Journal of Emergency Nursing最新文献

Introduction: The prehospital interventions provided by helicopter emergency medical services are crucial for improving rescue efficiency and success rates. We aimed to assess and describe the literature on prehospital rescue interventions provided by helicopter emergency medical services personnel worldwide.

Methods: A comprehensive search was conducted via PubMed, MEDLINE, Embase, Web of Science, and CINAHL from January 1, 2010, to September 30, 2025, to identify studies for patients of any age involving helicopter prehospital interventions. Two authors independently completed the data extraction and quality assessment.

Results: Among 10,731 records, 80 studies were included with a total sample size of 3,343,377 cases, of whom 963,779 were transported by helicopter emergency medical services. Of the 84 identified prehospital interventions provided by helicopter emergency medical services crews, 18 high-frequency core emergency interventions were extracted and categorized into 4 systems: circulatory, respiratory, locomotor, and other. The most frequent interventions were endotracheal intubation, drug treatment, and cardiopulmonary resuscitation. Subgroup analyses of "trauma patients only," "cardiac arrest only," and "trauma and non-trauma patients" indicated that advanced airway management, hemodynamic stabilization, and supportive drug therapy were consistently critical across all groups.

Discussion: The helicopter emergency medical services teams provided a wide spectrum of intervention services. Evaluating the interventions is important to gain insight into uniform practices, terminology, and documentation. Identifying intervention outcomes and efficacy is crucial for guiding future research and developing evidence-based, standardized helicopter emergency intervention guidelines.

Introduction: This study aimed to measure the effectiveness of a tutoring program designed for the development of competencies in novice nurses in a hospital emergency service. The development of nursing competencies is essential to ensure patient safety and quality care. Health care systems should implement programs that enhance competency and facilitate the professional transition of new nurses to ensure safe clinical environments.

Methods: A quasi-experimental, longitudinal, and prospective study was conducted in the emergency department of a tertiary hospital in Spain between 2023 and 2024. Newly hired nurses (n = 63) were allocated to an experimental group, which received a structured tutoring program led by a single tutor, and to a control group. Competency levels were evaluated by the tutor using validated rubrics. Data were analyzed with descriptive and inferential statistics, with significance set at P<.05.

Results: The experimental group demonstrated significant improvements in all evaluated competencies compared with the control group (P<.05). Gains were maintained at 6 months, supporting the program's sustained effectiveness.

Discussion: The findings of this study have important implications for health care settings, showing that the development of a tutoring program within hospitals is an effective measure for the competency and professional development of nurses.

Introduction: The accurate and consistent assessment of pain in adolescents is very important for appropriate treatment and care. This study aimed to compare the pain assessment by parents, physicians, nurses, and adolescents in pediatric patients admitted to the emergency department for evaluation.

Methods: This cross-sectional study was conducted with 352 adolescents aged 11 to 18 years who complained of pain, their parents, and caring physicians and nurses. Data were collected between January 2023 and February 2024 using the Descriptive Information Form and the visual analog scale for adolescents, parents, physicians, and nurses.

Results: The visual analog scale pain score was 6.79 (1.73) in adolescents' self-assessment of pain. Parents evaluated adolescents' pain as 6.73 (SD 1.87), physicians as 4.38 (SD 1.90), and nurses as 4.19 (SD 1.78). The overall adolescent-parent agreement was low (Cohen's weighted κ = 0.201), and there was a discrepancy between adolescent-nurse (κ = -0.008) and adolescent-physician agreement (κ = 0.005). Pain assessment reliability between adolescents and parents was good (intraclass correlation coefficient, 0.772; 95% CI, 0.719-0.815), whereas it was moderate between adolescents and nurses (intraclass correlation coefficient, 0.591; 95% CI, 0.496-0.669) and weak between adolescents and physicians (intraclass correlation coefficient, 0.353; 95% CI, -0.157 to 0.627).

Discussion: The reliability of pain assessment between adolescents and parents was good. The pain assessment scores of physicians and nurses were lower than adolescents themselves and their parents. Parents' assessment of pain should be taken into account when adolescents' self-reports are unavailable.

Introduction: Pediatric emergency departments are high-intensity settings where nurses must make rapid decisions while delivering high-quality, compassionate care. Individual innovativeness has been identified as a potential factor influencing caring behaviors; however, its role in pediatric emergency nursing is not yet known. This study aimed to examine this relationship and the mediating role of demographic characteristics.

Methods: This descriptive cross-sectional study included 195 pediatric emergency nurses working in pediatric emergency departments throughout Turkey. Data were collected using an online survey consisting of a demographic form, the Individual Innovativeness Scale, and the Caring Behaviors Inventory-24. Descriptive statistics and correlation analyses were conducted using SPSS version 27. Mediation analysis was performed using Hayes' PROCESS macro v4.3 to examine the indirect effects of demographic variables.

Results: The mean total score on the Individual Innovativeness Scale was 68.09 (SD = 17.30), and the mean item score on the Caring Behaviors Inventory was 3.91 (SD = 0.67). A strong positive correlation was identified between individual innovativeness and caring behaviors (r = 0.827; P < .001). Age, sex, educational level, and professional experience partially mediated this relationship.

Discussion: Individual innovativeness is significantly associated with caring behaviors in pediatric emergency nurses. The demographic characteristics of nurses were found to have a partial mediating role in this relationship. Promoting nurses' innovative attitudes may support the integration of evidence-based care in pediatric emergency settings.

Introduction: Foreign body airway obstruction is a time-critical emergency. Traditional techniques such as back blows and abdominal thrusts are widely recommended yet may be ineffective in certain populations. Antichoking suction devices such as LifeVac and Dechoker have gained popularity in out-of-hospital settings, despite limited supporting evidence.

Methods: We conducted a systematic review and meta-analysis following Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Studies involving humans or simulation models in which antichoking devices were used for foreign body airway obstruction management were included. Seven databases were searched. Methodological quality was assessed using the Mixed Methods Appraisal Tool and Strengthening the Reporting of Observational Studies in Epidemiology. A meta-analysis of proportions was performed to estimate airway clearance success rates, and subgroup analyses were conducted by device and study model (human vs manikin).

Results: Six studies (n = 789) met the inclusion criteria. The overall success rate for airway clearance was 92.26%. LifeVac had the highest success rate (97.79%) and lowest heterogeneity (I² = 34.2%), followed by Dechoker (94.82%; I² = 80.4%) and the Heimlich maneuver (71.11%; I² > 80%). Studies using human subjects showed slightly higher success and lower variability than manikin-based studies. A mean of 2 attempts per device was needed. However, high heterogeneity and potential publication bias were noted.

Discussion: Antichoking devices may be useful in selected scenarios, but their comparative effectiveness remains unproven. Current evidence is limited and affected by bias. Traditional techniques should remain the priority in airway obstruction management. Further independent, high-quality research is needed to clarify the clinical value of antichoking devices.

Introduction: Accurate triage in emergency departments is critical to patient safety and resource management. Despite the widespread use of validated triage tools, decision-making inconsistencies remain, often owing to inadequate or variable training. Previous research suggests that structured training interventions can improve triage performance, but there is no consolidated evidence to guide best practices in training design.

Objective: This protocol outlines a systematic review and meta-analysis to synthesize quantitative evidence on the effectiveness of triage training interventions for emergency nurses. The review aims to identify which training modalities are most effective in improving triage accuracy and related outcomes.

Methods: The review will follow the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. A comprehensive search will be conducted in PubMed, Cumulative Index to Nursing and Allied Health Literature, Embase, Scopus, and Web of Science using both Medical Subject Headings terms and free-text keywords. Eligible studies will include randomized controlled trials, quasi-experimental, and pre-post intervention studies involving emergency nurses and reporting accurate triage rate performance outcomes. Two independent reviewers will conduct study selection, data extraction, and quality appraisal using the Joanna Briggs Institute critical appraisal tools. A meta-analysis will be performed depending on whether random-effects or fixed effects are used for heterogeneity. Systematic synthesis will be conducted if meta-analysis is not feasible. This protocol is registered in PROSPERO (registration no: CRD42025115681).

Discussion: Findings from this review will inform evidence-based triage education, supporting ED leaders and nurse educators in implementing effective training programs to improve decision making and patient safety.

Introduction: Emergency nurses face significant occupational challenges that affect workplace interactions. This study examined whether weekly working hours mediate the relationship between occupational anxiety and argumentativeness among emergency nurses. It was hypothesized that increased levels of both occupational anxiety and argumentativeness were associated with longer working hours.

Methods: A cross-sectional correlational study was conducted in a full-service public hospital located in an urban area in eastern Turkey. A total of 114 emergency nurses participated in the study. The inclusion criteria required current emergency department employment and consent; nurses on long-term leave were excluded. Occupational anxiety and argumentativeness were measured using validated scales, with weekly working hours as a potential mediator of this relationship. The analysis included correlation, regression, mediation analysis, and structural equation modeling.

Results: Nurses reported high occupational anxiety (mean = 101.83; SD = 9.74) and slightly above-average argumentativeness (mean = 31.69; SD = 4.15). Strong positive correlations were found among weekly working hours, occupational anxiety, and argumentativeness (r = 0.58-0.74; P<.001). Male sex (β = 3.75; P = .033) and longer working hours (β = 4.52; P<.001) were significant predictors of higher occupational anxiety. Mediation analysis confirmed that working hours partially mediated the anxiety-argumentativeness relationship, verified by structural equation modeling with good fit indices (χ²/df = 2.01; comparative fit index = 0.952; root mean square error of approximation = 0.056).

Discussion: Emergency nurses experience heightened occupational anxiety directly related to argumentativeness, with weekly working hours serving as a partial mediator. The results emphasize the need for psychosocial workload management and communication training programs in demanding health care environments.

Introduction: Managing clinical deterioration in emergency departments is a critical aspect of patient safety. Junior nurses often face psychological challenges owing to their limited experience and the high-pressure environment, which can affect their performance and professional growth. Understanding these psychological experiences is essential for developing targeted support strategies. This study aimed to explore the psychological experiences of junior emergency nurses in recognizing and responding to clinical deterioration.

Methods: A qualitative descriptive design was used, using semistructured interviews with 18 junior emergency nurses recruited via purposive sampling. A conventional content analysis was used to analyze the data. The study results were explained within the framework of Benner's theory.

Results: Three phases of psychological experiences were identified: the initiation phase (characterized by stress, fear, and anxiety and reliance on protocols and mentorship), the adaptation phase (marked by early pattern recognition and anticipation, collaborative judgment and peer learning, and building confidence through repetition), and the growth phase (defined by increasing independence and proactive clinical leadership, reflection and learning, and developing resilience). Junior emergency nurses' negative psychological experiences decreased over time, whereas their positive experiences and professional competencies improved with increasing clinical exposure.

Discussion: This study highlights the evolving psychological needs of junior emergency nurses during their professional development. Tailored support strategies, including nurse residency programs, mentorship, simulation-based training, teamwork enhancement, leadership development, reflective practice, and resilience building, are crucial to foster confidence and competence in managing clinical deterioration. These findings provide valuable insights for nursing educators and managers to improve training and support programs, ultimately enhancing patient safety and care quality.