Journal of Emergency Nursing最新文献

{"title":"Assessing Handover Quality in the Emergency Department: Evaluating Communication Between EMS and Triage Nurses Using the Handoff CEX Italian Scale","authors":"Flavio Gheri PhD(c), RN,&nbsp;Clarissa Presti BSc(c),&nbsp;Fabio Donnarumma MSc, RN,&nbsp;Domenica Petta MSc, RN","doi":"10.1016/j.jen.2025.07.009","DOIUrl":"10.1016/j.jen.2025.07.009","url":null,"abstract":"<div><h3>Introduction</h3><div>Patient handover is a crucial process that ensures the transfer of essential patient information from prehospital teams to hospital staff. Although these risks are widely recognized, significant variability persists in handover practices in health care settings. This highlights the need for robust, evidence-based strategies to standardize the process.</div></div><div><h3>Methods</h3><div>A prospective and descriptive study of a single-center design was implemented to evaluate the quality of handover between emergency medical personnel and clinical nurses within the emergency department using the validated Handoff Clinical Evaluation Exercise (CEX) Italian scale. The study used this scale in evaluating 6 distinct domains: organization/efficiency, mnemonic structures employed by health care professionals, communication skills, completeness of clinical information, treatments performed, and professional qualities manifested during handover.</div></div><div><h3>Results</h3><div>A total of 112 health care professionals participated in the study: 51 triage nurses and 62 emergency personnel, including physicians and nurses. Of 154 handover transactions, 84 interruptions (54.5%) occurred: 38.3% caused by health care professionals and 16.2% by others, such as patients, family members, administrative staff, etc. The results highlighted statistically significant differences in information transfer between emergency medical services personnel and triage nurses, with the latter generally receiving higher evaluations. The receiver group obtained better evaluations in all the variables analyzed than the providers.</div></div><div><h3>Discussion</h3><div>This study provides a significant contribution to understanding a crucial communication process in critical patient management, laying the foundations for future studies that can explore strategies to improve handover in similar settings.</div></div>","PeriodicalId":51082,"journal":{"name":"Journal of Emergency Nursing","volume":"52 1","pages":"Pages 186-192.e1"},"PeriodicalIF":2.3,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144977769","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}

{"title":"The Effect of Workplace Violence on Emotional Labor and Turnover Intention of Emergency Service Employees: A Model Study","authors":"Esra Bekircan PhD,&nbsp;Mustafa Sabak MD,&nbsp;Tufan Alatli MD,&nbsp;Fatma Boğan PhD,&nbsp;Emine Aykol MD,&nbsp;Mustafa Boğan MD","doi":"10.1016/j.jen.2025.07.017","DOIUrl":"10.1016/j.jen.2025.07.017","url":null,"abstract":"<div><h3>Introduction</h3><div>Workplace violence against health care workers in emergency services is an important worldwide problem in terms of their occupational health and safety. This study was aimed at investigating the effect of workplace violence experienced by physicians and nurses working in emergency services on their emotional labor and turnover intentions.</div></div><div><h3>Methods</h3><div>The relational research model, one of the quantitative research methods, was used in the study. The study was conducted with 199 health professionals working in the emergency departments of 3 different tertiary hospitals. The data were collected through face-to-face interviews using the emotional labor scale, the workplace violence scale, and the intention to quit scale.</div></div><div><h3>Results</h3><div>It was observed that physicians and nurses working in emergency services (hereafter referred to as “participants”) were exposed to verbal violence, physical violence, and sexual violence in the given order. There was a positive correlation between the scores obtained from the intention to quit scale and the workplace violence scale, between the emotional labor scale and the workplace violence scale, and between the emotional labor scale and the intention to quit scale. It was concluded that emotional labor did not mediate the relationship between workplace violence and intention to quit.</div></div><div><h3>Discussion</h3><div>The study concluded that participants’ exposure to workplace violence was associated with increased levels of both emotional labor and intention to quit. A positive correlation was identified, indicating that higher levels of emotional labor were linked to a greater intention to quit. It is recommended that the public be educated on the effective and appropriate use of emergency services and that psychiatric nurses provide psychological support to emergency service personnel.</div></div>","PeriodicalId":51082,"journal":{"name":"Journal of Emergency Nursing","volume":"52 1","pages":"Pages 158-169"},"PeriodicalIF":2.3,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145034522","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}

{"title":"Characteristics of an Urban Emergency Department Callback System for the Treatment of Sexually Transmitted Infections","authors":"Matteo F. Pieri BS,&nbsp;William Huang BS,&nbsp;Aditya Loganathan BS,&nbsp;Ryan Heidish BS,&nbsp;Andrew C. Meltzer MD, MS","doi":"10.1016/j.jen.2025.07.008","DOIUrl":"10.1016/j.jen.2025.07.008","url":null,"abstract":"<div><h3>Introduction</h3><div>Patient callbacks after discharge from the emergency department are critical for communicating diagnostic test results, especially for sexually transmitted infections such as gonorrhea and chlamydia. Although these callbacks are essential for timely treatment and patient education, they can be time consuming and administratively burdensome. This quality improvement initiative evaluates the volume, success rate, and primary reasons for emergency department callbacks over 6 years, focusing on patient notification, education, and treatment during their emergency department visit.</div></div><div><h3>Methods</h3><div>A retrospective analysis was conducted using an administrative data set of 3615 visits that required a callback to patients treated at an urban community emergency department in southeast Washington, DC, between March 2018 and June 2024. Data on callback attempts, reasons for callbacks, and patient follow-ups were extracted and analyzed. Descriptive statistics characterized the frequency and outcomes of these callbacks.</div></div><div><h3>Results</h3><div>Of the 3615 visits with at least 1 callback attempt, 21.2% of initial attempts failed to reach patients. Chlamydia and gonorrhea were the primary reasons for callbacks, accounting for 46.4% and 45.1% of ED cases requiring a callback, respectively. A notable 9.5% of visits requiring a callback required at least 3 attempts to reach the patient. In addition to gonorrhea and chlamydia, reasons for callbacks included positive results for herpes simplex virus, <em>Trichomonas vaginalis</em>, and various cultures. Limitations included missing data and free-text entries.</div></div><div><h3>Discussion</h3><div>The high volume of callbacks and the failure rate of initial attempts highlight inefficiencies in the current system. These findings suggest a need for improved technology and workflows to enhance timely treatment and reduce the burden on nursing and physician staff. Future studies should examine the impact of such interventions on treatment outcomes and workflow efficiencies.</div></div><div><h3>Conclusions</h3><div>Improving callback systems and incorporating rapid sexually transmitted infection testing could streamline ED operations, ensure timely patient treatment, and mitigate the spread of sexually transmitted infections. Further research is needed to validate these approaches and explore their broader implications for public health and clinical practice.</div></div>","PeriodicalId":51082,"journal":{"name":"Journal of Emergency Nursing","volume":"52 1","pages":"Pages 102-106"},"PeriodicalIF":2.3,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145202010","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}

{"title":"Enhancing Patient Care: Venous Thromboembolism Prophylaxis in the Emergency Department","authors":"Meredith Scannell PhD, APRN, MSN, MPH, SANE-A, DVNA, OCN,&nbsp;Sandi Mackey MSN, RN, TCRN,&nbsp;Caroline Boudrow MBA, BSN, RN, CNOR,&nbsp;Deborah Sullivan MS, RN,&nbsp;Chaitan K. Narsule MD, FACS","doi":"10.1016/j.jen.2025.08.009","DOIUrl":"10.1016/j.jen.2025.08.009","url":null,"abstract":"<div><div>Venous thromboembolism is a serious risk for hospitalized patients, especially those with long emergency department stays, yet preventive measures are often delayed. This review examines effective medication therapies and nursing interventions for venous thromboembolism prophylaxis in the emergency department. Accurate risk assessment, timely medication administration, and patient education are crucial. Medication prophylaxis, primarily with low-molecular-weight heparin, is preferred over mechanical methods. Barriers such as limited knowledge, unclear guidelines, patient refusal, and staffing shortages hinder optimal implementation. Strategies to improve prophylaxis include standardized protocols and nurse-driven initiatives. Emergency nurses are the first to care for patients in the healthcare setting and are in a key position to initiate risk assessments and additional prophylaxis but often lack the knowledge and resources. Healthcare institutions should prioritize education and address systemic barriers. Future research should focus on tailored guidelines for specific patient populations and evaluate prevention strategies. A multidisciplinary approach, incorporating evidence-based practices and patient input, is crucial for optimizing venous thromboembolism prevention and improving patient outcomes.</div></div>","PeriodicalId":51082,"journal":{"name":"Journal of Emergency Nursing","volume":"52 1","pages":"Pages 59-65"},"PeriodicalIF":2.3,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145208288","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}

{"title":"Development and Implementation of the Modified Pediatric Emergency Department Overcrowding Scale in Two Large Academic Pediatric Centers","authors":"Nathan Timm MD,&nbsp;Laura Kemp RN, DNP,&nbsp;Benjamin Kerrey MD, MS,&nbsp;Megan Elam EdD,&nbsp;Kevin M. Overmann MD, MS,&nbsp;Christina Lillich RN,&nbsp;Amanda Thorne DNP, RN,&nbsp;Jennell Collins MSN, RN,&nbsp;Melody Siska MBA,&nbsp;Michael Ponti-Zins MS,&nbsp;Elena Duma MD,&nbsp;Jessica Revet MSN, RN, CEN,&nbsp;Samuel Snell MSN, RN, NEA-BC, CEN, LSSBB,&nbsp;Aralola Ajiboye MSc, PMP,&nbsp;Daniel Imler MD","doi":"10.1016/j.jen.2025.08.008","DOIUrl":"10.1016/j.jen.2025.08.008","url":null,"abstract":"<div><div>Emergency department crowding is a chronic problem within health care systems. The consequences of crowding are well documented with negative impacts on patient outcomes, patient/family satisfaction, staff stress, and medical errors. This study describes the implementation of the Pediatric Emergency Department Overcrowding Scale in 2 emergency departments, a 45-bed and a 22-bed, within a large pediatric academic medical center. Initial work revealed the scale worked well at a 45-bed emergency department but significantly underreported crowding at the 22-bed emergency department. A bed capacity correction factor was developed and incorporated in the Pediatric Emergency Department Overcrowding Scale formula, thus standardizing the view of crowding in each emergency department. The modified Pediatric Emergency Department Overcrowding Scale provided real-time visualization of crowding in both emergency departments and health care system capacity management systems. The modified Pediatric Emergency Department Overcrowding Scale was shared with a pediatric emergency department within another large academic pediatric medical center. Implementation of the bed capacity correction factor into their system resulted in a similarly improved demonstration of emergency department crowding through the Pediatric Emergency Department Overcrowding Scale.</div></div>","PeriodicalId":51082,"journal":{"name":"Journal of Emergency Nursing","volume":"52 1","pages":"Pages 72-80"},"PeriodicalIF":2.3,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145208286","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}

{"title":"Psychosocial Care of Pregnancy Loss in the Emergency Department","authors":"Rebecca Mattson PhD, RN, PHN,&nbsp;Shandeigh N. Berry PhD, RN, CNE","doi":"10.1016/j.jen.2025.10.005","DOIUrl":"10.1016/j.jen.2025.10.005","url":null,"abstract":"<div><h3>Introduction</h3><div>Emergency departments in the United States manage nearly 900,000 visits annually for early pregnancy loss. Patients frequently report limited emotional support, inadequate provider knowledge, and insufficient communication.</div></div><div><h3>Methods</h3><div>A pre- and postintervention design was used to assess ED staff knowledge, attitudes, and supportive care skills related to reproductive grief. Demographic data were collected. Paired <em>t</em> tests evaluated changes across 7 educational domains.</div></div><div><h3>Results</h3><div>The analytic sample (N = 39) consisted of chaplains (7.7%), nurses (61.6%), patient care assistants (7.7%), radiology technicians (5.1%), social workers (5.1%), and ED technicians (12.8%). Postintervention analyses demonstrated increased mean scores across all domains, including emotional support, patient-centered care, discharge planning, bereavement care, community resources, staff support, and communication (<em>P</em> &lt; .0001).</div></div><div><h3>Discussion</h3><div>The findings suggest that staff education may improve miscarriage care. Additional research is necessary to confirm these results, establish validity, and assess generalizability across settings.</div></div>","PeriodicalId":51082,"journal":{"name":"Journal of Emergency Nursing","volume":"52 1","pages":"Pages 18-23"},"PeriodicalIF":2.3,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145886349","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}

{"title":"Information for Readers","authors":"","doi":"10.1016/S0099-1767(25)00502-1","DOIUrl":"10.1016/S0099-1767(25)00502-1","url":null,"abstract":"","PeriodicalId":51082,"journal":{"name":"Journal of Emergency Nursing","volume":"52 1","pages":"Page A10"},"PeriodicalIF":2.3,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145886420","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}

{"title":"Application of Multistrategy Improvement Gray Wolf Algorithm to Optimize Extreme Gradient Boosting in Emergency Triage","authors":"Tichen Huang BMgmt,&nbsp;Yuyan Jiang MSc,&nbsp;Rumeijiang Gan MSc,&nbsp;Heping Wang PhD,&nbsp;Fuyu Wang PhD,&nbsp;Yan Li PhD","doi":"10.1016/j.jen.2025.07.015","DOIUrl":"10.1016/j.jen.2025.07.015","url":null,"abstract":"<div><h3>Introduction</h3><div>Effective triage in the emergency department (ED) is essential for optimizing resource allocation, improving efficiency, and enhancing patient outcomes. Conventional systems rely heavily on clinical judgment and standardized guidelines, which may be insufficient under growing patient volumes and increasingly complex presentations.</div></div><div><h3>Methods</h3><div>We developed a machine learning triage model, MIGWO-XGBOOST, which incorporates a Multi-strategy Improved Gray Wolf Optimization (MIGWO) algorithm for parameter tuning. Missing data were processed, and the dataset was randomly split into 80 percent for training and 20 percent for testing. Model performance was evaluated against standard XGBOOST, GWO XGBOOST, AdaBoost, LSTM, and CNN-BiGRU.</div></div><div><h3>Results</h3><div>MIGWO-XGBOOST improved accuracy by 8.5 percent over unoptimized XGBOOST and reduced optimization time by 9,285 seconds relative to GWO-XGBOOST. Compared with other benchmarks, accuracy gains were 12.5 percent over AdaBoost, 3.3 percent over LSTM, and 1.9 percent over CNN-BiGRU. These results demonstrate both predictive strength and computational efficiency in complex data environments.</div></div><div><h3>Discussion</h3><div>MIGWO-XGBOOST provides a robust framework for rapid and precise triage decisions in the ED. By enhancing accuracy while substantially reducing computational time, this approach demonstrates the potential of advanced machine learning to support emergency decision-making and optimize patient care pathways.</div></div>","PeriodicalId":51082,"journal":{"name":"Journal of Emergency Nursing","volume":"52 1","pages":"Pages 170-185"},"PeriodicalIF":2.3,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145024790","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}

{"title":"Brain Edema After Cosmetic Botulinum Toxin Injection: A Case Report","authors":"Lan Lai BSN, RN,&nbsp;Zhongxiang Wang MSN, RN,&nbsp;Yajun Sun MSN, RN","doi":"10.1016/j.jen.2025.08.013","DOIUrl":"10.1016/j.jen.2025.08.013","url":null,"abstract":"<div><div>A 26-year-old woman presented to the emergency department with progressive symptoms including fever, pharyngeal pain, dysphagia, bilateral ptosis, and generalized weakness after cosmetic botulinum toxin injections to the neck. This case report aimed to describe an unusual presentation of botulinum neurotoxin-associated central nervous system involvement. This manuscript is a case review describing the clinical course, diagnostic challenges, and management strategies of brain edema after botulinum toxin type A exposure. Key points include the importance of recognizing nontraditional presentations of botulism in emergency settings, the potential for central neurologic complications after cosmetic procedures, and the critical role of emergency nurses in early symptom recognition, airway management, and multidisciplinary coordination for antitoxin administration and intensive care support.</div></div>","PeriodicalId":51082,"journal":{"name":"Journal of Emergency Nursing","volume":"52 1","pages":"Pages 41-45"},"PeriodicalIF":2.3,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145187479","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}

{"title":"The Power of Positive Self-Affirmation","authors":"Michael Dustin Bass DNP, MHA, RN, CEN, NEA-BC","doi":"10.1016/j.jen.2025.10.014","DOIUrl":"10.1016/j.jen.2025.10.014","url":null,"abstract":"","PeriodicalId":51082,"journal":{"name":"Journal of Emergency Nursing","volume":"52 1","pages":"Page 1"},"PeriodicalIF":2.3,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145886422","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}