International Emergency Nursing[JOURNAL]
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200 papers
Pediatric emergency nurses' knowledge, competence, and barriers in trauma-informed care: A cross-sectional study.
Elzeiny A, Loutfy A, Alkubati SA … +4 more , Zoromba MA, El-Monshed AH, Ali AS, Abdelaziz Mohamed FS
Int Emerg Nurs · 2025 Dec · PMID 41248598 · Publisher ↗
BACKGROUND: pediatric emergency nurses play a critical role in caring for children who have experienced traumatic events in the emergency departments. Trauma-informed care (TIC) is an essential approach that considers th...
BACKGROUND: pediatric emergency nurses play a critical role in caring for children who have experienced traumatic events in the emergency departments. Trauma-informed care (TIC) is an essential approach that considers the psychological, behavioral, and social implications of trauma. This study aims to assess pediatric emergency nurses' knowledge, perceived competence, and barriers related to TIC in emergency departments (EDs). METHODS: A cross-sectional design was conducted with 106 pediatric emergency nurses working in the pediatric emergency departments of three public hospitals in Egypt. Data was collected through an interview questionnaire with permission using the TIC Provider Survey Version 2.0 - Pediatric Survey. Descriptive statistics and multiple regression analysis were used to analyze the data. RESULTS: Most pediatric emergency nurses in emergency departments were female (69.8 %). Their mean knowledge score was 39.16 (SD = 9.03), and they expressed favorable opinions about TIC with a mean score of 22.37 (SD = 4.26) (range: 9 to 28). Self-rated competence in specific TIC aspects varied, but providers demonstrated favorable views toward incorporating TIC into their practice overall. The top three significant barriers to TIC implementation were: (1) "Confusing or unclear information on TIC" (67 %), (2) "Scope of practice constraints" (46.2 %), and (3) "Lack of training" (66 %). CONCLUSIONS: Although pediatric emergency nurses in emergency departments demonstrated limited knowledge, with only 4 out of 13 items answered correctly by more than 50% of participants, their overall mean score suggests moderate awareness TIC. However, their practical application emained deficient. Prioritizing enhanced education and training can improve recognition and management of psychosocial and behavioral consequences, positively impacting children's and parents' outcomes while fostering a trauma-sensitive culture among pediatric emergency nurses.
The applicability of artificial intelligence in managing emergency patients: An umbrella review.
Almagharbeh WT, Alharrasi M, Khan Rony MK … +3 more , Kabir S, Alrazeeni DM, Akter F
Int Emerg Nurs · 2025 Dec · PMID 41242110 · Publisher ↗
BACKGROUND: Artificial intelligence (AI) is increasingly reshaping emergency medicine and nursing by enabling faster, more accurate, and scalable decision-making. In high-pressure settings such as emergency departments (...
BACKGROUND: Artificial intelligence (AI) is increasingly reshaping emergency medicine and nursing by enabling faster, more accurate, and scalable decision-making. In high-pressure settings such as emergency departments (EDs), AI technologies have shown promise in improving triage, diagnostics, clinical decision-making, and operational efficiency. Despite this potential, the current body of evidence remains fragmented, with a lack of comprehensive synthesis across diverse AI applications. AIM: This umbrella review aimed to synthesize existing review-level evidence on the applicability of artificial intelligence in managing emergency patients. METHODS: A systematic umbrella review was conducted following PRISMA guidelines. Systematic reviews, scoping reviews, and narrative syntheses focusing on AI in emergency settings were identified through comprehensive searches in five major databases. The search covered studies published between January 2013 and March 2025. Data were extracted on AI types, clinical focus areas, implementation strategies, outcomes, and barriers. The Joanna Briggs Institute (JBI) checklist was used for quality assessment, and findings were synthesized thematically. RESULTS: A total of 24 eligible reviews were included. The analysis revealed AI's significant impact across four major domains: triage and risk stratification, diagnostic support, clinical decision-making, and workflow optimization. Tools such as machine learning and deep learning improved diagnostic accuracy, decision consistency, and patient flow. However, barriers such as interoperability issues, lack of explainability, data privacy concerns, and legal ambiguity were consistently reported. CONCLUSION: AI holds transformative potential in emergency patient management. While clinical benefits are clear, widespread adoption depends on addressing technical, ethical, and regulatory challenges. Future efforts should focus on explainable, validated, and user-integrated AI systems to ensure responsible and equitable implementation in emergency care.
Emergency nurses' roles in supporting surrogate decision-making through remote family meetings: Insights from COVID-19 visitation restrictions.
Momiyama S, Katayanagi H, Nakabayashi M … +4 more , Fujino T, Sato Y, Noguchi T, Hishinuma H
Int Emerg Nurs · 2025 Dec · PMID 41240741 · Publisher ↗
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Development of a core competency assessment framework for frontline nurses responding to infectious disease emergencies: A three-year initiative at a regional medical center.
Xu ST, Li RL, Zhang JF … +4 more , Chen JQ, Chen QF, Zhou JY, Dai ZJ
Int Emerg Nurs · 2025 Dec · PMID 41176870 · Publisher ↗
OBJECTIVE: The aim of this study was to develop a scientifically grounded core competency assessment framework for frontline nurses engaged in infectious disease emergency response. METHODS: An initial index system for e...
OBJECTIVE: The aim of this study was to develop a scientifically grounded core competency assessment framework for frontline nurses engaged in infectious disease emergency response. METHODS: An initial index system for evaluating core competencies was formulated through a comprehensive review of the literature and structured group discussions. The Delphi method was used to conduct two rounds of expert consultation between August and November 2024, involving 18 experts in the field. RESULTS: The expert response rate was 100% in both consultation rounds. The authority coefficients for the experts were 0.886 and 0.953 for the first and second rounds, respectively. Coefficients of variation ranged from 0 to 0.357 in the first round and from 0 to 0.115 in the second. The Kendall's concordance coefficients for the first to fourth-level indicators were 0.222, 0.210, 0.330, and 0.339 in the first round, and 0.325, 0.307, 0.389, and 0.374 in the second round. The finalized framework consisted of 3 first-level indicators, 13 second-level indicators, 42 third-level indicators, and 106 fourth-level indicators. CONCLUSION: The resulting core competency assessment framework demonstrates scientific rigor and comprehensiveness. It offers a practical reference for the selection and training of primary care nursing personnel during infectious disease emergencies and supports the development of emergency nursing teams coordinated by regional medical centers.
Response to the comments on "A systematic review on suction-based airway clearance devices for foreign body airway obstruction".
Limonti F, Palermo N, Paludi MA … +4 more , Semeraro A, Ermanno D, Ganzino S, Ramacciati N
Int Emerg Nurs · 2025 Dec · PMID 41172606 · Publisher ↗
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Noise sensitivity, attention deficit-hyperactivity levels and individualized care behaviors of nurses working in the emergency department: A descriptive and cross-sectional multicenter study.
Yıldız E, Karabey T, Karagözoğlu Ş
Int Emerg Nurs · 2025 Dec · PMID 41172605 · Publisher ↗
AIM: This study was conducted to determine the noise sensitivity, attention deficit-hyperactivity level, and individualized care behaviors of nurses working in the emergency department. METHODS: The descriptive and cross...
AIM: This study was conducted to determine the noise sensitivity, attention deficit-hyperactivity level, and individualized care behaviors of nurses working in the emergency department. METHODS: The descriptive and cross-sectional multicenter study was conducted with 232 nurses working in the emergency department between December 2023 and February 2024. Data were collected using the Personal Information Form, Weinstein Noise Sensitivity Scale, Individualised Care Scale, and Adult Attention Deficit-Hyperactivity Disorder Self-Report Scale. We adhered to the STROBE checklist for reporting. RESULTS: The mean age of the nurses was 30.33 ± 7.12 years (Min:23; Max:62) and 63.4 % were female. The mean total score of the Weinstein Noise Sensitivity Scale was 91.09 ± 16.06, the mean total score of Individualised Care Scale-A was 3.56 ± 0.70, the mean total score of Individualised Care Scale-B was 3.72 ± 0.74, and the mean total score of Attention Deficit-Hyperactivity Disorder Self-Report Scale was 28.40 ± 9.57. CONCLUSION: It was found that nurses had high levels of noise sensitivity, individualized care behaviors, and attention deficit hyperactivity. In the emergency department, high noise levels, distraction and the need for rapid intervention may make nursing care difficult. It is recommended that noise sources be identified and noise reduction interventions be made.
Effect of sleep quality on alarm fatigue among emergency nurses.
Şener A, Çınarlı T, Köse D
Int Emerg Nurs · 2025 Dec · PMID 41161079 · Publisher ↗
BACKGROUND: Considering that patient care is provided for 24 h without interruption in the emergency service, the work roles in this service require a state of full wakefulness. Alarm fatigue is defined as the main cause...
BACKGROUND: Considering that patient care is provided for 24 h without interruption in the emergency service, the work roles in this service require a state of full wakefulness. Alarm fatigue is defined as the main cause of clinical alarm management problems. Alarm fatigue, that cannot be managed in a full sense, may make desensitize emergency nurses and may endanger patient safety. AIM: The aim of the study was to determine the effect of sleep quality on alarm fatigue of emergency nurses. METHODS: This research used the descriptive, cross-sectional and correlational study pattern. The study was completed with 183 emergency nurses from May-November 2023. Data were collected using the Descriptive Information Form, Pittsburgh Sleep Quality Index (PSQI) and the Nurses' Alarm Fatigue Scale. Data were analyzed using IBM SPSS V26 program. RESULTS: Of nurses, 96.2 % worked shifts and 38.8 % stated their monthly working hours were more than 240 h. Of those working shifts, 77.6 % slept after their shift, 56.8 % experienced sleep problems and 43.3 % stated they required support to be able to easily fall asleep. The mean scores on the Nurses' Alarm Fatigue Scale were 24.98 ± 6.16, while mean scores for the PSQI were 9.08 ± 3.48. There was a statistically significant, low level positive correlation between PSQI scores and Alarm Fatigue Scale scores (r = 0.178). Additionally, the simple linear regression model created with the aim of investigating the effect of PSQI scores on Alarm Fatigue Scale scores was identified to be statistically significant (F = 5.897; p = 0.016). CONCLUSION: With the aim of empowering nurses working irregular night shifts in institutions providing health services, offering education and teaching programs should be considered. In conclusion, our research will help to create a safer, more effective and encouraging hospital environment for both patients and emergency service nurses.
The effectiveness of a gate channel device on pain in the pediatric emergency department: A randomized controlled trial.
Andrews TJ, Fennell J, Wrotniak BH … +1 more , Territo H
Int Emerg Nurs · 2025 Dec · PMID 41151204 · Publisher ↗
OBJECTIVES: Phlebotomy is an important source of self-reported pain in the pediatric emergency department. The purpose of this study was to compare the effectiveness of Buzzy®, a vibrating cold device, to vapocoolant and...
OBJECTIVES: Phlebotomy is an important source of self-reported pain in the pediatric emergency department. The purpose of this study was to compare the effectiveness of Buzzy®, a vibrating cold device, to vapocoolant and control in reducing child-reported and parent-perceived pain during IV placement in the pediatric emergency department. METHODS: Patients ages 6-18 years who required IV insertion in the emergency department were randomized to Buzzy, vapocoolant or control groups. The Faces Pain Scale - Revised was used to assess both patient pain and parent perceived pain. RESULTS: 171 patients were randomized into the 3 groups: 56 in the Buzzy group, 57 in the vapocoolant group and 58 in the control group. Patient-reported FACES pain scores decreased significantly from pre- to post-intervention in the Buzzy group (5.41 ± 2.90 to 3.58 ± 2.87, p < 0.01) but not in the vapocoolant group (4.54 ± 2.65 to 3.84 ± 3.12, not significant), or the control group (5.03 ± 3.01 to 4.57 ± 3.43, not significant). Guardian-reported pain scores also showed significant reductions in the Buzzy group (3.46 ± 2.88 to 1.69 ± 2.28, p < 0.01) and vapocoolant group (3.06 ± 2.93 to 2.24 ± 2.56, p < 0.05), with no significant change in the control group (2.86 ± 2.85 to 2.79 ± 2.84). CONCLUSIONS: This study supports the utility of Buzzy® as a clinically effective resource in the management of phlebotomy related pain and demonstrates that it is as good or better than vapocoolant in the pediatric emergency department.
The use of machine learning in predicting clinical outcomes in emergency pre-examination triage: A systematic review of the literature.
Jiang Y, Zhao J, Juan H
Int Emerg Nurs · 2025 Dec · PMID 41151203 · Publisher ↗
OBJECTIVE: To investigate the application status of machine learning model in the prediction of clinical outcomes in emergency pre-examination and triage, and to analyze its characteristics, advantages and disadvantages,...
OBJECTIVE: To investigate the application status of machine learning model in the prediction of clinical outcomes in emergency pre-examination and triage, and to analyze its characteristics, advantages and disadvantages, so as to add an objective tool for medical staff to predict the clinical outcome of patients in the process of pre-examination and triage. METHODS: The literature review method was used to search PubMed, Web of Science, Embase, Cochrane Library, China Biomedical Literature Database, CNKI, Wanfang, VIP and other databases, and the literature that met the inclusion criteria was screened and the specific information of the machine learning model in the literature was extracted. RESULTS: A total of 12 articles that met the criteria were included, including 5 machine learning models, which were mainly used in clinical outcomes such as hospital admission, death, intensive care unit admission, hospital transfer, and home. CONCLUSION: The overall sensitivity of the machine learning model is high, but there are few literature studies on the prediction of clinical outcomes for pre-test triage, so relevant large-sample studies should be carried out in clinical practice to achieve the combination of subjective and objective evaluation tools to improve the accuracy of prediction and ensure patient safety.
Australian rural nurses' experiences of the implementation and impact of HIRAID® emergency nursing framework on nursing practice. A qualitative study.
Kennedy B, Curtis K, Kourouche S … +2 more , Fry M, McCloughen A
Int Emerg Nurs · 2025 Dec · PMID 41124781 · Publisher ↗
INTRODUCTION: Evaluation of implementation strategies by end-users provides valuable insights into mechanisms of use and can identify areas for improvement. In February 2021, the HIRAID® emergency nursing framework was i...
INTRODUCTION: Evaluation of implementation strategies by end-users provides valuable insights into mechanisms of use and can identify areas for improvement. In February 2021, the HIRAID® emergency nursing framework was implemented in 10 sites across a predominantly rural Australian health district. The aim of this study was to explore the emergency nurses' experiences of implementation and perceived impact on nursing practice. METHODS: A qualitative descriptive study was conducted using semi-structured interviews October-December 2021. Emergency nurses were recruited during implementation. Interviews were conducted by telephone, recorded and transcribed verbatim. Data were imported to NVivo and an inductive analytic approach was undertaken, guided by Granheim and Lundman's iterative conventional qualitative content analysis method. RESULTS: Thirteen experienced emergency nurses participated, from eight implementation sites. Four overarching categories were developed. Two related to the impact of HIRAID® on practice, influencing communication and critical thinking. The remaining categories related to organisational and individual factors that can influence implementation, and the educational program design and delivery for staff training. CONCLUSION: Despite identified challenges in implementation in a rural context, participants all perceived some benefit to the HIRAID® intervention. The study highlights areas where modifications should be considered from the end-user's perspective for future implementation activities.
Lessons learned from health and disaster operations during the 2023 Turkey earthquake: Perspectives of foreign relief and health teams.
Kivi HK, Nazari S, Zamani E … +1 more , Mahdian H
Int Emerg Nurs · 2025 Dec · PMID 41110198 · Publisher ↗
BACKGROUND: The 2023 Turkey earthquake represented a significant challenge for health and disaster management systems, necessitating a coordinated response to address the urgent needs of affected populations. This paper...
BACKGROUND: The 2023 Turkey earthquake represented a significant challenge for health and disaster management systems, necessitating a coordinated response to address the urgent needs of affected populations. This paper explores the experiences and insights of foreign relief and health teams deployed during the disaster, highlighting the challenges encountered, strategies employed, and lessons learned. METHODOLOGY: Utilizing a mixed-methods approach, this study incorporates in-depth, semi-structured interviews with health professionals and disaster response workers. Additionally, operational functions and assessments were observed to provide a comprehensive understanding of the response mechanisms employed during the earthquake. Data collection continued until data saturation and collected data were analyzed using the thematic analysis method, and the results were classified into different categories and sub-categories. FINDINGS: Extracting experiences in the earthquake of Turkey in 2023; after conducting 26 interviews and data saturation, was reached. The obtained data were divided into 8 categories and 47 sub-categories. Categories include; Response operations, international aid, social partnership, disease care system, planning and response to health emergencies, environmental health, communication and cooperation, coordination, leadership, and control in health operations. CONCLUSION: The lessons learned from the health and disaster operations during the 2023 Turkey earthquake provide valuable insights for improving disaster response frameworks worldwide. Understanding the complexities of such emergencies is essential for enhancing the resilience of health systems in the face of future disasters. Additionally, Rapid response teams in the healthcare sector must be thoroughly equipped and ready for action, as they often encounter a myriad of challenges during the complex response process of international missions. Their preparedness is critical in effectively addressing emergent health crises, ensuring timely and appropriate interventions in high-pressure situations.
Barriers and enablers to evidence-based practice for the initial management of women with early pregnancy bleeding in the Emergency Department.
Trostian B, Curtis K, Dikshit S … +5 more , Binks S, Smith A, Munroe B, Hicks G, McCloughen A
Int Emerg Nurs · 2025 Dec · PMID 41106240 · Publisher ↗
BACKGROUND: Women with early pregnancy bleeding experience care variations. We developed a guideline based on best available evidence to guide Emergency Department (ED) management. AIM: To identify the barriers and enabl...
BACKGROUND: Women with early pregnancy bleeding experience care variations. We developed a guideline based on best available evidence to guide Emergency Department (ED) management. AIM: To identify the barriers and enablers to the use of an evidence-based guideline for initial management of women with early pregnancy bleeding in the ED. METHODS: A mixed methods survey was distributed to 476 staff from four EDs and one Urgent Care Centre, across a health district. Quantitative data were analysed using jamovi (version 2.3.28) and qualitative data were coded and grouped into subcategories and categories. Enablers and barriers were identified, and quantitative and qualitative results were integrated. FINDINGS: One hundred and four staff completed the survey (response rate 21.8%). Two barriers to evidence-based practice were identified: knowledge and training gap; and ED resources and workload. Two enablers: ED clinician belief about appropriateness of care; and women are willing to stay, wait and/or request care. Two functioned as both enablers and barriers: guideline is available, however elements are absent or not applicable; and ED clinicians are confident in some but not all aspects of care. CONCLUSION: Multiple enablers and barriers were identified that may affect the implementation of evidence-based practice for the management of early pregnancy bleeding.
Paramedic nursing students' experiences of clinical placement in an ambulance where the teacher is another clinical supervisor - A qualitative study.
Seppänen K, Tanninen A, Venesoja A
Int Emerg Nurs · 2025 Dec · PMID 41061504 · Publisher ↗
BACKGROUND: Clinical placements are crucial for paramedic nursing students' and other healthcare students' learning. However, students' experiences of guidance in placements vary. Our aim was to describe paramedic nursin...
BACKGROUND: Clinical placements are crucial for paramedic nursing students' and other healthcare students' learning. However, students' experiences of guidance in placements vary. Our aim was to describe paramedic nursing students' experiences of clinical placement in an ambulance where the teacher was another supervisor. METHODS: This descriptive qualitative study used purposeful sampling to interview 22 paramedic nursing students who completed their ambulance clinical placement with teacher supervision between April and December 2023. Data were analyzed using inductive content analysis. FINDINGS: One main category "Paramedic nursing students' professional growth", and two generic categories "Teachers' supervising competence" and "Student-centered view" were generated. Students highlighted low threshold to ask questions, different perspective on supervising, and experiences of being safe, as well as time spent on ambulance tasks, learning discussions, learning experiences, and a targeted weekly schedule in a clinical placement where the teacher was their supervisor. CONCLUSION: Embedding pedagogically trained teachers as clinical supervisors in ambulance placements enhances paramedic students' professional growth by fostering a safe, structured, and student-centered learning environment. Familiar teacher-student relationships, low thresholds for questions, and reflective learning discussions contribute to meaningful supervision and highlight the need for pedagogical competence in ambulance settings.
South African emergency nurses' perceptions and experiences of workplace violence: A qualitative study.
Maimela KB, Abukari AS, Korsah EK … +1 more , Schmollgruber S
Int Emerg Nurs · 2025 Dec · PMID 41061503 · Publisher ↗
BACKGROUND: Workplace violence (WPV) is a persistent challengein emergency departments (EDs), exacerbated by complex sociocultural dynamics, institutional shortcomings, and insufficient support systems. Emergency healthc...
BACKGROUND: Workplace violence (WPV) is a persistent challengein emergency departments (EDs), exacerbated by complex sociocultural dynamics, institutional shortcomings, and insufficient support systems. Emergency healthcare providers in South Africa work in high-pressure environments, frequently encountering aggression from patients and families who misunderstand the nature of emergency care. AIM: To explore nurses' perceptions and experiences of workplace violence in the emergency departments in South Africa. METHODS: This study used a qualitative descriptive design. Five semi-structured focus group discussions with 20 emergency nurses in South Africa. Data were analysed using thematic analysis. The study followed the COREQ guidelines. FINDINGS: Three themes emerged: contributors to violence, barriers to reporting workplace violence, and environmental and institutional challenges. Contributors to violence were frequently fuelled by public misconceptions about emergency care procedures, particularly unrealistic triage expectations and staff confrontational behaviours. Barriers to reporting were evidenced by unclear reporting protocols, fear of retaliation or futility, and a culture of managerial indifference. The identified environmental and institutional challenges included insufficient security presence, hazardous physical environments, and a lack of structured support mechanisms. CONCLUSION: In South African EDs, WPV is exacerbated by socio-cultural misunderstandings, managerial complacency, and structural weaknesses. Addressing these issues will necessitate comprehensive strategies, such as improved institutional leadership, formalised reporting systems, and proactive safety interventions.
Nurses' perspectives on providing analgesia in the Italian prehospital emergency setting: A phenomenological study.
Sandroni F, Pugliese MP, Magagna S … +3 more , Sebastiani S, Samolsky Dekel BG, Imbriaco G
Int Emerg Nurs · 2025 Dec · PMID 41056830 · Publisher ↗
BACKGROUND: Effective pain management is a fundamental aspect of prehospital emergency care. However, numerous barriers, including inconsistent protocols, limited pharmacological options, and documentation gaps, hinder o...
BACKGROUND: Effective pain management is a fundamental aspect of prehospital emergency care. However, numerous barriers, including inconsistent protocols, limited pharmacological options, and documentation gaps, hinder optimal pain relief. Emergency medical services (EMS) nurses play a crucial role in assessing and managing pain, yet their perspectives on prehospital analgesia remain underexplored. OBJECTIVE: This study aims to explore the experiences and perceptions of Italian EMS nurses regarding prehospital pain management, identifying key challenges and potential improvements. METHODS: A qualitative study was conducted using an interpretative phenomenological approach. Semi-structured interviews were performed with 14 EMS nurses from various Italian regions. Data was analyzed through thematic analysis, identifying recurring themes related to pain assessment, treatment, and documentation. RESULTS: Five main themes emerged: (1) variability in analgesia protocols and pharmacological options, (2) inconsistent pain assessment and documentation, (3) challenges in pain management related to specific patient populations or environmental and logistical factors, (4) nurses' personal experiences shaping their approach to pain management, and (5) interprofessional collaboration challenges. While nurses emphasized the importance of systematic pain evaluation, barriers such as legal restrictions, inconsistent protocols, and limited pharmacological options were frequently reported. CONCLUSION: Prehospital pain management by EMS nurses in Italy faces significant challenges. Expanding protocol-approved pharmacological options, improving documentation practices, and enhancing training for pain management in vulnerable populations could improve care. A standardized, evidence-based national framework is needed to optimize pain relief and ensure equitable patient outcomes.
Emergency nurses' experiences of caring for critically ill patients requiring intensive care in the emergency department.
Akbaş Uysal D, Ekiz E
Int Emerg Nurs · 2025 Dec · PMID 41056829 · Publisher ↗
BACKGROUND: Emergency departments' red zones are complex clinical environments requiring both emergency interventions and intensive care-level services, representing a critical area of focus in this special issue on emer...
BACKGROUND: Emergency departments' red zones are complex clinical environments requiring both emergency interventions and intensive care-level services, representing a critical area of focus in this special issue on emergency critical care. Nurses working in these settings face multifaceted challenges, including role ambiguity, time constraints, and limited resources. However, few studies have explored these experiences through theoretical models. OBJECTIVE: This study aims to provide an in-depth exploration of nurses' experiences delivering intensive care-level care to critically ill patients in the red zones of emergency departments, within a theoretical framework. METHOD: Using a phenomenological qualitative approach, semi-structured interviews were conducted with 21 emergency nurses from various regions in Turkey. Data were analyzed using Braun and Clarke's six-step thematic analysis, and findings were conceptually interpreted through Meleis's Transition Theory and Tanner's Clinical Judgment Model. FINDINGS: Four main themes and eleven subthemes emerged, including challenges in clinical judgment, role incompatibilities, and systemic shortages. Guided by Meleis's framework, findings indicate that adherence to intensive care standards and clinical education enhances competence, confidence, and reflective practice, informing nursing practice and policy. CONCLUSION: Nurses in emergency department red zones face multifaceted challenges, including the demands of multitasking, complexities in decision-making, and structural limitations in providing care for critically ill patients. The study emphasizes that clinical judgment is shaped not only by individual competencies but also by the availability of systemic support. These results underscore the necessity of establishing clear clinical guidelines, implementing structured team-based care models, and developing practice-oriented training programs to facilitate nurses' transition between emergency and intensive care settings.
Adaptation and validation of the critical care family needs inventory - Emergency department (CCFNI-ED) in Indonesian emergency care settings.
Rukhama RA, Septian RB, Listyaningrum D
Int Emerg Nurs · 2025 Dec · PMID 41052484 · Publisher ↗
OBJECTIVES: This study aimed to assess the validity, reliability, and cultural adaptation of the Critical Care Family Needs Inventory - Emergency Department (CCFNI-ED) into the Indonesian language. METHODS: The study was...
OBJECTIVES: This study aimed to assess the validity, reliability, and cultural adaptation of the Critical Care Family Needs Inventory - Emergency Department (CCFNI-ED) into the Indonesian language. METHODS: The study was conducted in three phases, including the translation and cultural adaptation process, content and face validation by six emergency nursing experts, and construct validity and reliability testing through a cross-sectional survey of 120 family members of patients in three emergency departments in Indonesia. Data analysis included the item-level content validity index (I-CVI), Cronbach's alpha, item-total correlation, and exploratory factor analysis (EFA). RESULTS: The results showed a total Cronbach's alpha value of 0.931, with all subscales having values greater than 0.70. The I-CVI value for all items was 1, indicating excellent content validity. EFA yielded six factors from 24 items, explaining 64.7 % of the total variance, with all items showing loadings ≥ 0.50 and communalities > 0.50. The correlations between subscales were significant (p < 0.01), with the strongest relationship observed between participation and communication (r = 0.720). CONCLUSIONS: The CCFNI-ED instrument is valid and reliable for assessing family needs in patient care within emergency settings. This can enhance the quality of family-centered services in emergency departments.
Artificial intelligence for improved decision-making in diabetic emergency survival: A cross-sectional study.
Nikentari LA, Kristianto H, Yuliatun L … +2 more , Haedar A, Tirma Irawan PL
Int Emerg Nurs · 2025 Dec · PMID 41046577 · Publisher ↗
AIMS: This study aims to develop and validate an artificial intelligence -driven survival prediction model using the Random Forest algorithm to support clinical decision-making in diabetic emergency cases. The model is d...
AIMS: This study aims to develop and validate an artificial intelligence -driven survival prediction model using the Random Forest algorithm to support clinical decision-making in diabetic emergency cases. The model is designed to assist emergency nurses in triage prioritization and resource allocation to improve patient outcomes. METHODS: A retrospective cross-sectional study was conducted using medical records of 1,047 diabetic emergency patients treated at regional hospital in Indonesia, from 2019 to 2024. Key clinical variables, including age, gender, blood glucose levels, Glasgow Coma Scale, triage classification, and insulin use, were analyzed. Logistic regression identified significant survival predictors, and random forest model was developed for survival prediction. Model performance was evaluated using accuracy, sensitivity, specificity, and the area under the receiver operating characteristic AUC (Area Under Curve). RESULTS: The random forest model identified GCS and triage classification as the most significant predictors of survival. Patients with higher GCS scores and immediate triage classification (P1) had a greater likelihood of survival. The model demonstrated high predictive performance, achieving an accuracy of 94.9 %, sensitivity of 95.6 %, specificity of 93.7 %, and an AUC of 0.96. CONCLUSION: The AI-based random forest model demonstrated excellent predictive accuracy, supporting its integration into emergency nursing workflows. Implementing AI-driven decision-support systems in emergency departments may enhance triage accuracy, to improve survival outcomes in diabetic emergencies, future studies should focus on external validation and the integration of additional clinical parameters to further refine model performance.
Nasal high flow therapy in the emergency department - A prospective study.
Türe E
Int Emerg Nurs · 2025 Dec · PMID 41046576 · Publisher ↗
Abstract loading — click title to view on PubMed.
Emergency nurses and the care of people who have self-harmed: A meta-ethnography.
Molloy L, Aldahmashi H, Merrick TT … +5 more , Lewer K, Alanazi FK, Doyle L, Keogh B, Wand T
Int Emerg Nurs · 2025 Dec · PMID 41045684 · Publisher ↗
BACKGROUND: Self-harm is a significant public health issue and a key focus of health policies globally. Emergency departments (EDs) often see self-harm cases, with emergency nurses playing a crucial role. However, care i...
BACKGROUND: Self-harm is a significant public health issue and a key focus of health policies globally. Emergency departments (EDs) often see self-harm cases, with emergency nurses playing a crucial role. However, care is inconsistent and substandard due to a lack of evidence-based practices and mixed attitudes among nurses. OBJECTIVE: To understand the social context of emergency nurses' practice with self-harm patients by synthesising qualitative research findings. METHOD: Noblit and Hare's meta-ethnography method was used to synthesise qualitative studies. Three databases (PsychINFO, CINAHL, and MEDLINE) were searched for relevant studies over the period October 2013 to July 2025. Five studies with rich qualitative data were included. RESULTS: Nurses often feel discomfort and uncertainty when caring for self-harm patients due to a lack of knowledge and confidence. Emotional responses like frustration and anger can negatively impact care quality. Service barriers, including time constraints, lack of privacy, and inadequate guidelines, further hinder optimal care. However, with experience and education, nurses develop greater comfort and skills. The presence of mental health specialists in EDs enhances nurses' confidence and care quality. Focused education and training are crucial for changing attitudes and improving care for self-harm patients. CONCLUSION: The meta-ethnography highlights the need for improved education and training for ED nurses in mental health care. Enhancing the physical environment of EDs and fostering a culture of shared responsibility for mental health care can improve service users' outcomes and professional satisfaction for nurses.
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