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Advancing triage quality: Practical considerations for implementing the Australasian Triage Scale indicators. 推进分诊质量:实施澳大拉西亚分诊量表指标的实际考虑。
IF 2.1 4区 医学 Q2 EMERGENCY MEDICINE Pub Date : 2025-09-20 DOI: 10.1016/j.auec.2025.09.005
Parth Aphale, Himanshu Shekhar, Shashank Dokania
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引用次数: 0
Seen, heard, supported: Recognising and responding to Female Genital Mutilation/Cutting in the Australian emergency department 看到、听到、支持:承认和应对澳大利亚急诊科的女性生殖器切割/切割。
IF 2.1 4区 医学 Q2 EMERGENCY MEDICINE Pub Date : 2025-09-16 DOI: 10.1016/j.auec.2025.06.003
Haddijatou Hughes
Female genital mutilation/ cutting (FGM/C) describes the practice of injuring or removing part or all of the external female* genitalia and is a process that serves no medical benefit.2 Approximately 230 million females** worldwide have undergone this human rights violation.1,2 These women are at risk of illness and may seek emergency care. FGM/C is illegal in all Australian states and territories7,8 and not traditionally practised here; however, the number of women in Australia living with FGM/C is increasing. Australian healthcare workers have limited knowledge of FGM/C.6 Women are not only impacted by the procedures themselves but also by the scarcity of robust research, which leaves Emergency Departments (EDs) without adequate guidance. A gap exists in the literature, which has real-life implications. Australian EDs must be equipped to care for people who have undergone this harmful cultural practice. This paper examines the barriers to effective care and explore recommendations to enhance outcomes for these women.
女性生殖器切割(FGM/C)描述了伤害或切除部分或全部女性外部生殖器的做法,是一种没有医疗益处的过程全世界大约有2.3亿女性**遭受过这种人权侵犯这些妇女有患病的危险,可能会寻求紧急护理。女性生殖器切割在澳大利亚所有州和地区都是非法的7,8,在这里也没有传统习俗;然而,澳大利亚遭受女性生殖器切割/残割的妇女人数正在增加。澳大利亚保健工作者对女性生殖器切割/C.6的了解有限妇女不仅受到手术本身的影响,而且还受到缺乏强有力的研究的影响,这使得急诊科(ed)没有充分的指导。文献中存在差距,这对现实生活有影响。澳大利亚的急诊医生必须配备设备来照顾那些经历过这种有害文化习俗的人。本文探讨了有效护理的障碍,并探讨了提高这些妇女结果的建议。
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引用次数: 0
Predictors of end-of-life care among emergency nurses: A cross-sectional study in Korea. 韩国急诊护士临终关怀的预测因素:一项横断面研究。
IF 2.1 4区 医学 Q2 EMERGENCY MEDICINE Pub Date : 2025-09-15 DOI: 10.1016/j.auec.2025.09.003
Ji Seon Lee, Sook Jung Kang

Background: With emergency departments (EDs) facing growing demand to provide end-of-life care (EOLC), it has become more important to identify the factors that influence the EOLC practices of ED nurses. This study examined the effects of nursing professional values, the nursing work environment, and compassion competence on the EOLC practices of ED nurses.

Methods: This cross-sectional descriptive study was conducted with 136 ED nurses in Korea. Statistical analysis was conducted to examine the relationships among key variables and identify significant predictors of EOLC practices.

Results: EOLC practices exhibited a significant positive correlation with nursing professional values (r = .43), the work environment (r = .42), and compassion competence (r = .60; all p < .001). Compassion competence was the strongest predictor of EOLC practices (β = 0.497, p < .001), explaining 39 % of the variance.

Conclusions: Compassion competence was the most influential factor affecting EOLC practices among ED nurses. These findings highlight the need to incorporate compassion training into ongoing education and create supportive environments that promote emotionally attuned care, even in high-pressure emergency settings.

背景:随着急诊科(EDs)提供临终关怀(EOLC)的需求日益增长,确定影响急诊科护士临终关怀实践的因素变得更加重要。本研究探讨护理专业价值观、护理工作环境和同情心能力对急诊科护士EOLC实践的影响。方法:对韩国136名急诊科护士进行横断面描述性研究。统计分析检验了关键变量之间的关系,并确定了EOLC实践的显著预测因子。结果:EOLC实践与护理专业价值观呈显著正相关(r = )。43)、工作环境(r = 。结论:同情心能力是影响急诊科护士EOLC实践的最重要因素。这些发现强调了将同情心训练纳入持续教育的必要性,并创造支持性环境,以促进情感协调的护理,即使在高压紧急情况下也是如此。
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引用次数: 0
Frontline mental resilience: Lessons learned from the pandemic experience. 一线心理复原力:从大流行经验中吸取的教训。
IF 2.1 4区 医学 Q2 EMERGENCY MEDICINE Pub Date : 2025-09-12 DOI: 10.1016/j.auec.2025.09.002
Pooja Khurana, Raja Zirwatul Aida Binti Raja Ibrahim, Khatijah Omar, Azlinzuraini Binti Ahmad

Background: The COVID-19 pandemic affected frontline Healthcare Workers (HCWs) immensely, subjecting them to extreme psychological distress. The current study assesses the burnout, anxiety, depression, PTSD, and resilience levels among HCWs and analyses the efficacy of institutional mental health interventions.

Methods: A cross-sectional longitudinal study design that combined quantitative surveys and qualitative interviews was employed. There were 500 HCWs from public hospitals, private hospitals, primary healthcare centres, and emergency response teams who took part. Validated measures included the Maslach Burnout Inventory (MBI), Generalized Anxiety Disorder-7 (GAD-7), Patient Health Questionnaire-9 (PHQ-9), PTSD Checklist (PCL-5), and Connor-Davidson Resilience Scale (CD-RISC). Descriptive statistics, chi-square tests, t-tests, and logistic regression were used in data analysis.

Results: Psychological distress was common, with 42.5 % burnout, 35.2 % anxiety, 29.8 % depression, and 21.4 % PTSD. Long hours (OR = 1.85, p < 0.001), high patient volume (OR = 1.67, p < 0.001), and absence of PPE (OR = 1.52, p = 0.002) were major contributors, and robust workplace support (OR = 0.75, p = 0.037) was protective. Qualitative interviews revealed key themes, including persistent sleep disturbances, Mental Health Support, Emotional and Social consequences, Impact on relationships and fear of infecting family members.

Conclusion: HCWs experienced extreme psychological distress throughout the pandemic, which requires additional mental health policies, organizational support, and greater access to digital interventions.

背景:2019冠状病毒病大流行对一线医护人员造成了巨大影响,使他们遭受了极大的心理困扰。本研究评估了医护人员的倦怠、焦虑、抑郁、创伤后应激障碍和恢复力水平,并分析了机构心理健康干预的效果。方法:采用定量调查与定性访谈相结合的横断面纵向研究设计。共有500名来自公立医院、私家医院、初级保健中心和紧急应变队的医护人员参加。经验证的测量方法包括Maslach倦怠量表(MBI)、广泛性焦虑障碍量表-7 (GAD-7)、患者健康问卷-9 (PHQ-9)、PTSD检查表(PCL-5)和Connor-Davidson弹性量表(CD-RISC)。资料分析采用描述性统计、卡方检验、t检验和逻辑回归。结果:心理困扰普遍存在,倦怠率为42.5% %,焦虑率为35.2% %,抑郁率为29.8% %,PTSD为21.4% %。结论:在整个大流行期间,卫生保健工作者经历了极度的心理困扰,这需要额外的精神卫生政策、组织支持和更多的数字干预措施。
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引用次数: 0
A scoping review of randomised controlled trials in vascular access devices in emergency departments. 急诊科血管通路装置随机对照试验的范围综述
IF 2.1 4区 医学 Q2 EMERGENCY MEDICINE Pub Date : 2025-09-01 Epub Date: 2025-04-14 DOI: 10.1016/j.auec.2025.03.004
Hui Grace Xu, Yang Camila Zhao, Jed Duff, Nicole Marsh

Aims: To synthesise findings from randomised controlled trials (RCTs) on vascular access devices (VADs) in emergency departments (EDs).

Background: VADs play a critical role in EDs, enabling rapid delivery of supportive therapies to address urgent medical needs. This scoping review will map current evidence and determine areas to focus future research priorities.

Methods: Following Arksey and O'Malley's scoping review framework, a comprehensive search was conducted (2012-2024) across four databases. RCTs that focused on peripheral intravenous catheters, central venous catheters, arterial catheters, or intraosseous catheters in an ED setting were included.

Results: 48 RCTs were included, a majority focused on peripheral intravenous catheters (n = 41, 85 %), followed by central venous catheters (n = 4, 8 %), arterial catheters (n = 2, 4 %), and intraosseous catheters (n = 1, 3 %). The findings were categorised by intervention type, including vessel visualisation technology, catheter design, dressing and securement design, distraction techniques, topical anaesthetics, inserter models, and other related techniques. The top three most frequently reported outcomes were insertion success (n = 21), time to successful insertion (n = 20), and catheter-related complications (n = 19).

Conclusion: This review provides ED clinicians with current evidence on VAD technologies and techniques, enabling them to select and implement the most effective options into daily practice reduce costs and improve patient satisfaction.

目的:综合急诊(ed)血管通路装置(VADs)的随机对照试验(RCTs)的研究结果。背景:VADs在急诊科中发挥着关键作用,能够快速提供支持性治疗以满足紧急医疗需求。这一范围审查将绘制当前证据图,并确定未来研究重点的领域。方法:遵循Arksey和O'Malley的范围审查框架,在四个数据库中进行了全面的检索(2012-2024)。包括在ED环境中使用外周静脉导管、中心静脉导管、动脉导管或骨内导管的随机对照试验。结果:48相关的包括,大多数集中在周边静脉导管(n = 41岁,85年 %),紧随其后的是中央静脉导管(n = 4,8 %),动脉导管(n = 2,4 %),和intraosseous导管(n = 1,3 %)。研究结果按干预类型进行分类,包括血管可视化技术、导管设计、敷料和安全设计、牵引技术、局部麻醉、插入器模型和其他相关技术。最常见的三个结果是插入成功(n = 21)、成功插入时间(n = 20)和导管相关并发症(n = 19)。结论:本综述为急诊科临床医生提供了VAD技术和技术的最新证据,使他们能够在日常实践中选择和实施最有效的方案,降低成本,提高患者满意度。
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引用次数: 0
From triage to departure: Older adults' ED journey. A mixed methods study. 从分诊到离开:老年人的ED之旅。混合方法研究。
IF 2.1 4区 医学 Q2 EMERGENCY MEDICINE Pub Date : 2025-09-01 Epub Date: 2025-03-26 DOI: 10.1016/j.auec.2025.03.005
Melinda Williamson, Kristie J Harper, Sarah Bernard, Courtenay Harris

Background: Rising Emergency Department (ED) demand strains resources to assess and manage frail older adults. Allied health supports comprehensive care, disposition planning and patient safety in the ED but often intervenes late. This study investigated factors affecting allied health referrals and co-designed an early allied health frailty service.

Methods: An explanatory sequential mixed-methods approach was used. Patient journey mapping of low acuity older ED patients was followed by stakeholder focus groups.

Results: From triage, 20 older ED patients waited a mean of 110 minutes (SD 83 minutes) for doctor assessment, 123 minutes (SD 116 minutes) for an ED bed and 355 minutes (SD 297 minutes) for allied health assessment with a mean ED length of stay (LOS) of 685 minutes (SD 444 minutes). Qualitative analysis of focus group discussions identified perceived benefits of an early allied health service including shorter LOS, earlier disposition planning, increased staff confidence and streamlined decision making. Perceived barriers were lack of space, competing assessments with doctors and incomplete investigations. Perceived solutions were refining the inclusion criteria and staff education.

Conclusion: Allied health assessment occurred six hours post presentation, outside national targets. Opportunities and barriers identified supported the development of an earlier allied health frailty service.

背景:急诊科(ED)日益增长的需求使评估和管理体弱老年人的资源紧张。联合健康支持综合护理,处置计划和病人安全在急诊科,但往往干预晚。本研究调查了影响联合健康转诊的因素,并共同设计了早期联合健康虚弱服务。方法:采用解释性顺序混合方法。通过利益相关者焦点小组对低敏锐度老年急诊科患者进行随访。结果:从分诊开始,20例老年急诊科患者等待医生评估的平均时间为110 分钟(SD 83 分钟),等待急诊科床位的平均时间为123 分钟(SD 116 分钟),等待联合健康评估的平均时间为355 分钟(SD 297 分钟),平均急诊科住院时间(LOS)为685 分钟(SD 444 分钟)。焦点小组讨论的定性分析确定了早期联合保健服务的感知好处,包括缩短工作期限、更早规划处置、提高工作人员信心和简化决策。人们认为的障碍是缺乏空间、与医生相互竞争的评估以及不完整的调查。人们认为的解决办法是改进纳入标准和工作人员教育。结论:联合健康评估发生在报告后6小时,超出国家目标。确定的机会和障碍支持了早期联合脆弱保健服务的发展。
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引用次数: 0
The T2 nurse - A novel role to reduce time to treatment for critically ill patients in a metropolitan emergency department. T2护士——在城市急诊科减少危重病人治疗时间的新角色。
IF 2.1 4区 医学 Q2 EMERGENCY MEDICINE Pub Date : 2025-09-01 Epub Date: 2025-05-17 DOI: 10.1016/j.auec.2025.05.001
Helen Zaouk, Michael Piza, Sabrina Naz, Aaron de Los Santos, Jordan Fenech, Kelly Bivona, Robbie Cruceanu, Sarah Kourouche

Background: Delayed access to treatment in the Emergency Department for patients presenting with time-critical presentations leads to increased morbidity and mortality. This study aimed to determine if the introduction of a novel 'T2 Nurse' nursing role to initiate assessment and treatment for time-critical (category 2) patients reduces time to treatment (TTT).

Methods: This pre/post-implementation pilot study used routinely collected performance data from all category 2 patients presenting to an emergency department in NSW, Australia from January 2023 to July 2024 using regression analysis.

Results: 17,332 pre-implementation records and 16,989 post-implementation records were examined. The mean average TTT pre-implementation was 27 min compared to 12 min during the program, with a mean daily average TTT reduced by 15.4 min post-implementation. After adjusting for seasonal variation, the T2 program significantly reduced average waiting time by approximately 8 min. There was a sustained increase in performance targets with over 80 % of category 2 patients seen within the recommended time post-implementation (a 42 % increase).

Conclusion: The implementation of a T2 nurse role led to statistically and clinically significant sustained improvements in TTT particularly when the T2 Nurse initiates treatment, which may lead to improved health outcomes.

背景:在急诊科延迟获得治疗的病人提出的时间紧迫的表现导致发病率和死亡率增加。本研究旨在确定引入一种新的“T2护士”护理角色,以启动对时间紧迫(2类)患者的评估和治疗,是否会缩短治疗时间(TTT)。方法:这项实施前/实施后的试点研究使用了2023年1月至2024年7月在澳大利亚新南威尔士州急诊科就诊的所有2类患者的常规数据,并进行了回归分析。结果:共检查实施前记录17,332份,实施后记录16,989份。实施前平均TTT为27 分钟,而实施期间平均TTT为12 分钟,实施后平均每日TTT减少15.4 分钟。在对季节变化进行调整后,T2程序显著减少了平均等待时间约8 分钟。执行目标持续增加,超过80% %的2类患者在实施后推荐的时间内就诊(增加42% %)。结论:T2护士角色的实施导致TTT在统计学和临床上显著的持续改善,特别是当T2护士开始治疗时,这可能导致改善的健康结果。
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引用次数: 0
The impact of emergency nurse practitioners on short-term survival in out-of-hospital cardiac arrest. 急诊护士从业人员对院外心脏骤停短期生存的影响。
IF 2.1 4区 医学 Q2 EMERGENCY MEDICINE Pub Date : 2025-09-01 Epub Date: 2025-02-17 DOI: 10.1016/j.auec.2025.02.002
Weerapont Kaewpaengchan, Wachira Wongtanasarasin, Worapot Khampeera, Borwon Wittayachamnankul

Background: Emergency Medical Services (EMS) are critical for improving survival in out-of-hospital cardiac arrest (OHCA). The expertise of EMS team leaders, such as emergency nurse practitioners (ENPs), may impact patient outcomes. This study aimed to evaluate the role of ENPs and their association with outcomes in OHCA.

Methods: A retrospective analysis was conducted on OHCA cases treated by EMS from 2017 to 2020. Data included ENP presence, number of healthcare personnel, patient demographics, initial rhythm, bystander CPR, physician presence, patient access time, and scene time. Primary outcome was prehospital return of spontaneous circulation (ROSC), with secondary outcome being ROSC at the emergency department (ED).

Results: Among 212 OHCA cases treated by EMS, ENPs were present in 14.6 % of cases. Prehospital ROSC was 11.3 %, while ROSC at the ED was 48.1 %. ENP presence was not associated with increased prehospital ROSC (p = 0.19) but was linked to higher overall ROSC rates at the ED (p = 0.03).

Conclusions: Including ENPs in EMS teams may improve short-term survival outcomes for OHCA patients, particularly at the ED. Further research is needed to explore the broader impact of ENPs in prehospital care.

背景:紧急医疗服务(EMS)对提高院外心脏骤停(OHCA)患者的生存率至关重要。EMS团队领导的专业知识,如急诊护士从业人员(ENPs),可能会影响患者的结果。本研究旨在评估ENPs的作用及其与OHCA预后的关系。方法:回顾性分析2017 ~ 2020年EMS治疗的OHCA病例。数据包括ENP存在、医护人员数量、患者人口统计学、初始心律、旁观者CPR、医生存在、患者就诊时间和现场时间。主要终点是院前自发循环恢复(ROSC),次要终点是急诊科(ED)的ROSC。结果:EMS治疗的212例OHCA患者中,ENPs发生率为14.6% %。院前ROSC为11.3 %,急诊科ROSC为48.1 %。ENP的存在与院前ROSC增加无关(p = 0.19),但与急诊科总ROSC率升高有关(p = 0.03)。结论:将ENPs纳入EMS团队可能会改善OHCA患者的短期生存结果,特别是在急诊科。需要进一步的研究来探索ENPs在院前护理中的更广泛影响。
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引用次数: 0
Developing practice-level quality indicators to assist in evaluating the application of the Australasian Triage Scale: A modified e-Delphi process. 发展实践水平的质量指标,以协助评估澳大拉西亚分诊量表的应用:一个修改的e-德尔菲过程。
IF 2.1 4区 医学 Q2 EMERGENCY MEDICINE Pub Date : 2025-09-01 Epub Date: 2025-03-17 DOI: 10.1016/j.auec.2025.03.001
Wayne Varndell, Matthew Lutze, Carrie Janerka

Background: Triage quality is central to patient safety and the efficient distribution of emergency department resources. Currently, there are no identified quality indicators for application of the Australasian Triage Scale.

Aim: To address a gap in quality indicators specific to triage.

Design: A literature review and modified Delphi technique.

Method: A review of the literature published between 2001 and 2024 was conducted to identify potential indicators and metrics of triage quality, and were categorised across six quality of care domains (patient-centeredness, timeliness, effectiveness, equity, efficiency and safety). Three consecutive online surveys where panellists rated these indicators for perceived appropriateness, validity and feasibility were completed between August and December 2023.

Results: From the review, 17 initial quality indicators across six quality of care domains were developed. Following round 1, 3 indicators were modified and 8 indicators were added. After two further survey rounds, 18 (72 %) indicators met consensus.

Conclusion: An expert panel validated a set of triage quality indicators for measuring Australian triage practice. A continuous quality improvement approach is required to optimise triage practice, develop processes for detecting and reducing patient harm and minimising variation. Further research is needed to test applicability of the indicators.

背景:分诊质量对患者安全和急诊科资源的有效分配至关重要。目前,澳大拉西亚分诊量表的应用还没有确定的质量指标。目的:填补分诊质量指标方面的空白:设计:文献综述和改良德尔菲技术:对 2001 年至 2024 年间发表的文献进行回顾,以确定分诊质量的潜在指标和衡量标准,并在六个护理质量领域(以患者为中心、及时性、有效性、公平性、效率和安全性)进行分类。2023 年 8 月至 12 月期间,连续完成了三项在线调查,由小组成员对这些指标的适当性、有效性和可行性进行评分:根据审查结果,制定了 17 个初步质量指标,涵盖 6 个护理质量领域。第一轮调查后,修改了 3 项指标,增加了 8 项指标。再经过两轮调查后,18 项指标(72%)达成共识:专家小组验证了一套用于衡量澳大利亚分诊实践的分诊质量指标。需要采取持续的质量改进方法来优化分诊实践,制定检测和减少患者伤害的流程,并最大限度地减少差异。需要进一步开展研究,以检验这些指标的适用性。
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引用次数: 0
Emergency clinical nurse specialist practice in Victoria and New South Wales: A cross-sectional study. 维多利亚州和新南威尔士州的急诊临床护士专家实践:一项横断面研究。
IF 2.1 4区 医学 Q2 EMERGENCY MEDICINE Pub Date : 2025-09-01 Epub Date: 2025-03-20 DOI: 10.1016/j.auec.2025.03.002
Sarah Wiggs, Abra Osborne, Julia Morphet

Background: Emergency Clinical Nurse Specialists (CNS) are experts in treating patients across the lifespan in the dynamic, unpredictable and busy Emergency Department (ED). The aim of this paper was to create a profile of the Emergency CNS role and practice, and assess work satisfaction.

Methods: An online cross-sectional survey based on the College of Emergency Nursing Australasia's Practice Standards for the Specialist Emergency Nurse was conducted in the Australian states of Victoria and New South Wales.

Results: There were 59 survey responses. The domains Lawful Practice, Professional Ethics and Communication were rated as practiced with the greatest frequency, and Lawful Practice and Teamwork were rated very important by respondents. 79 % of CNSs planned to continue working in ED, with all CNSs reporting plans to continue working in healthcare. 77 % of CNSs were satisfied in their current role.

Conclusion: The Practice Standards for the Specialist Emergency Nurse are used regularly and are relevant to CNS practice. CNSs are largely satisfied with their role, which is versatile and multifaceted. However, CNSs face challenges to perform all elements of their role, and reported protected non-clinical time and collaboration with management as enablers to their role.

背景:急诊临床专科护士(CNS)是在动态、不可预测和繁忙的急诊科(ED)治疗患者的专家。本文的目的是创建一个概况的应急中枢神经系统的作用和实践,并评估工作满意度。方法:在澳大利亚维多利亚州和新南威尔士州进行了一项基于澳大利亚急诊护理学院急诊护士执业标准的在线横断面调查。结果:共收到59份问卷。受访者认为“法律实践”、“职业道德”和“沟通”是最常使用的领域,而“法律实践”和“团队合作”被认为非常重要。79% %的CNSs计划继续在急诊科工作,所有CNSs报告计划继续在医疗保健行业工作。77 %的CNSs对目前的角色感到满意。结论:《专科急诊护士执业标准》的使用较为规范,与中枢神经系统执业有一定的相关性。CNSs在很大程度上对他们的角色感到满意,这是一个多功能和多方面的角色。然而,CNSs面临着履行其角色的所有要素的挑战,并报告了保护非临床时间和与管理层合作作为其角色的推动者。
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引用次数: 0
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Australasian Emergency Care
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