making, this review will provide insights into how intuition contributes to patient safety, care quality, and clinical practice.

导读：直觉在护理决策中起着至关重要的作用，特别是在高压环境中，如急诊科和重症监护病房。护理决策，特别是在高度复杂的情况下，如护理危重病患者，可能涉及直觉作为一种补充逻辑推理的美学知识形式。直觉能够识别模式，预测并发症，并迅速采取行动，从而影响护理的质量和安全。尽管越来越多的人认识到其相关性，但与使用直觉相关的结果仍然不够系统化，这突出了在高级护理中绘制现有证据的必要性。目的：本研究的目的是绘制现有的科学证据关于使用直觉在护士对重症病人的决策结果。方法：本次范围审查将使用JBI方法进行。检索将在5个数据库中进行：CINAHL Complete， PubMed/MEDLINE， Web of Science核心合集（Web of Science）， ProQuest学位论文和论文引文索引（Web of Science）和Scopus。不受日期限制。研究将由两名独立的盲审人员使用Rayyan软件进行筛选，流程分为两个阶段：首先对标题和摘要进行初步筛选，然后根据预先确定的纳入和排除标准对可能符合条件的文章进行全文阅读。研究方案已在开放科学框架（DOI 10.17605/OSF.IO/VUZWX）上注册。讨论：通过绘制与护士决策中使用直觉相关的结果，本综述将深入了解直觉如何有助于患者安全、护理质量和临床实践。

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引用次数: 0

Crowding, Boarding, and Patient Throughput in the Emergency Department 急诊科的拥挤、登机和病人吞吐量

IF 2.3 4区医学 Q2 EMERGENCY MEDICINE

Journal of Emergency Nursing

Pub Date : 2026-01-01 DOI: 10.1016/j.jen.2025.08.005

Dawn Peta BN, RN, ENC(C) (Past President, National Emergency Nurses Association, and Clinical Educator, SZ Rural Acute), Sharon Vanairsdale Carrasco DNP, RN, APRN, NP, CNS, CEN, ACNS-BC, NP-C, FAEN, FAAN (Clinical Professor)

引用次数: 0

Psychiatric Nursing Attitudes in Emergency Departments: An Explorative Study Among Italian Nurses 急诊科精神科护理态度：意大利护士的探索性研究

IF 2.3 4区医学 Q2 EMERGENCY MEDICINE

Journal of Emergency Nursing

Pub Date : 2026-01-01 DOI: 10.1016/j.jen.2025.07.010

Yun-Chen Chang PhD, RN, Rocco Mea RN, Wen-Yu Hu PhD, FAAN, RN, Elsa Vitale PhD, RN

Background

In emergency settings, nurses should have knowledge and skills to manage both physical and psychological diseases, including psychiatric disorders. This study aimed to explore the perceived level of knowledge among nurses regarding key topics in the training and management of psychiatric emergencies and, specifically, to determine any associations between the education level and work experience of nurses and their self-perceived competence in managing psychiatric emergencies and examine their knowledge of these areas, with a particular focus on topics considered most critical in the contemporary literature.

Methods

An observational, cohort, cross-sectional, and multicenter study was conducted from August to September 2022 to all registered nurses who were employed both in private and public emergency departments, using the “Snowball sampling” technique.

Results

A total of 413 Italian nurses were surveyed. Significant differences were reported in item no. 2 (P = .016), “How do you assess your current knowledge of issues relevant to emergency psychiatry?” according to work experience; item no. 5 (P = .001), “Have you ever been a victim of assault by the psychiatric patient during his shift?” according to work experience; and item no. 9 “How often do you resort to the use of counseling/hospitalization in psychiatry wards?” according to nursing education (P = .008). Several arguments were identified as important for in-depth knowledge in psychiatric emergencies.

Discussion

Given the rising prevalence and complexity of mental health crises presenting in emergency settings, there is an urgent need to integrate targeted psychiatric emergency training into both undergraduate nursing curricula and ongoing professional development programs.

背景：在急诊环境中，护士应该具备处理包括精神疾病在内的生理和心理疾病的知识和技能。本研究旨在探讨护士在培训和管理精神病学紧急情况的关键主题方面的认知知识水平，特别是确定护士的教育水平和工作经验与他们在管理精神病学紧急情况方面的自我认知能力之间的联系，并检查他们对这些领域的知识，特别关注当代文献中最重要的主题。方法：采用“雪球抽样”技术，于2022年8月至9月对所有在私立和公立急诊科工作的注册护士进行观察性、队列、横断面和多中心研究。结果：共调查意大利护士413名。第1项报告有显著差异。2 (P = .016)，根据工作经验，“你如何评估你目前对急诊精神病学相关问题的了解？”项目编号5 (P = .001)，根据工作经验，“你是否曾在精神病患者当班期间受到他的攻击？”项目编号。9根据护理教育调查，“你在精神科病房接受心理咨询/住院治疗的频率是多少？”有几个论点被认为对深入了解精神紧急情况很重要。讨论：鉴于在紧急情况下出现的精神健康危机日益普遍和复杂，迫切需要将有针对性的精神病学应急培训纳入本科护理课程和正在进行的专业发展计划。

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引用次数: 0

Human Factors in Simulation-Based Education for Emergency Nursing in Disasters 灾害急救护理模拟教学中的人为因素

IF 2.3 4区医学 Q2 EMERGENCY MEDICINE

Journal of Emergency Nursing

Pub Date : 2026-01-01 DOI: 10.1016/j.jen.2025.09.004

Lt. Jamla Rizek DNP, MBA, RN, CEN, CPEN, NHDP-BC, NRP, FAEN, Sarah Wells MSN, RN, CEN, CNL, Mirza Aun Muhammad Baig MBBS, MCAI, MRCPI Pediatrics, PgDip Clinical Education, CPHFH (IHI), Luis E. Caso Vega MBA, BSN, RN, CEN, CPEN, NE-BC, TCRN, Muhammed Fawzi Aljerari

引用次数: 0

Enhancing Emergency Triage Clinical Decision Support System: Further Considerations on Cognitive Task Analysis Findings 加强急诊分诊临床决策支持系统：对认知任务分析结果的进一步思考

IF 2.3 4区医学 Q2 EMERGENCY MEDICINE

Journal of Emergency Nursing

Pub Date : 2026-01-01 DOI: 10.1016/j.jen.2025.07.011

Zekai Yu BEng

引用次数: 0

Leading With Authenticity: Reducing Workplace Violence in the Emergency Department 真实领导：减少急诊科的工作场所暴力

IF 2.3 4区医学 Q2 EMERGENCY MEDICINE

Journal of Emergency Nursing

Pub Date : 2026-01-01 DOI: 10.1016/j.jen.2025.08.010

Patricia Kunz Howard PhD, RN, CEN, CPEN, TCRN, NE-BC, FAEN, FAAN, JoAnn Lazarus MSN, RN, CEN, FAEN, Margaret Spencer BA

Workplace violence is a widespread issue in emergency departments, posing significant physical and emotional risks to health care workers. Authentic leadership, centered on transparency, empathy, and ethical behavior, has emerged as a potential approach to mitigate these risks by fostering trust, collaboration, and a safety culture. By addressing the root causes of violence and empowering teams through open communication, effective role modeling, and comprehensive training, authentic leaders can create supportive environments that reduce violence and improve outcomes for both staff and patients.

工作场所暴力是急诊科普遍存在的问题，对卫生保健工作者造成重大的身心风险。以透明度、同理心和道德行为为中心的真正的领导，已经成为通过培养信任、合作和安全文化来减轻这些风险的潜在方法。通过解决暴力的根本原因，并通过开放的沟通、有效的角色塑造和全面的培训赋予团队权力，真正的领导者可以创造支持性的环境，减少暴力，改善工作人员和患者的结果。

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“I Feel Like My Child’s Health Is Hanging by a Thread”: A Grounded Theory of Experiences of Parents of Children With Cancer During Emergency Department Visits “我觉得我的孩子的健康悬在一线”：癌症儿童父母在急诊室就诊期间的经验的基础理论。

IF 2.3 4区医学 Q2 EMERGENCY MEDICINE

Journal of Emergency Nursing

Pub Date : 2026-01-01 DOI: 10.1016/j.jen.2025.06.007

Meltem Gürcan PhD, RN, Sevcan Atay Turan PhD, RN, Emine Efe PhD, RN, Ayşegül İşler PhD, RN

Introduction

This study aimed to generate an explanatory framework to obtain a more detailed understanding of the experiences of parents of children with cancer during ED visits.

Methods

A grounded theory approach was used for the present study. Semistructured format interviews were conducted with 12 parents of children with cancer. Data collection and generation were managed simultaneously for analysis. The qualitative data were analyzed using open, axial, and selective coding.

Results

The core category summarizes parents’ concerns and fears about their child’s health. The core category was identified as “I feel like my child’s health is hanging by a thread.” Four main categories with related subcategories were developed that revealed the experiences of parents of children with cancer: “Focusing on the specific conditions of childhood cancer,” “Expectation of healing care behaviors,” “Reflections of the ED visit on the parents and children,” and “Implementing family-centered emergency care.”

Discussion

The study developed a grounded theory that provides a guideline for the pediatric emergency team on the priority issues in the care of pediatric oncology patients and the importance of the care approach for parents. Parents emphasized that their children’s health was vulnerable, and they needed resources created by the supportive care practice to create an optimal healing environment in the pediatric emergency department.

本研究旨在建立一个解释框架，以更详细地了解癌症儿童的父母在急诊科就诊时的经历。方法：本研究采用扎根理论方法。对12位癌症患儿的父母进行了半结构化访谈。数据收集和生成同时进行分析。定性数据分析采用开放，轴向和选择性编码。结果：核心类别总结了父母对孩子健康的担忧和恐惧。核心类别被确定为“我觉得我孩子的健康岌岌可危”。以癌症患儿家长的经验为主要类别及相关的子类别：“关注儿童癌症的具体情况”、“对治疗护理行为的期望”、“急诊科访问对家长和孩子的反思”和“实施以家庭为中心的急诊护理”。讨论：该研究发展了一个有根据的理论，为儿科急诊团队提供了关于儿科肿瘤患者护理优先问题的指导方针，以及护理方法对家长的重要性。家长们强调，他们的孩子的健康是脆弱的，他们需要由支持性护理实践创造的资源，在儿科急诊科创造一个最佳的治疗环境。

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