Journal of Emergency Nursing最新文献

英文中文

Charting the Course: Exploring the Dynamic Impact of Mentorship Programs on Nurse Practitioner Satisfaction and Health Care Outcomes 绘制课程：探索指导计划对护士执业满意度和医疗保健结果的动态影响。

IF 2.3 4区医学 Q2 EMERGENCY MEDICINE

Journal of Emergency Nursing

Pub Date : 2026-01-01 Epub Date: 2025-08-26 DOI: 10.1016/j.jen.2025.07.014

Tiffany D. Reabold DNP, FNP-BC, Veronica Quattrini DNP, MS, FNP-BC, FAANP

Introduction

This project aimed to address high turnover rates among novice nurse practitioners in the emergency department, attributable to low job satisfaction. Dissatisfaction among nurse practitioner staff is linked to decreased engagement, productivity, and suboptimal patient outcomes and negatively affects both novice and seasoned staff morale. Low job satisfaction correlates with higher turnover rates, increased departmental costs, and a decline in the overall quality of patient care. Outcomes from this project confirmed that mentoring positively affects job satisfaction and the transition of novice nurse practitioners.

Methods

Conducted in a large urban academic medical center, this project involved 7 novice nurse practitioner participants. Inspired by the National Association of Neonatal Nurse Practitioners Mentoring Toolkit, a 10-week Knowledge to Action Framework structured mentorship program was devised. It included an introductory session, individual mentor-protégé meetings, and a wrap-up session. Pre- and postintervention evaluations used the Misener Nurse Practitioner Job Satisfaction Scale.

Results

Preintervention Misener Nurse Practitioner Job Satisfaction Scale scores averaged 176.3, increasing to 206.4 after the intervention, with a statistically significant improvement (T = −1.82; P = .046).

Discussion

Mentorship programs offer significant benefits to nurse practitioners, contributing to improved clinical practice and more efficient health care systems by improving job satisfaction, reducing turnover rates, enhancing patient outcomes, and curbing costs. However, further research is needed to establish definitive evidence of their long-term impact.

简介：本项目旨在解决急诊科新护士从业人员因工作满意度低而导致的高流失率。护士从业人员的不满与敬业度下降、生产力下降和患者预后不佳有关，并对新手和经验丰富的员工士气产生负面影响。较低的工作满意度与较高的离职率、增加的部门成本以及患者护理整体质量的下降有关。本研究结果证实师徒辅导对护理新手的工作满意度及转型有正向影响。方法：本研究在一所大型城市学术性医疗中心进行，研究对象为7名执业护士新手。受全国新生儿护士从业人员指导工具包协会的启发，设计了一个为期10周的从知识到行动框架的结构化指导计划。它包括一个介绍性会议，个别导师- prosam会议和一个总结会议。干预前和干预后的评估采用了Misener护士从业人员工作满意度量表。结果：干预前护士从业人员工作满意度量表平均得分为176.3分，干预后平均得分为206.4分，差异有统计学意义（T = -1.82; P = 0.046）。讨论：师徒计划为执业护士提供了显著的好处，通过提高工作满意度、降低离职率、提高患者治疗效果和控制成本，有助于改善临床实践和提高医疗保健系统的效率。然而，需要进一步的研究来确定其长期影响的明确证据。

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引用次数: 0

Effect of Distracting Methods on Procedure-Related Fear, Anxiety, and Pain During Intramuscular Injection: A Randomized Controlled Trial 分散注意力方法对肌肉注射过程中手术相关恐惧、焦虑和疼痛的影响：一项随机对照试验。

IF 2.3 4区医学 Q2 EMERGENCY MEDICINE

Journal of Emergency Nursing

Pub Date : 2026-01-01 Epub Date: 2025-09-09 DOI: 10.1016/j.jen.2025.08.003

Elfidan Gülduran MSc, RN, Gülçin Özalp Gerçeker PhD, RN

Introduction

Distraction methods such as virtual reality and cold vibration devices (Buzzy) are recommended during vascular access. Few studies focused on distraction during intramuscular injection.

Methods

This study evaluated the effect of distraction methods on procedure-related pain, fear, and anxiety during the intramuscular injection in children aged 5 to 12 years in the pediatric emergency department. In the study, children (n = 126) were assigned to 4 groups: virtual reality, manual pressure vibration, Buzzy, and control groups. Heart rate, respiration, blood pressure, and partial oxygen saturation were measured before, during, and after the procedure. Emotional behavior was evaluated using the Children’s Emotional Manifestation Scale before the procedure. After the procedure, pain, fear, and anxiety were evaluated using the Child Fear Scale, Child Anxiety Scale–State, Wong-Baker FACES Pain Scale, and Color Analog Scale. The mean scores obtained from the scales were compared using the Kruskal–Wallis analysis (Clinical Trials number: NCT04847934).

Results

The diastolic and median blood pressure values were higher, and the partial oxygen value was lower in the control group after the procedure. There was no statistical difference among the groups in terms of emotional behavior before the procedure. There was a statistical difference among the groups in terms of pain scores, but no difference was found in terms of fear and anxiety.

Discussion

Virtual reality, manual pressure vibration, and Buzzy distractions were effective on intramuscular injection–related pain. Future studies should also focus on intramuscular injection–related fear and anxiety.

导读：在血管通路中，建议使用虚拟现实和冷振动设备（Buzzy）等分散注意力的方法。很少有研究关注肌内注射过程中的注意力分散。方法：本研究评估了在儿科急诊科5 - 12岁儿童肌肉注射过程中，牵开方法对手术相关疼痛、恐惧和焦虑的影响。在研究中，儿童（n = 126）被分为4组：虚拟现实组、手动压力振动组、buzz组和对照组。术前、术中、术后分别测量心率、呼吸、血压和部分血氧饱和度。术前使用儿童情绪表现量表评估情绪行为。手术后，使用儿童恐惧量表、儿童焦虑状态量表、Wong-Baker面部疼痛量表和颜色模拟量表对疼痛、恐惧和焦虑进行评估。使用Kruskal-Wallis分析比较从量表获得的平均得分（临床试验号：NCT04847934）。结果：对照组患者术后舒张压、中位血压升高，部分氧值降低。在手术前的情绪行为方面，两组之间没有统计学差异。在疼痛评分方面，两组之间存在统计学差异，但在恐惧和焦虑方面没有发现差异。讨论：虚拟现实，手动压力振动和嗡嗡干扰对肌肉注射相关疼痛有效。未来的研究还应关注肌肉注射相关的恐惧和焦虑。

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引用次数: 0

Sources of Discomfort and Treatment Strategies for Trauma Patients in the Pre-Hospital Setting: A Scoping Review 院前创伤患者不适感的来源及治疗策略——范围综述

IF 2.3 4区医学 Q2 EMERGENCY MEDICINE

Journal of Emergency Nursing

Pub Date : 2026-01-01 Epub Date: 2025-10-03 DOI: 10.1016/j.jen.2025.08.014

Filipe Melo MScN, RN, Margarida Reis Santos PhD, RN, Miguel Castelo-Branco Sousa PhD, MD, Cátia Mota MScPsych, Mauro Mota PhD, RN

Introduction

Trauma remains a leading cause of mortality and long-term disability worldwide, often causing significant discomfort during prehospital care. Addressing these discomforts effectively is crucial for improving patient outcomes. This scoping review aimed to identify and categorize the types of discomforts experienced by adult trauma victims in prehospital settings and map the pharmacologic and nonpharmacologic interventions used to mitigate them.

Methods

This scoping review followed the Joanna Briggs Institute framework and Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews guidelines. A comprehensive search was performed in databases including MEDLINE, CINAHL, Scopus, Embase, PsycINFO, Joanna Briggs Institute Evidence Synthesis, Cochrane Database, and relevant gray literature sources. Studies involving adult trauma patients (≥18 years) in prehospital care that reported on discomfort and interventions were included without restrictions on publication date.

Results

Seventeen studies met the inclusion criteria, covering various international contexts. Acute pain was the most frequently reported discomfort, followed by anxiety, fear, cold-induced discomfort, and discomfort caused by immobilization. Pharmacologic interventions predominantly included opioids, nonsteroidal anti-inflammatory drugs, paracetamol, ketamine, and methoxyflurane, whereas nonpharmacologic interventions comprised acupressure, transcutaneous electrical nerve stimulation, cryotherapy, warming measures, communication strategies, and emotional support. Nonpharmacologic interventions, especially acupressure and communication techniques, showed promising results in reducing pain and anxiety.

Discussion

The findings underline the multidimensional nature of discomfort in prehospital trauma care and highlight effective interventions, including pharmacologic and complementary nonpharmacologic strategies. However, significant gaps remain regarding standardized assessment tools for non–pain-related discomforts and combined interventions. This review underscores the necessity for comprehensive management protocols and further research to optimize patient comfort and care outcomes in trauma settings.

创伤仍然是世界范围内死亡和长期残疾的主要原因，经常在院前护理期间引起严重不适。有效地解决这些不适对于改善患者预后至关重要。本综述旨在识别和分类院前环境中成人创伤受害者所经历的不适类型，并绘制用于减轻这些不适的药物和非药物干预措施。方法：该范围评价遵循乔安娜布里格斯研究所框架和系统评价的首选报告项目，以及范围评价指南的元分析扩展。综合检索MEDLINE、CINAHL、Scopus、Embase、PsycINFO、Joanna Briggs Institute Evidence Synthesis、Cochrane Database等数据库及相关灰色文献来源。涉及院前护理的成人创伤患者（≥18岁）的研究报告了不适和干预措施，不受发表日期的限制。结果：17项研究符合纳入标准，涵盖了不同的国际背景。急性疼痛是最常见的不适，其次是焦虑、恐惧、寒冷引起的不适和固定引起的不适。药物干预主要包括阿片类药物、非甾体抗炎药、扑热息痛、氯胺酮和甲氧基氟醚，而非药物干预包括穴位按压、经皮神经电刺激、冷冻疗法、加热措施、沟通策略和情感支持。非药物干预，特别是指压和交流技术，在减轻疼痛和焦虑方面显示出有希望的结果。讨论：研究结果强调了院前创伤护理中不适的多维性，并强调了有效的干预措施，包括药物和补充的非药物策略。然而，在非疼痛相关不适的标准化评估工具和联合干预措施方面仍存在重大差距。这篇综述强调了综合管理方案和进一步研究的必要性，以优化创伤环境中患者的舒适度和护理结果。

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引用次数: 0

Auricular Hematoma and Development of Cauliflower Ear 花椰菜耳的耳廓血肿与发育

IF 2.3 4区医学 Q2 EMERGENCY MEDICINE

Journal of Emergency Nursing

Pub Date : 2026-01-01 Epub Date: 2026-01-03 DOI: 10.1016/j.jen.2025.07.012

Joo Shiang Ang MBBS, Wan San Angeline Tan MN, APN, RN, Wai Jian Lionel Ang RN, Xinyi Lin MBBS

引用次数: 0

Emergency Nursing Review Questions: January 2026 急诊护理评论问题：2026年1月

IF 2.3 4区医学 Q2 EMERGENCY MEDICINE

Journal of Emergency Nursing

Pub Date : 2026-01-01 Epub Date: 2026-01-03 DOI: 10.1016/j.jen.2025.08.011

Benjamin E. Marett EdD, MSN, CEN, CCRN, COHN-S, NPD-C, NE-BC, TCRN, FAEN, FAHA, Luis E. Caso Vega MBA, BSN, RN, CEN, CPEN, NE-BC, TCRN

引用次数: 0

What Would Mother Say? Whole Blood and RhD Alloimmunization in Trauma Resuscitation 妈妈会怎么说？全血和RhD同种异体免疫在创伤复苏中的应用

IF 2.3 4区医学 Q2 EMERGENCY MEDICINE

Journal of Emergency Nursing

Pub Date : 2026-01-01 Epub Date: 2026-01-03 DOI: 10.1016/j.jen.2025.09.005

John Ramos MMS, PA-C, CAQ-EM

Low-titer type O whole blood has demonstrated survival benefits and improved hemostatic resuscitation compared with component-based transfusion. Although alloimmunization is a concern for women of childbearing potential, more recent evidence suggests that the absolute risk is low compared with the need to preserve maternal life. The administration of whole blood to women of childbearing potential is safer with postexposure Rh immunoprophylaxis and modern advances in the management of fetal anemia.

与基于成分的输血相比，低滴度的O型全血已显示出生存益处和改善的止血复苏。虽然同种异体免疫对有生育潜力的妇女来说是一个问题，但最近的证据表明，与维持产妇生命的需要相比，绝对风险较低。随着暴露后Rh免疫预防和胎儿贫血管理的现代进展，对有生育潜力的妇女全血管理更安全。

引用次数: 0

Artificial Intelligence: Implications for Emergency Nursing Practice 人工智能：对急诊护理实践的影响

IF 2.3 4区医学 Q2 EMERGENCY MEDICINE

Journal of Emergency Nursing

Pub Date : 2026-01-01 Epub Date: 2026-01-03 DOI: 10.1016/j.jen.2025.11.001

Jordan Rose DNP, RN, PHN, FNP-BC, Anna Valdez PhD, RN, PHN, CEN, CFRN, FAEN, FAADN

引用次数: 0

Perceived Relationships Between Emergency Department Staffing Patterns and Missed Care, Missed Decompensation, and Delays in Care 急诊科人员配置模式与错过护理、错过补偿和护理延误之间的关系。

IF 2.3 4区医学 Q2 EMERGENCY MEDICINE

Journal of Emergency Nursing

Pub Date : 2026-01-01 Epub Date: 2025-09-09 DOI: 10.1016/j.jen.2025.08.002

Lisa Wolf PhD, RN, CEN, FAEN, FAAN, Ellen Benjamin PhD, RN, CEN, Paul Clark PhD, RN, FAEN, Michael Callihan PhD, RN, CEN, NRP, FAEN

Introduction

When emergency department staffing is inadequate, patient care may be missed. Information regarding the association between missed care and staffing is lacking in the emergency department setting. This study aimed to explore considerations for and configurations of staffing patterns and their relationship to missed care, missed decompensation, and delays in care.

Methods

This study used an exploratory qualitative approach with data derived from focus groups and analyzed using qualitative content analysis. A total of 39 emergency nurses in varied roles attending a national conference were recruited. The Consolidated Criteria for Reporting Qualitative Research checklist was used to guide the reporting of this study.

Results

Participants reported information grouped into 5 major categories: ratios, staffing patterns, work ethic, role of administration, and missed care. Both staff and charge nurses reported a preference for a 1:3 nurse-to-patient ratio, with higher patient ratios described as leading to missed care, missed decompensation, and delays in care.

Discussion

The individual and institutional elements of staffing decisions may have a significant impact on patient outcomes in the form of missed care, missed diagnoses, and delayed care. Staffing decisions may also affect the psychological health of emergency nurses by fostering burnout. Across roles, nurses perceive a disconnect between the ED environment and staffing plans generated by persons outside the department. Future research should focus quantitatively on relationships between staffing patterns and patient and nursing outcomes.

简介：当急诊科人员配备不足时，可能会错过患者护理。关于错过护理和人员配置之间的关系的信息缺乏在急诊科设置。本研究旨在探讨人员配置模式及其与错过护理、错过失偿和护理延误的关系。方法：本研究采用探索性定性方法，收集焦点小组数据，并采用定性内容分析法进行分析。总共招募了39名不同角色的急诊护士参加一次全国会议。定性研究综合报告标准检查表用于指导本研究的报告。结果：参与者报告的信息分为5个主要类别：比例，人员配置模式，职业道德，管理角色和错过的护理。工作人员和主管护士都报告首选1:3的护士与患者比例，较高的患者比例被描述为导致错过护理，错过代偿和护理延误。讨论：人员配置决策的个人和机构因素可能会以漏诊、漏诊和延迟护理的形式对患者结果产生重大影响。人员配置决策也可能通过促进倦怠影响急诊护士的心理健康。在各个角色中，护士认为急诊科环境和部门外人员制定的人员配备计划之间存在脱节。未来的研究应集中于人员配置模式与患者和护理结果之间的定量关系。

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引用次数: 0

Identifying the High-Risk Obstetric Patient at Triage 鉴别分诊时的高危产科病人

IF 2.3 4区医学 Q2 EMERGENCY MEDICINE

Journal of Emergency Nursing

Pub Date : 2026-01-01 Epub Date: 2026-01-03 DOI: 10.1016/j.jen.2025.07.013

Lisa Wolf PhD, RN, CEN, FAEN, FAAN

引用次数: 0

Code Malignant Hyperthermia: Malignant Hyperthermia in the Emergency Department—Implications for Nursing 代号恶性热疗：急诊科的恶性热疗-护理意义。

IF 2.3 4区医学 Q2 EMERGENCY MEDICINE

Journal of Emergency Nursing

Pub Date : 2026-01-01 Epub Date: 2025-09-09 DOI: 10.1016/j.jen.2025.07.016

Marlene Porter PhD, RN, CEN, NPD-BC, CCRN

Malignant hyperthermia is a rare, life-threatening hypermetabolic reaction that can strike unexpectedly in the emergency department, demanding swift recognition and intervention to save lives. This syndrome can be fatal if not treated and occurrs in 1 in 100,000 adults and 1 in 30,000 children, with a 3% to 5% mortality rate. Although often associated with perioperative environments, malignant hyperthermia should remain on the radar for emergency nurses, especially when patients exhibit sudden hyperthermia, muscle rigidity, and tachycardia after intubation or procedural sedation. This article emphasizes early recognition, rapid intervention strategies, and preparedness protocols tailored to the ED context to improve outcomes for patients with malignant hyperthermia.

恶性高热是一种罕见的、危及生命的高代谢反应，可在急诊科意外发作，需要迅速识别和干预以挽救生命。如果不加以治疗，这种综合征可能是致命的，成人发病率为10万分之一，儿童发病率为3万分之一，死亡率为3%至5%。尽管恶性高热通常与围手术期环境有关，但急诊护士仍应警惕恶性高热，特别是当患者在插管或程序性镇静后出现突然高热、肌肉僵硬和心动过速时。这篇文章强调早期识别、快速干预策略和针对ED环境的准备方案，以改善恶性高热患者的预后。

引用次数: 0

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