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Equitable Care in the Emergency Care Setting 急诊护理环境中的公平护理。
IF 1.8 4区 医学 Q2 EMERGENCY MEDICINE Pub Date : 2024-11-01 DOI: 10.1016/j.jen.2024.01.005
Cheryl Riwitis DNP, APRN, FNP-BC, CEN, CFRN, TCRN, EMT-B, FAEN, Joanne E. Navarroli MSN, RN, CEN
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引用次数: 0
Information for Readers 读者信息
IF 1.8 4区 医学 Q2 EMERGENCY MEDICINE Pub Date : 2024-08-20 DOI: 10.1016/S0099-1767(24)00199-5
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引用次数: 0
A Quality Improvement Project to Enhance Emergency Nurse Workplace Violence Reporting 加强急诊护士工作场所暴力报告的质量改进项目
IF 1.8 4区 医学 Q2 EMERGENCY MEDICINE Pub Date : 2024-08-20 DOI: 10.1016/j.jen.2024.07.001
Ross M. Scallan DNP, APRN, AGCNS-BC, ATC, Ava Speciale MSN, RN, CNML, Kathryn E.M. Kasen MBA, BSN, RN, CEN, NEA-BC, David Martin PhD, Ha Do Byon PhD, MS, MPH, RN, Beth A. Quatrara DNP, APRN, CMSRN, ACNS-BC

Introduction

Workplace violence is a pervasive, perpetual, and underreported problem in the emergency department. Nurses experience devastating physical and psychological consequences owing to workplace violence exposure. Understanding workplace violence is challenging due to nurse underreporting. Improvement in capturing workplace violence cases can help drive data-informed, sustainable solutions to workplace violence prevention. The purpose of this project was to better capture the full extent of workplace violence in the emergency department through enhanced nurse workplace violence reporting.

Methods

In collaboration with emergency nurses and management, the project team used a multi-interventional approach and designed a feasible electronic reporting instrument to capture workplace violence events in real time by reducing nurse reporting barriers. Participating nurses accessed the instrument by scanning a quick-response code with their mobile phones. This code was strategically located on wall flyers and individual name badge stickers. Data were collected using Qualtrics software and analyzed using SPSS Statistics, which summarized the descriptive statistics.

Results

Two months after implementation, the electronic reporting instrument recorded 94 quick response code scans and 59 workplace violence reports, resulting in a 1080% increase in ED workplace violence reporting compared with the 2 months prior to implementation. The 59 workplace violence reports comprised 78% registered nurses, 19% emergency medical technicians, and 3% other health care workers. Workplace violence events were most frequent from 12:01 pm to 6:00 pm in treatment rooms (37%), triage (29%), waiting room (19%), behavioral health section (15%), and hallway (12%).

Discussion

A multi-interventional approach, coupled with a feasible, readily available electronic reporting instrument, enhanced ED workplace violence reporting and facilitated a better capture of ED workplace violence. Although nurse underreporting is still likely occurring, an emergence of workplace violence data trends can provide data-driven solutions in workplace violence prevention. Continued efforts to reduce the barriers that inhibit reporting are needed to foster a safe and supportive culture surrounding workplace violence reporting.

引言 工作场所暴力是急诊科一个普遍、长期存在且报告不足的问题。工作场所暴力给护士的身心造成了毁灭性的后果。由于护士报告不足,了解工作场所暴力问题具有挑战性。改进对工作场所暴力案例的捕捉有助于推动以数据为依据的、可持续的工作场所暴力预防解决方案。本项目旨在通过加强护士的工作场所暴力报告,更好地全面掌握急诊科的工作场所暴力情况。方法在急诊科护士和管理层的合作下,项目小组采用了多干预方法,设计了一种可行的电子报告工具,通过减少护士报告障碍来实时掌握工作场所暴力事件。参与项目的护士可通过手机扫描快速反应代码来使用该工具。该代码被战略性地放置在墙上的传单和个人胸牌贴纸上。结果实施两个月后,电子报告工具记录了 94 次快速反应代码扫描和 59 次工作场所暴力报告,与实施前两个月相比,ED 工作场所暴力报告增加了 1080%。这 59 份工作场所暴力报告中,78% 为注册护士,19% 为急诊技术人员,3% 为其他医护人员。下午 12:01 至下午 6:00 期间,治疗室(37%)、分诊室(29%)、候诊室(19%)、行为健康科(15%)和走廊(12%)的工作场所暴力事件最为频繁。尽管护士报告不足的情况仍有可能发生,但工作场所暴力数据趋势的出现可以为工作场所暴力预防提供数据驱动的解决方案。需要继续努力减少阻碍报告的障碍,以培养围绕工作场所暴力报告的安全和支持性文化。
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引用次数: 0
Board of Directors 董事会
IF 1.8 4区 医学 Q2 EMERGENCY MEDICINE Pub Date : 2024-08-20 DOI: 10.1016/S0099-1767(24)00198-3
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引用次数: 0
The Leader in the Field 该领域的领导者
IF 1.8 4区 医学 Q2 EMERGENCY MEDICINE Pub Date : 2024-08-20 DOI: 10.1016/j.jen.2024.07.003
Chris Dellinger MBA, BSN, RN, FAEN
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引用次数: 0
Prioritizing Well-Being: Fostering a Healthy Work Environment for Emergency Nurses 优先考虑身心健康:为急诊护士营造健康的工作环境
IF 1.8 4区 医学 Q2 EMERGENCY MEDICINE Pub Date : 2024-08-20 DOI: 10.1016/j.jen.2024.07.002
Fatma Refaat Ahmed PhD, RN, Fiona Timmins PhD, FAAN, RGN
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引用次数: 0
Supporting the Mental Health of Early Career Emergency Nurses 为初入职场的急诊护士提供心理健康支持
IF 1.8 4区 医学 Q2 EMERGENCY MEDICINE Pub Date : 2024-08-20 DOI: 10.1016/j.jen.2024.03.004
Sarah K. Wells MSN, RN, CEN, CNL, Meris Shuwarger BSN, RN, CEN, TCRN, Casey Green BSN, RN, CCRN-CMC, CTRN, CFRN, CEN, TCRN, CPEN, CNRN, NRP
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引用次数: 0
Development of an Emergency Nurse Internship to Promote a Healthy Work Environment and Improve Nurse Retention 制定急诊护士实习计划,促进健康的工作环境,提高护士留任率。
IF 1.8 4区 医学 Q2 EMERGENCY MEDICINE Pub Date : 2024-07-23 DOI: 10.1016/j.jen.2024.06.006
Megan Hignight MSN, RN, APRN, ACCNS-AG, EBP-C, Karrie Boss DNP, RN, APRN, ACCNS-AG, EBP-C, CCRN, Mustafa Culcuoglu PhD, MS, Penelope Gorsuch DNP, RN, NEA-BC, EBP-C, FACHE

Introduction

Following the COVID-19 pandemic, a community emergency department was facing a staffing crisis with new emergency registered nurse turnover rates as high as 83.3%. There were limited experienced emergency nurses available to train the large number of novice nurses hired to fill vacancies. Based on this, the emergency department needed to restructure the orientation process to better align with evidence-based strategies and available resources.

Methods

The Seven Steps of Evidenced-based Practice were used to identify the best practices for an orientation program specific to the emergency department. Based on the evidence, a 16-week, competency-based, emergency nurse internship was implemented in the 33-bed community emergency department.

Results

The primary outcome of this initiative was new emergency nurse retention, which demonstrated a statistically significant reduction from 81.8% (pre-intervention) to 11.1% (post-intervention) (P < .001). Additionally, there was an improvement in the scores for each of the 6 healthy work environment standards.

Discussion

Based on the outcomes of this initiative, an emergency nurse internship is an effective method to improve emergency nurse competence and retention, contributing to a healthier work environment.

简介COVID-19 大流行之后,一个社区急诊部门面临着人员危机,新急诊注册护士的流失率高达 83.3%。经验丰富的急诊护士人数有限,无法培训大量新手护士填补空缺。有鉴于此,急诊科需要重组迎新流程,以便更好地与循证策略和可用资源保持一致:方法:采用 "循证实践七步骤 "来确定急诊科迎新计划的最佳实践。在此基础上,33 张病床的社区急诊科实施了为期 16 周、以能力为基础的急诊护士实习计划:结果:这一举措的主要成果是新急诊护士的留用率从干预前的 81.8%下降到干预后的 11.1%(P 讨论):根据这项计划的结果,急诊护士实习是提高急诊护士能力和留用率的有效方法,有助于创造更健康的工作环境。
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引用次数: 0
Implementation of Coaching to Address Burnout in Emergency Clinicians 实施辅导以解决急诊医生的职业倦怠问题。
IF 1.8 4区 医学 Q2 EMERGENCY MEDICINE Pub Date : 2024-07-23 DOI: 10.1016/j.jen.2024.06.007
Kelly Hines-Stellisch DNP, FNP-C, ENP-C, NC-BC , Kate Susteric Gawlik DNP, APRN-CNP, FAANP, FNAP, FAAN , Alice M. Teall DNP, APRN-CNP, NC-BC, FAANP, FNAP , Sharon Tucker PhD, APRN-CNS, NC-BC, EBP-C, FNAP, FAAN

Background

Factors including sleep disturbances, shift work, secondary traumatization, and workplace violence make emergency nurses uniquely susceptible to burnout. A recent study cited nearly half of emergency registered nurses (49.3%) experienced moderate to severe burnout. There is an urgent need for evidence-based solutions to address burnout and turnover in emergency nurses. The objective of this quality improvement project was to determine the effectiveness of a wellness coaching program for reducing burnout and turnover in emergency nurses and advanced practice providers.

Methods

Baseline assessments of burnout and turnover intention were measured at the beginning of the coaching program and measured again upon completion of the coaching program.

Intervention

Eight registered nurses and 2 advanced practice providers from an emergency department in a west coast community hospital completed 6 to 8 weeks of wellness coaching led by a board-certified nurse coach. The wellness coaching program was an evidence-based, modular curriculum in which participants chose the number and length of sessions.

Results

An average of 6 hours of individualized, 1-on-1 wellness coaching was completed over 7.5 weeks. The project resulted in a large reduction in emotional exhaustion and turnover intention, no effect on depersonalization, and a small reduction in lack of personal achievement (Cohen’s d = 0.79, 1.53, −0.18, and −0.35). Ninety percent of clinicians agreed or strongly agreed that coaching helped improve their burnout and said they would consider it again in the future.

Conclusion

This quality improvement project demonstrates wellness coaching was an evidence-based solution for improving burnout and turnover in emergency nurses. More investigation is needed to determine duration of reduction of these outcomes.

背景:睡眠障碍、轮班工作、二次创伤和工作场所暴力等因素使急诊护士特别容易产生职业倦怠。最近的一项研究表明,近一半的急诊注册护士(49.3%)有中度至重度职业倦怠。急需以证据为基础的解决方案来解决急诊护士的职业倦怠和人员流失问题。本质量改进项目旨在确定健康指导计划对减少急诊护士和高级医疗服务提供者的职业倦怠和离职率的有效性:方法:在辅导计划开始时对职业倦怠和离职意向进行基线评估,并在辅导计划完成后再次进行评估:来自西海岸一家社区医院急诊科的 8 名注册护士和 2 名高级医疗服务提供者完成了为期 6 到 8 周的健康辅导,辅导由一名经委员会认证的护士教练负责。健康指导计划是一项以证据为基础的模块化课程,参与者可以选择课程的次数和时长:结果:在 7.5 周的时间里,平均完成了 6 个小时的一对一个性化健康指导。该项目大大降低了情绪衰竭和离职意向,对人格解体没有影响,个人成就感缺失略有减少(Cohen's d = 0.79、1.53、-0.18 和 -0.35)。90%的临床医生同意或非常同意辅导有助于改善他们的职业倦怠,并表示今后会再次考虑接受辅导:该质量改进项目表明,健康辅导是一种以证据为基础的解决方案,可改善急诊护士的职业倦怠和离职率。还需要进行更多的调查,以确定减少这些结果的持续时间。
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引用次数: 0
Emergency Nursing Review Questions: September 2024 急诊护理复习题:2024 年 11 月。
IF 1.8 4区 医学 Q2 EMERGENCY MEDICINE Pub Date : 2024-07-14 DOI: 10.1016/j.jen.2024.06.004
Benjamin E. Marett EdD, MSN, CEN, TCRN, CCRN, COHN, NPD-C, NE-C, FAEN, FAHA, AnnMarie Papa DNP, RN, CEN, NE-BC, FAEN, FAAN
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引用次数: 0
期刊
Journal of Emergency Nursing
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