International Emergency Nursing[JOURNAL]
Sun
200 papers
From ngerti to nglakoni: A ki Hadjar Dewantara-informed Lens for autism-informed De-escalation in emergency departments.
Setiawan A, Handayani A, Fitriana S … +1 more , Lestari FW
Int Emerg Nurs · 2026 Jul · PMID 42398450 · Publisher ↗
Abstract loading — click title to view on PubMed.
Can AI improve triage quality? A preliminary assessment of ChatGPT performance in evaluating triage decisions.
Ramacciani Isemann C, Burresi S, Innocenti S … +1 more , Righi L
Int Emerg Nurs · 2026 Jul · PMID 42391742 · Publisher ↗
BACKGROUND: Ensuring accuracy and consistency in emergency department (ED) triage is vital to patient safety. Despite the presence of standardized protocols, variability in triage decisions remains a challenge. This stud...
BACKGROUND: Ensuring accuracy and consistency in emergency department (ED) triage is vital to patient safety. Despite the presence of standardized protocols, variability in triage decisions remains a challenge. This study explores the potential of ChatGPT, a large language model (LLM), as a retrospective evaluator to assess the appropriateness of nurse-assigned triage levels according to the Tuscan Triage System (STT). METHODS: Fifty anonymized triage scenarios derived from an institutional quality-review and educational framework were included. Each scenario was independently reviewed and coded by two certified triage experts, with a third expert resolving any disagreement. ChatGPT (GPT-4o, OpenAI) was subsequently prompted to evaluate each scenario and determine whether the triage level originally assigned was appropriate. The model's assessments were compared with the expert-defined reference standard. Metrics included overall agreement, Cohen's Kappa, macro-averaged precision, recall, F1-score, and class-specific sensitivity and specificity. RESULTS: Exact agreement between ChatGPT and expert assessments was found in 46% of cases. Discrepancies were more frequently under-triage (38%) than over-triage (16%). Overall agreement, measured by Cohen's Kappa, was 0.243. Performance was higher in high-complexity cases (κ = 0.313; F1 = 0.704), but decreased in moderate and low-complexity categories. Most misclassifications occurred between adjacent triage strata. CONCLUSIONS: ChatGPT demonstrated moderate alignment with expert-assigned triage levels, particularly in critical cases. While not suitable for autonomous triage, the model shows potential as a retrospective quality assurance tool. Further refinement and clinical validation are required before integration into audit processes or decision support frameworks.
Pain catastrophizing and its role in acute emotional distress among emergency trauma patients: Implications for emergency nursing care.
Cengiz T, Yılmaz E
Int Emerg Nurs · 2026 Jul · PMID 42385397 · Publisher ↗
AIM: This study aimed to assess the role of pain catastrophizing in acute emotional distress, including pain, fear, and state anxiety, among trauma patients presenting to the emergency department. METHODS: A cross-sectio...
AIM: This study aimed to assess the role of pain catastrophizing in acute emotional distress, including pain, fear, and state anxiety, among trauma patients presenting to the emergency department. METHODS: A cross-sectional study was conducted with 400 adult trauma patients presenting with isolated upper or lower extremity fractures. Data were collected using a sociodemographic form, the Visual Analog Scale (VAS) for pain/fear, the Pain Catastrophizing Scale (PCS), and the Spielberger State Anxiety Inventory (STAI-State). Descriptive statistics and structural equation modeling were used to examine associations among pain-related, cognitive, and psychological variables. RESULTS: Participants reported moderate to high levels of acute pain (VAS = 7.05 ± 1.74), fear (VAS = 5.66 ± 2.12), pain catastrophizing (PCS = 24.19 ± 12.37), and state anxiety (STAI-S = 46.60 ± 6.40). Pain intensity and fear were strongly associated (rₛ = 0.865, p < 0.001). Both variables showed significant positive associations with pain catastrophizing and state anxiety (all p < 0.001). Structural equation modeling indicated that the associations between pain- and fear-related distress and state anxiety were accounted for by pain catastrophizing. When catastrophizing was considered, the associations between pain or fear and state anxiety were no longer evident. CONCLUSION: These findings underscore the importance of early, nurse-led assessment of pain catastrophizing to identify emergency trauma patients at risk for acute emotional distress and to inform holistic emergency nursing care.
Healthcare professionals' lived experiences of resuscitation during pregnancy: A hermeneutic phenomenological study.
Öçal G, İlçioğlu K
Int Emerg Nurs · 2026 Jun · PMID 42378961 · Publisher ↗
INTRODUCTION: Cardiopulmonary resuscitation during pregnancy is a rare but high-risk emergency that requires rapid, coordinated, and pregnancy-specific interventions. This study aimed to explore healthcare professionals'...
INTRODUCTION: Cardiopulmonary resuscitation during pregnancy is a rare but high-risk emergency that requires rapid, coordinated, and pregnancy-specific interventions. This study aimed to explore healthcare professionals' lived experiences of cardiopulmonary resuscitation during pregnancy and to understand perceptions of preparedness, emotional responses, and interprofessional team dynamics in emergency care settings. METHODS: A qualitative study using a hermeneutic phenomenological approach was conducted. Data were collected in November 2025 through in-depth semi-structured interviews with 22 healthcare professionals (nurses, physicians, and a midwife) working in the emergency department of a public hospital in Türkiye. Interviews were audio-recorded, transcribed verbatim, and analyzed using an interpretive hermeneutic phenomenological framework to identify shared meanings and themes. RESULTS: Four interrelated themes were constructed, reflecting the paradox of rare events, emotional reflections, team dynamics, and knowledge and training needs. Participants described maternal resuscitation as a rare, highly stressful emergency characterized by ethical responsibility for both mother and fetus. Preparedness was perceived to depend less on individual technical knowledge and more on experiential learning, clear role allocation, and collective team efficacy. Emotional burden was intensified by the dual responsibility of care, while effective teamwork was a key protective factor supporting clinical performance and psychological resilience. CONCLUSION: Maternal resuscitation is experienced as a complex, relational, and ethically demanding emergency rather than a purely technical intervention. Preparedness is shaped by emotional regulation, interprofessional collaboration, and experiential competence alongside clinical knowledge.
Beyond simulation: Reflections on confidence measurement, instructional design, and transferability in paramedic mental health education.
Zakariyah MF, Artha IKAJ, Kristanto A … +2 more , Lestari GD, Nursalim M
Int Emerg Nurs · 2026 Jun · PMID 42372653 · Publisher ↗
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Comparative effectiveness of interventions for difficult intravenous access in adults: A systematic review and network meta-analysis of randomized controlled trials.
Chen B, Song Y, Jia J
Int Emerg Nurs · 2026 Jun · PMID 42372652 · Publisher ↗
BACKGROUND: Difficult intravenous access (DIVA) affects an estimated 8%-39% of hospitalized adults and is associated with treatment delays, increased pain, and elevated healthcare costs. Multiple interventions have been...
BACKGROUND: Difficult intravenous access (DIVA) affects an estimated 8%-39% of hospitalized adults and is associated with treatment delays, increased pain, and elevated healthcare costs. Multiple interventions have been developed to address this challenge, yet, to our knowledge, no network meta-analysis (NMA) has simultaneously compared the full range of available interventions in adult patients. METHODS: A systematic search of PubMed, Embase, the Cochrane Library, and Web of Science was conducted from inception through February 1, 2026, for randomized controlled trials comparing any DIVA intervention with standard practice or another active intervention in adults. Primary outcomes were first-attempt and overall success rates. Secondary outcomes included number of attempts, procedure time, pain score, and patient satisfaction. Random-effects NMA was performed using the netmeta package in R. Treatment rankings were summarized using P-scores. Subgroup analyses, meta-regression, sensitivity analyses, and publication bias assessments were conducted. RESULTS: Twenty-four RCTs (8014 participants) evaluating 11 active interventions were included. For first-attempt success, ultrasound guidance (OR = 5.58; 95% CI: 2.74-11.36) and local warming (OR = 5.72; 95% CI: 1.71-19.19) were significantly superior to standard practice. For overall success, only ultrasound guidance achieved significance (OR = 4.12; 95% CI: 2.07-8.19). Local warming uniquely reduced procedure time and pain, while near-infrared devices reduced cannulation attempts and improved patient satisfaction. Long catheters were associated with increased pain and longer procedure times. Meta-regression identified publication year and DIVA status as significant effect modifiers. No publication bias was detected. CONCLUSIONS: Ultrasound-guided cannulation showed the most consistent benefit for first-attempt and overall success and rested on the strongest evidence base; local warming showed a comparable but less certain effect from limited data. A stratified, context-sensitive approach integrating patient acuity, resource availability, and intervention-specific profiles appears reasonable, although the sparse network and the transitivity assumption temper the certainty of these conclusions.
Advancing recognition of resuscitation medication location in emergencies: A quality improvement pilot project in emergency nursing education using deliberate practice simulation.
Tedford NJ, Diamond JB, Nelsen G … +2 more , Weaver N, Spanos S
Int Emerg Nurs · 2026 Jun · PMID 42364452 · Publisher ↗
INTRODUCTION: Deliberate practice simulation (DPS) is a tool that can enhance learning through repetitive, task-oriented education with immediate feedback. We aimed to increase emergency nurses' knowledge of commonly use...
INTRODUCTION: Deliberate practice simulation (DPS) is a tool that can enhance learning through repetitive, task-oriented education with immediate feedback. We aimed to increase emergency nurses' knowledge of commonly used medications and their storage locations in a pediatric emergency department. METHODS: This quality improvement (QI) pilot project utilized an observational, cross-sectional assessment approach. Through plan-do-study-act (PDSA) cycles, we initiated this project in the pediatric emergency department at a level-one pediatric trauma center. Quantitative needs assessment and baseline data on emergency nurse knowledge of the location of resuscitation medications were collected. "Pass" was considered 26 out of 33 correct (∼79%) on graded electronic assessments. DPS sessions used the crash cart with verbal quizzing on the medications. Data were analyzed using descriptive statistics, and paired t-tests were conducted to determine the effect of DPS on emergency nurses' pass rates on our graded electronic assessments. RESULTS: Thirty-six emergency nurses participated in each cycle. With the use of DPS, there was a notable increase in the percentage of those who achieved "pass" from 8.3% to 55.6% (mean increase of 47.3%, p < 0.01). The proportion of correctly identified medication locations increased from 69% to 78% (mean increase of 9%, p < 0.003). Participants improved on the paired t-test in knowledge assessment scores (mean increase of 4.6 points or 22%, p < 0.00001). CONCLUSION: Our QI pilot project demonstrates notable improvement in emergency nurses' knowledge of resuscitation medication location in emergencies through deliberate practice simulation. These findings suggest DPS can improve resuscitation efficiency and offers a promising approach to emergency nursing education.
Predictive modeling in hospital admission decision-making for obstetric emergency department patients at 18 weeks or more of pregnancy: A retrospective study.
Zhao J, Liu Y, Hu J … +3 more , Huang H, Jiang Y, Gao J
Int Emerg Nurs · 2026 Jun · PMID 42364451 · Publisher ↗
BACKGROUND: This study developed a predictive model for hospital admission decision-making among obstetric emergency department (ED) patients at 18 weeks or more of pregnancy. METHODS: The clinical data of 44,421 patient...
BACKGROUND: This study developed a predictive model for hospital admission decision-making among obstetric emergency department (ED) patients at 18 weeks or more of pregnancy. METHODS: The clinical data of 44,421 patients (22,211 in the training group and 22,210 in the validation group) at 18 weeks or more of pregnancy who visited the ED of a hospital in China in 2024, were included. Least absolute shrinkage and selection operator regression was used for the initial screening of 14 risk factors. Binary logistic regression was used to build a nomogram model. RESULTS: Vaginal fluid leakage, gestational age ≥ 37 weeks, multiple pregnancy, and intrahepatic cholestasis of pregnancy significantly increased hospital admission risk; abnormal fetal movements and re-examination of fetal monitoring were protective factors. The area under the curve values of the nomogram model in the training and validation groups were 0.842 (95% confidence interval (CI): 0.837-0.848) and 0.830 (95% CI: 0.824-0.835), respectively. The calibration curve showed high consistency between predicted values and actual hospital admission rates. Brier scores in the training and validation groups were 0.147 and 0.154, respectively. Clinical decision curve analysis confirmed a significant net benefit when the threshold probability was >15%. CONCLUSIONS: The predictive model facilitates rapid decision-making.
Biomarkers of long-term mortality in seizure patients treated by emergency medical services: Score development and validation.
Bandrés SM, Conty JLM, Polonio-López B … +9 more , Gonzalez SD, Picón CR, Cañamero SR, Jiménez JJB, Rabanales-Sotos J, Mateos LM, Conty-Serrano R, Martín-Rodríguez F, Sanz-García A
Int Emerg Nurs · 2026 Jun · PMID 42364450 · Publisher ↗
BACKGROUND: Seizures are one of the most attended neurological emergencies in the prehospital context. The categorization of the risk of these patients is a great challenge for health professionals, due to the limited in...
BACKGROUND: Seizures are one of the most attended neurological emergencies in the prehospital context. The categorization of the risk of these patients is a great challenge for health professionals, due to the limited information, leading to inaccurate diagnoses. The aim of this study was to explore the development and validation of a long-term mortality predictive score that considers vital signs and biomarkers in seizure patients. METHODS: A prospective, multicenter study was conducted by emergency medical services (EMS) in Spain, including five advanced life support units, 27 basic life support units and four emergency services. The sample consisted of adults who suffered prehospital seizures, in which vital signs and blood tests were recorded using point-of-care tests (POCTs) to predict long-term all cause 1 year mortality. RESULTS: The sample consisted of 198 patients, in whom 33 mortality events were recorded. Our predictive model identified age, Glasgow Coma Scale (GCS) score, hemoglobin, serum Anion Gap (SAG), international normalized ratio (INR), and Charlson comorbidity index as risk factors, revealing and AUC of the score of 0.743 (95%CI 0.624-0.862). CONCLUSION: This study has identified hemoglobin, SAG and INR as prehospital biomarkers capable of predicting long-term mortality in patients who have suffered prehospital seizures. The combination of these new biomarkers to age and GCS into a score available for EMS staff could be a practical and effective tool that improves risk stratification and patient management.
"Sometimes my job is like doing a quiz but never getting the answers": Emergency nurses' experience of patient outcome ambiguity - a survey study.
Caulfield R, Fethney J, Ogilvie R … +2 more , Gullick J, Wiseman T
Int Emerg Nurs · 2026 Jun · PMID 42364449 · Publisher ↗
INTRODUCTION: Emergency nursing involves rapid decision-making, undifferentiated patient presentations, and limited opportunity for follow-up, often leaving patient and family outcomes unknown. Although outcome ambiguity...
INTRODUCTION: Emergency nursing involves rapid decision-making, undifferentiated patient presentations, and limited opportunity for follow-up, often leaving patient and family outcomes unknown. Although outcome ambiguity has been linked to occupational distress, its nature and impact remain poorly understood. Existing knowledge is largely inferred from broader research on burnout and secondary trauma, leaving a gap in understanding how 'not knowing' shapes the professional and personal lives of emergency nurses. OBJECTIVES: This study aimed to explore the frequency, scope, and impact of ambiguity relating to patient and/or significant others' clinical, personal, and social outcomes, and to identify strategies used by emergency nurses to mitigate its effects. METHODS: A 17-item online survey was analysed using descriptive and inferential statistics and reflexive thematic analysis of free-text responses. RESULTS: Almost all participants (99%) reported experiencing outcome ambiguity, most related to whether a patient survived or died. Negative impacts were reported on professional practice (74.8%) and personal life (84.9%). Three themes describing ambiguity salience were identified in free-text data: the impact of extreme events, the vulnerability of paediatric patients, and impacts on the clinician self. CONCLUSION: Outcome ambiguity is pervasive in emergency nursing and affects both professional practice and personal wellbeing. Rare but extreme cases carry disproportionate emotional weight, highlighting the inseparability of clinical, emotional, and ethical dimensions of emergency nursing. Addressing ambiguity is critical to supporting emergency nurses' wellbeing.
Pathways linking emergency department work environment to nurse's burnout: The mediating effects of teamwork and workload.
Kim J, Lee E
Int Emerg Nurs · 2026 Jun · PMID 42364448 · Publisher ↗
INTRODUCTION: Emergency departments are high-intensity environments marked by unpredictable patient inflow and frequent interruptions. Although burnout among emergency nurses is well-documented, the pathways linking the...
INTRODUCTION: Emergency departments are high-intensity environments marked by unpredictable patient inflow and frequent interruptions. Although burnout among emergency nurses is well-documented, the pathways linking the work environment to burnout remain insufficiently understood. OBJECTIVE: This study aimed to determine whether the nursing work environment is associated with burnout among emergency nurses through the lenses of teamwork and perceived workload. METHODS: A cross-sectional survey was conducted with 156 emergency department nurses from general and tertiary hospitals in South Korea. A sequential multiple mediation analysis was performed using the PROCESS Macro Model 6 with 5000 bootstrap samples. RESULTS: A favorable nursing work environment was directly associated with lower levels of burnout and indirectly related to burnout through teamwork and workload. Both teamwork and workload independently mediated this relationship; however, the sequential pathway from teamwork to workload was not significant. CONCLUSION: Burnout among emergency nurses reflects both organizational conditions and individual susceptibility. Prevention strategies should focus on enhancing the nursing work environment and managing workloads, while also acknowledging teamwork as a crucial organizational resource in emergency care settings.
Development of an emergency department missed nursing care scale using the Delphi method.
Wang M, Zhang L, Zhang L … +4 more , Wu C, Xu H, Liu F, Lang H
Int Emerg Nurs · 2026 Jun · PMID 42364447 · Publisher ↗
BACKGROUND: Missed nursing care is a common and critical issue in emergency departments, where high patient acuity, time pressure, and frequent interruptions compromise patient safety and care quality, yet no validated e...
BACKGROUND: Missed nursing care is a common and critical issue in emergency departments, where high patient acuity, time pressure, and frequent interruptions compromise patient safety and care quality, yet no validated emergency-specific missed nursing care scale currently exists in domestic emergency care settings. OBJECTIVES: The aim of this study was to develop a valid and reliable emergency department-specific scale, based on universal and existing specialized scales, to assess missed nursing care in emergency settings. METHODS: A modified Delphi method was used. A total of 21 experts were invited. The process consisted of two rounds. Preliminary scale items were developed through a literature review, qualitative interviews, and research team discussion based on the missed nursing care theoretical model and Maslow's hierarchy of needs theory. From November 2025 to January 2026, 21 experts in emergency medicine, nursing, and nursing management from various healthcare institutions were invited to participate in two rounds of online Delphi studies. The first round involved rating the initial items' importance, proposing viewpoints and suggestions for improvement and identifying of redundant and/or missing items. The second round re-evaluated and provided feedback on the revised items from the first round. RESULTS: Two Delphi rounds were completed: 21 of 24 invited experts responded in Round 1, and 17 of 21 responded in Round 2. Among 91 statements evaluated in Round 2, 88 (96.7%) achieved consensus (importance score ≥ 4 and CV ≤ 0.25). The ultimately formed Emergency Department Missed Nursing Care Assessment Scale comprises three sections: The Emergency Missed Nursing Care Items include five dimensions: Safety-Related Care, Physiological Needs-Related Care, Affection-Related Care, Respect-Related Care, and Cognitive Needs-Related Care, totaling 43 items. The Emergency Missed Nursing Care Causes dimension comprises seven categories: human resource factors, material resource factors, communication factors, nursing team factors, patient family factors, organizational management factors, and work environment factors, totaling 30 items; The Emergency Missed Nursing Care Outcomes dimension encompasses three categories: patient level, nurse level, and hospital level, totaling 15 items, The overall content validity index (S-CVI) of the scale is 0.87. CONCLUSIONS: The Missed Nursing Care Scale, developed using the Delphi method, demonstrates strong content validity, which provides a solid foundation for its scientific rigor. Its reliability is intended to be further verified through large-scale surveys, thereby offering a targeted evaluation tool for investigating missed nursing care in emergency departments. PATIENT OR PUBLIC CONTRIBUTION: Patient participation is a crucial component in the initial development of this scale. We conducted semi-structured interviews with five patients who had received treatment in the emergency department. These interviews aimed to explore their experiences of missed nursing care during their emergency visits, understand the impacts of such shortcomings, and solicit their suggestions for improving care services. Their insights directly influenced the content and relevance of the preliminary scale items. Additionally, this study included perspectives from healthcare professionals by conducting semi-structured interviews with fourteen emergency department nurses. These interviews examined the issue of missed nursing care from a frontline clinical perspective, focusing on its occurrence in daily practice, influencing factors, and perceived consequences. The feedback from nurses played a crucial role in forming the initial item pool, ensuring the scale's contextual appropriateness and its clinical practicality.
Improving capability, opportunity and motivation to support hereditary angioedema patients experiencing life threatening attacks: Pilot evaluation of a video-based training tool for healthcare professionals.
Burton AE, Krajewska M, Olaluyi S … +2 more , Owen A, Dean S
Int Emerg Nurs · 2026 Jun · PMID 42364446 · Publisher ↗
BACKGROUND: Hereditary angioedema (HAE) is a rare inherited illness which causes swelling and can be life-threatening without urgent treatment. Patients who experience life-threatening throat swellings report poor emerge...
BACKGROUND: Hereditary angioedema (HAE) is a rare inherited illness which causes swelling and can be life-threatening without urgent treatment. Patients who experience life-threatening throat swellings report poor emergency care experiences and long-term psychological distress from these encounters. METHODS: A > 5-min video intervention to improve emergency care for hereditary angioedema was developed using behaviour change theory. The video was piloted with nursing students using a mixed-methods evaluation approach including a pre-test post-test pilot experimental design and open-ended survey questions. RESULTS: Capability, opportunity and motivation to support HAE patients in need of emergency care improved following intervention exposure. The video was perceived to be engaging, educational, and motivating and appeared to shift attitudes and intentions towards listening, validating, and acting promptly when caring for patients. DISCUSSION: The short video intervention shows promise for use with emergency care professionals. Improvements could include supplementing the video with further resources and cues to action such as infographics. Evaluation with emergency care professionals and assessment of longer-term information retention and behaviour change is needed.
'Holding the line for patients'-Emergency nurses' experiences during a prolonged physician shortage crisis: A qualitative study.
Kim MH, Yoo HJ
Int Emerg Nurs · 2026 Jun · PMID 42364445 · Publisher ↗
BACKGROUND: A nationwide healthcare crisis, characterized by a strained emergency care system and a significant shortage of physicians, has created substantial shifts in the clinical environment and directly affected eme...
BACKGROUND: A nationwide healthcare crisis, characterized by a strained emergency care system and a significant shortage of physicians, has created substantial shifts in the clinical environment and directly affected emergency nurses who serve on the front lines of patient care. OBJECTIVES: This study aimed to explore emergency nurses' experiences during a prolonged healthcare crisis. METHODS: A descriptive qualitative study was conducted. Data were collected from November 2024 to February 2025. Individual interviews were conducted using semi-structured, open-ended questions. Nurses with at least one year of experience in the emergency department were recruited. Fifteen nurses participated, and the interviews were analysed using conventional content analysis. The study adhered to the Consolidated Criteria for Reporting Qualitative Research. RESULTS: Three themes were identified: (i) Chaos phase: Disruption of emergency department operations (ii) Transitional phase: Nurses' dedicated efforts to fill gaps from physicians' absence, and (iii) Adaptation phase: Stepping into more advanced emergency nursing. CONCLUSION: Emergency nurses play a pivotal role in safeguarding patients' health through close collaboration with physicians and active participation in clinical decision-making. Even during crises, they maintain core nursing responsibilities while providing compassionate care and delivering patient- and family-centered care as a key aspect of their practice. As nursing roles expand, enhancing nurses' competencies requires policy support, including the development of a practical education system and the institutionalization of standardized competency assessments.
Comment on "Effectiveness of AI-assisted ESI triage on accuracy and selected outcomes in emergency nursing: A systematic review".
Narasimharao Davuluri PSL, Segireddy AR, Sheelam GK
Int Emerg Nurs · 2026 Jun · PMID 42361539 · Publisher ↗
Abstract loading — click title to view on PubMed.
Pilot adaptation and preliminary psychometric evaluation of the QuIN16VIPs-ET questionnaire to assess workplace violence among prehospital emergency nurses.
Gheri F, Palomares SM, Ramacciati N
Int Emerg Nurs · 2026 Jun · PMID 42361538 · Publisher ↗
BACKGROUND: Workplace violence (WPV) represents a major occupational hazard in emergency care, yet validated instruments specifically designed for the prehospital emergency care context remain lacking. This study aimed t...
BACKGROUND: Workplace violence (WPV) represents a major occupational hazard in emergency care, yet validated instruments specifically designed for the prehospital emergency care context remain lacking. This study aimed to adapt and conduct a preliminary psychometric evaluation of the Questionnaire for the National Survey on Violence against Emergency Department Nurses (QuIN16VIPs) for use in prehospital emergency care (QuIN16VIPs-ET). METHODS: A prospective pilot study was conducted among 33 prehospital emergency nurses working in an Italian prehospital emergency care service. The adaptation process included expert panel assessment of item clarity and contextual relevance, followed by pilot administration with test-retest evaluation after 7 days. Feasibility outcomes included recruitment, questionnaire completion, missing data, survey usability, and temporal stability. Internal consistency was assessed using Cronbach's alpha and McDonald's omega, while test-retest reliability was evaluated using intraclass correlation coefficients (ICC). RESULTS: The questionnaire demonstrated excellent feasibility, with a 100% completion and retention rate and no missing data across administrations. No operational or technical difficulties were reported during questionnaire administration. Internal consistency was high (Cronbach's α = 0.903; McDonald's ω = 0.905), and test-retest reliability demonstrated excellent temporal stability (ICC range: 0.87-0.94). CONCLUSION: The QuIN16VIPs-ET demonstrated satisfactory feasibility, internal consistency, and temporal stability, supporting its potential applicability in future multicenter psychometric and epidemiological investigations on workplace violence in prehospital emergency care.
Spinal motion restriction in the emergency healthcare setting: A cross-sectional study of knowledge, attitudes, and practices.
Oteir A, Husein M, Alhawatmeh H … +2 more , Chang YT, Williams B
Int Emerg Nurs · 2026 Jun · PMID 42335484 · Publisher ↗
BACKGROUND: Spinal motion restriction (SMR) remains a fundamental component of trauma care, yet its routine application has been increasingly questioned. Evidence supporting selective SMR has grown; however, limited data...
BACKGROUND: Spinal motion restriction (SMR) remains a fundamental component of trauma care, yet its routine application has been increasingly questioned. Evidence supporting selective SMR has grown; however, limited data exist on the knowledge, attitudes, and practices of emergency healthcare providers (HCP) across the prehospital and hospital settings, particularly in low- and middle-income settings. OBJECTIVE: This study aimed to examine knowledge, attitudes, and practices (KAP) towards spinal motion restriction (SMR) among prehospital and in-hospital emergency HCPs in Jordan. METHODS: This is a cross-sectional study using a purpose-built questionnaire. The questionnaire assessed demographics, knowledge, attitudes, and practices regarding SMR. KAP scores were calculated using validated scales with established internal consistency. RESULTS: A total of 363 participants completed the questionnaire. The median age was 30 years (IQR 27-33) and most participants were male (85.1%). Approximately three-fifths (59.8%) were working in hospital settings, and only 36.4% reported receiving prior trauma courses. Overall knowledge related to SMR was low to moderate, with limited awareness of validated selective SMR tools; fewer than one-third of participants reported awareness of the Canadian C-Spine Rule (CCR) or NEXUS criteria. Knowledge scores did not differ significantly between trauma-trained and untrained participants but were higher among prehospital HCPs. Attitudes towards SMR were generally neutral and were not significantly associated with training status or work setting. Self-reported practice scores were relatively high, with no significant differences between prehospital and hospital HCPs or trained and untrained HCPS. CONCLUSION: Despite widespread trauma exposure and training, important gaps persist in SMR-related knowledge and decision-rule awareness among emergency HCPs. Neutral attitudes and high self-reported practice scores may mask inconsistent evidence-based decision-making. These findings highlight the need for targeted, competency-based SMR education and system-level alignment across the emergency healthcare setting, with relevance to emergency care systems in the Middle East and North Africa Region (MENA) and other resource-constrained settings.
Effects of emergency department overcrowding on admitted patient outcomes: A systematic review of etiology and risk.
Agostinho J, Santos E, Santos D … +3 more , Cardoso D, Mota M, Ribeiro O
Int Emerg Nurs · 2026 Jun · PMID 42302416 · Publisher ↗
OBJECTIVE: To determine the effects of emergency department (ED) overcrowding on the following outcomes of admitted patients: mortality; hospital length-of-stay (LOS); time to antibiotic; time to thrombolysis; and time t...
OBJECTIVE: To determine the effects of emergency department (ED) overcrowding on the following outcomes of admitted patients: mortality; hospital length-of-stay (LOS); time to antibiotic; time to thrombolysis; and time to analgesic. METHOD: Systematic review of etiology and risk including adult patients, aged 18 years or more, admitted to ED settings who were exposed to overcrowding. Search strategy ran in MedicLatina, CINAHL Complete, MEDLINE Complete, Cochrane Central Register of Controlled Trials, SciELO, Banco de teses da CAPES, RCAAP, and OpenGrey. Assessment of risk of bias, data extraction, and synthesis were performed by two reviewers independently. RESULTS: Out of 3500 records, 30 fulfilled the inclusion criteria. The results of the studies show that overcrowding in ED contributes to an increase in mortality, longer LOS and delays in the administration of antibiotics and analgesics. No evidence was found that overcrowding influences time to thrombolysis. However, seven of the studies concluded that overcrowding was not associated with increased mortality. CONCLUSION: ED overcrowding has a negative impact on outcomes of admitted patients, highlighting its influence on the quality of care provided in ED settings. In future research, it is important to understand which factors contribute to overcrowding to create strategies to overcome this public health problem.
Beyond communication skills: Language, context, and meaningful communication in pre-hospital emergency care.
Barroso CJV, Sedon MRC, Ontolan CLVO
Int Emerg Nurs · 2026 Jun · PMID 42296641 · Publisher ↗
Abstract loading — click title to view on PubMed.
Network meta-analysis of the effect of different nursing management models on the intra-hospital transport of critically ill patients in the emergency department.
Jiang Y, Hu J, Zhao J … +4 more , Wang L, Gao J, Yang M, Zhao Y
Int Emerg Nurs · 2026 May · PMID 42139854 · Publisher ↗
OBJECTIVE: To evaluate the effects of seven nursing management modes on the intra-hospital transport effect of critically ill patients in the emergency department through a network meta-analysis. METHODS: PubMed, Web of...
OBJECTIVE: To evaluate the effects of seven nursing management modes on the intra-hospital transport effect of critically ill patients in the emergency department through a network meta-analysis. METHODS: PubMed, Web of Science, EMbase, Cochrane Library, CNKI, VIP, Wanfang, and China Biomedical Literature Database were searched for randomized and non-randomized controlled trials on the effect of different nursing management models on the intra-hospital transport effect of critically ill patients in the emergency department, the search period was from January 2014 to October 2024, and Revman 5.4 was used for traditional meta-analysis and ADDIS in data analysis software 1.16.6 Perform a network meta-analysis. RESULTS: A total of 43 studies involving 8009 patients and 7 modes of care management were included. The results showed that in terms of adverse event indicators, safety management (P < 0.00001), risk management (P < 0.00001), PDCA cycle management (P < 0.00001), seamless management (P = 0.003), and risk management combined with PDCA cycle management (P = 0.001) were better than those of conventional care transport. In terms of transfer time, only safety management (P < 0.00001), risk management (P < 0.00001) and seamless management (P < 0.00001) were better than those of conventional nursing transport mode. In terms of patient satisfaction, safety management (P < 0.00001), risk management (P < 0.00001), risk management combined with PDCA cycle management (P = 0.007), and seamless management (P < 0.00001) were better than those of conventional nursing transport mode. CONCLUSION: Among the seven nursing management models, risk management combined with PDCA cycle management may be the optimal management mode to reduce the number of adverse events in hospital transport and improve patient satisfaction, and the safety management model can reduce the time of hospital transport to a certain extent. This study has certain limitations due to factors such as sample size and research methodology, and further verification is needed in the future.
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