Department Nurses Research Articles

Current state and influencing factors in airbag management among emergency department nurses: A multicenter study

BACKGROUND The emergency department (ED) plays a critical role in establishing artificial airways and implementing mechanical ventilation. Managing airbags in the ED presents a prime opportunity to mitigate the risk of ventilator-associated pneumonia. Nonetheless, existing research has largely overlooked the understanding, beliefs, and practical dimensions of airway airbag management among ED nurses, with a predominant focus on intensive care unit nurses. AIM To investigate the current status of ED nurses' knowledge, beliefs, and practical behaviors in airway airbag management and their influencing factors. METHODS A survey was conducted from July 10th to August 10th, 2023, using convenience sampling on 520 ED nurses from 15 tertiary hospitals and 5 sary hospitals in Shanghai. Pathway analysis was utilized to analyze the influencing factors. RESULTS The scores for ED nurses' airway airbag management knowledge were 60.26 ± 23.00, belief was 88.65 ± 13.36, and behavior was 75.10 ± 19.84. The main influencing factors of airbag management knowledge included participation in specialized nurse or mechanical ventilation training, department, and work experience in the department. Influencing factors of airbag management belief comprised knowledge, department, and participation in specialized nurse or mechanical ventilation training. Primary influencing factors of airbag management behavior included knowledge, belief, department, participation in specialized nurse or mechanical ventilation training, and professional title. The belief in airbag management among ED nurses acted as a partial mediator between knowledge and behavior, with a total effect value of 0.513, and an indirect effect of 0.085, constituting 16.6% of the total effect. CONCLUSION ED nurses exhibit a positive attitude toward airbag management with relatively standardized practices, yet there remains room for improvement in their knowledge levels. Nursing managers should implement interventions tailored to the characteristics of ED nurses' airbag management knowledge, beliefs, and practices to enhance their airbag management proficiency.

Comparison of the correlation between moral sensitivity and clinical competence in emergency and intensive care nurses: A cross-sectional-correlation study

IntroductionNurses’ sensitivity to moral issues, especially in emergency and intensive care units is essential for providing complex nursing care. Therefore, the present study aimed to determine the correlation between moral sensitivity and clinical competence in emergency and intensive care nurses. MethodsThe present multi-center cross-sectional correlational study was conducted in 2022 on 180 nurses in five emergency departments and four intensive care units of general hospitals affiliated to Semnan University of Medical sciences. The study tools include a demographic questionnaire, 25 item Lutzen Moral Sensitivity Questionnaire (MSQ), and a standardized Competency Inventory for Registered Nurses (CIRN). Data were analyzed by mean, standard deviation and MANOVA, Pearson’s correlation coefficient test. ResultsThe two groups did not have significant differences in demographic characteristics (p < 0.05). Majority of two emergency department nurses (83.9%) and Intensive care nurses (81.8%) had a moderate level of moral sensitivity. Also, clinical competence of majority of emergency department nurses (73.3%) and Intensive care nurses (75.8%) were in moderate level. There was significant positive relationship between moral sensitivity with Clinical competence in emergency department nurses (p ≤ 0.01, r = 0.61). No significant relationship was observed between moral sensitivity and the clinical competence of intensive care nurses (p > 0.05, r = 0.15). ConclusionsThere is need for improving the level of knowledge of nurses about moral principles and increasing moral sensitivity which can expand the components of clinical competence, especially in intensive care units.

A review of nursing departments in higher education institutions in Turkey

Aims: The presence of qualified nurses is an indispensable element for the health system. The training of qualified nurses depends on nursing education and the provision of this education by specialized nurses. This study aims to examine the nursing departments in higher education institutions in Turkey in terms of some variables. Methods: The data of this descriptive study were collected between March 20 and 31, 2024 by using the “https://yokatlas.yok.gov.tr” and “https://akademik.yok.gov.tr” databases of the Council of Higher Education and the official websites of 158 universities. Results: It was observed that the majority of higher education institutions providing nursing education were located within the Faculty of Health Sciences (82.3%), were state universities (65.9%), and were located in the Marmara region (31.6%). It was determined that there were 3641 academicians in 158 universities throughout Turkey, the highest number of academic staff was in the department of “Internal Medicine Nursing”, the lowest number was in the department of “Education in Nursing”, and 5.5% of the academicians were from non-nursing fields. Conclusion: It was observed that there are widespread departments providing nursing education in universities throughout Turkey, although state universities are predominant, foundation universities also prioritize nursing departments and out-of-field academicians are involved in nursing education.

Assessment of Nurses' Job Satisfaction and Associated Factors in Management of Neurosurgery Procedures at Fujita Health University Bantane Hospital (Aichi, Nagoya, Japan).

Introduction Job satisfaction is a professional aspect that contributes to the achievement of objectives in general and in the health sector; it is a golden standard for having quality care. The satisfaction of nurses is a path toward humanized nursing. This article aims to evaluate the job satisfaction among nurses of the neurosurgery department at Bantane Hospital. Materials and Methods We conducted a cross-sectional study including 74 nurses at Bantane Hospital in Nagoya Japan in August 2023. Nurses responded to a questionnaire relating to job satisfaction. Univariate analysis was supported by bivariate analyses at the 95% significance level. Results The survey revealed that nurses aged between 18 and 29 were mostly represented (62.2%). Drip-injection medication was the most preferred activity (15 times) by Bantane nurses. The satisfaction rate was 63.5% and the fact of considering nurses point of view, good interpersonal relationships, and a considerable lunchtime period was statistically significant ( p < 0.05). Conclusion Transcendental motivation is a priority in the approach to humanize nursing by considering both monetary and nonmonetary incentives to motivate nurses.

The Impact of Online Learning Methods on Nursing Students' Motivation During the Covid-19 Pandemic: A Mixed Method Study

Aim: Online learning methods and digital tools have become more popular since the COVID-19 pandemic. This study investigated the effect of online learning methods on nursing students' motivation during the COVID-19 pandemic. Methods: This study adopted a mixed research design involving a quasi-experimental single-group posttest and a qualitative design. The research was conducted in the spring semester of the 2020-2021 academic year at the department of nursing of a state university in Ankara, Türkiye. The sample consisted of 237 students taking the “Surgical Diseases Nursing” course and the sample of the qualitative stage consisted of 20 students. The research had three stages. In the first stage, participants engaged in online interactive activities (Kahoot, Mentimeter, etc.), discussed case videos, and prepared cases based on group counseling throughout the semester. In the second stage, they discussed the group cases and then filled out the Instructional Materials Motivation Survey (IMMS) and the Achievement-Oriented Motivation Scale (AOMS). In the third stage, the researchers conducted three focus-group interviews to identify participants' experiences with online learning methods. The quantitative data were analyzed using descriptive statistics and Spearman’s correlation coefficient, while the qualitative data were analyzed using content analysis. Results: Participants had a total mean IMMS and AOMS score of 94.83±15.79 and 142.39±18.80, respectively. The results showed that participants were highly motivated by online learning methods. The focus-group interviews revealed three themes: “learning process,” “learning method,” and “personal development/experience.” Conclusion: Nursing students are highly motivated by online learning methods. Most nursing students believe online learning methods make them more motivated and interested, classes more fun, and new knowledge more permanent. They also think that online learning methods facilitate learning. Therefore, universities should offer nursing students more online learning methods.

Barriers and Facilitators of Using Clinical Guidelines for Cardiopulmonary Resuscitation from the Point of View of Emergency Department Nurses

Background: Cardiopulmonary resuscitation (CPR) is an emergency method to restore blood flow and spontaneous breathing in a person who has suffered cardiac arrest. Clinical practice guidelines are recommendations for nurses regarding the care of patients with specific conditions such as cardiac arrest. Accordingly, this study aimed to investigate the experiences of hospital emergency department nurses regarding the implementation of CPR guidelines. Methods: This study was conducted using a qualitative content analysis approach to investigate the experiences of 11 emergency department nurses. The participants were selected using purposive sampling. Data were collected through in-depth semi-structured interviews until saturation was reached. Data were analyzed using the content analysis method proposed by Graneheim and Lundman simultaneously with data collection. Results: Data analysis led to the identification of two main categories and ten subcategories. The categories included "barriers" with five subcategories (lack of knowledge and skills, low motivation, work pressure, lack of facilities, and lack of cooperation among the CPR team) and "facilitators" with five subcategories (facility development, teamwork, conscientiousness, adequate training, and effective supervision). Conclusion: Nursing managers can use nurses’ experiences to find appropriate ways to improve the use of clinical guidelines for CPR.

KNOWLEDGE AND ATTITUDES OF EMERGENCY NURSES REGARDING MEDICATION ERRORS

Medication errors in emergency departments can lead to significant patient harm. Understanding the knowledge and attitudes of healthcare professionals regarding these errors is critical for developing effective prevention strategies. Objective: To assess the knowledge and attitudes of emergency department nurses regarding medication errors. Methods: A descriptive, cross-sectional study was conducted in the Emergency Department of Sheikh Zayed Hospital, Rahim Yar Khan, from March 2023 to March 2024. A total of 150 nurses participated in the study. Data were collected using a 43-item questionnaire available in both Urdu and English. The questionnaire comprised six sections, focusing on knowledge, attitudes, and behaviors regarding medication errors. Responses were recorded on a Likert scale ranging from 1 (totally disagree) to 5 (totally agree). Statistical analysis included descriptive statistics to summarize the responses. Results: The mean age of the nurses was 43.6 ± 16.6 years, with 70% being female and 30% male. A majority of nurses agreed that medication errors can be reduced by calculating drug dosages beforehand (76%), using prepackaged drugs from the pharmacy (62%), and utilizing informative brochures and guidebooks (66%). Attitudes towards error reduction were positive, with recommendations for systematic training of healthcare staff (94%), raising awareness about risk management and prevention (90%), evaluating staff for eligibility (90%), and the importance of reporting and assessing errors (94%). Conclusion: Nurses in the emergency department possess sufficient knowledge and exhibit positive attitudes toward medication errors in the management and administration of IV drugs. However, ongoing training programs and awareness initiatives are essential to update nurses' knowledge and enhance patient safety.

The knowledge and skills of emergency department registered nursing staff at an academic hospital in South Africa, on endotracheal tube cuff manometry, before and after a training session

IntroductionAccurate management of endotracheal tube cuff pressure is essential to prevent patient morbidity and mortality. Due to increased length of stay of critically ill patients in emergency departments, it has become an increasingly important skill among Emergency Department nurses. MethodsThis prospective longitudinal interventional study was performed among registered nurses at the emergency departments in a Johannesburg Academic Hospital. The study aimed to determine their current knowledge and practical skills on endotracheal tube cuff manometry and assess the effectiveness of a training program. The training program was provided once, in the form of a narrated PowerPoint presentation developed by the researchers and involved theoretical and practical components. The participants' theoretical knowledge and practical skills were measured by using questionnaires and skill assessments. The theoretical and practical scores were compared pre- and post-training. ResultsOf the 63 registered nurses employed in the emergency departments, 95 % (60) participated in this study. 86 % reported having never received any formal training on endotracheal tube cuff manometry. Only 38.9 % used cuff manometry as standard practice and only 12.8 % checked it at appropriate 12-hourly intervals. The pre-training median score on theory was 4.5 (IQR=3.0) and improved to 7.0 (IQR=3.0) post-training. The maximum achievable score was 11 with a pre-training average of 41.8 % and post-training of 64.5 % (p = 0.001).The practical pre-training median score was 1.0 (IQR=8.0) and improved to 12.0 (IQR=2.0) post-training. The maximum achievable score was 12 with a pre-training average of 29.1 % and a post-training average of 93.3 % (p = 0.001). ConclusionThis study showed inadequate knowledge and skills on endotracheal cuff pressure manometry among registered nurses in the emergency department. It also correlates with other evidence that supports the need for ongoing training programs. Our training program led to significant improvement among participants in both knowledge and practical skills. This training program was well received by participants and deemed to be practice changing. The recommendation after this study will be for South African emergency units to consider using this study and training material as a guide for annual in-service training.

Nurses’ experience of loss, grief, family health and care targeting patients and families in long-term cancer illness: A qualitative study

PurposeThis study aimed to explore the experiences of registered nurses in hematology departments and primary care settings regarding loss, grief, and family health in adult patients and their families during long-term cancer illnesses. MethodA qualitative study was conducted taking a phenomenological hermeneutic approach. Data were collected between February and March 2023 through individual, semi-structured interviews with 12 nurses working in hematology departments and primary care settings in Denmark. The interviews were recorded, transcribed, and analyzed using thematic analysis. ResultsThe analysis resulted in the identification of four main themes with related subthemes: (1) Patients' individual losses leading to grief reactions, (2) Nurses' experience of families grieving the loss of former daily living, (3) Supporting families with family health as an implicit concept, and (4) Overcoming barriers through nurses’ care interventions targeting family health. Results showed that nurses encountered various losses and grief reactions affecting both patients and families. Barriers such as experience levels and working conditions affected care quality. Despite challenges, nurses addressed these by utilizing communication, involving families, and directing them to additional healthcare services. ConclusionThe study unveiled limited nurse awareness of family health, acknowledging its significance in patient and family care. The findings highlight the importance of improving nurses' comprehension of effectively supporting families as a cohesive unit in the context of long-term cancer illnesses.

Exploring determinants of hand hygiene among nursing students: A theory of planned behavior approach

BackgroundThis study aims to assess the hand hygiene behavior of nursing students and identify the factors influencing this behavior through the “Scale for Assessment Hand Washing Behavior in the Frame of Theory of Planned Behaviour (SAHBTPB)”.MethodsThis descriptive and cross-sectional study was undertaken at the nursing departments of the university’s faculty of health sciences in İzmir, Turkey between 2021 and 2022. A total of 240 nursing students were recruited as participants for this study. Data were collected with the SAHBTPB. The data was analyzed using descriptive statistics, the Chi-square test, and correlation analysis in the SPSS 21.0 program (p < .05).ResultsParticipation rate was 74.76%. The mean age of the students was 20.59 ± 1.59 years and 69.9% were woman. The nursing students’ total mean score of SAHBTPB was 147.5 ± 14.0 (min = 94; max = 176). There was a positively significant association between the total score and students’ gender, graduate level, and hand hygiene education status. There was no significant difference in scale total score mean based on the existence of dermatological problems on the students’ hands or their frequency of hand hygiene (p > .05).ConclusionThe mean scores of nursing students on the SAHBTPB were found to be at a good level. The sub-dimension “intention” was identified as an effective factor in predicting the hand hygiene behavior of the students. The findings have the potential to positively impact nursing education by increasing awareness among students and offering valuable insights for nurses and educators.

Emergency department triage decision-making by registered nurses: An instrument development study.

To develop and psychometrically test the triage decision-making instrument, a tool to measure Emergency Department Registered Nurses decision-making. Five phases: (1) defining the concept, (2) item generation, (3) face validity, (4) content validity and (5) pilot testing. Concept definition informed by a grounded theory study from which four domains emerged. Items relevant to the four domains were generated and revised. Face validity was established using three focus groups. The target population upon which the reliability and validity of the triage decision-making instrument was explored were triage registered nurses in emergency departments. Three expert judges assessed 89 items for content and domain designation using a 4-point scale. Psychometric properties were assessed by exploratory factor analysis, following which the names of the four domains were modified. The triage decision-making instrument is a 22-item tool with four factors: clinical judgement, managing acuity, professional collaboration and creating space. Focus group data indicated support for the domains. Expert review resulted in 46 items with 100% agreement and 13 with 66% agreement. Fifty-nine items were distributed to a convenience sample of 204 triage nurses from six hospitals in 2019. The Kaiser-Meyer-Olkin measures indicated that the data were sufficient for exploratory factor analysis. Bartlett's test indicated patterned relationships among the items (X 2 (231) = 1156.69). An eigenvalue of >1.0 was used and four factors explained 48.64% of the variance. All factor loadings were ≥0.40. Internal consistency was demonstrated by Cronbach's alphas of .596 factor 1, .690 factor 2, .749 factor 3 and .822 for factor 4. The triage decision-making instrument meets the criteria for face validity, content validity and internal consistency. It is suitable for further testing and refinement. The instrument is a first step in quantifying triage decision-making in real-world clinical environments. The triage decision-making instrument can be used for targeted triage interventions aimed at improving throughput and staff education. Dr. Tak Fung who is a member of the research team is a statistician. Development, validation and assessment of instruments/scales. Descriptive statistics. STROBE cross-sectional checklist. The TDI makes the complexity of triage decision-making visible. Identifying the influence of decision-making factors in addition to acuity that affect triage decisions will enable nurse managers and educators to develop targeted interventions and staff development initiatives. By extension, this will enhance patient care and safety.

Study on the integration of emergency IPAs in Nord-Pas-de-Calais: supervisors' perspectives

In the context of the introduction of advanced practice nurses in emergency departments (APNs), the Collège de Médecine d'Urgence du Nord-Pas-de-Calais teamed up with the Unité de Formation et de Recherche des Sciences de la Santé et du Sport at the University of Lille to conduct a survey of emergency department management teams, with the aim of gaining a better understanding of their needs. The results revealed a number of obstacles and levers to the implementation of APNs, and led to a better understanding of the patient pathways in these departments. As a result, the content of the university teaching program could be reviewed with a view to meeting the needs expressed in the field.

Bridging the Gap: Enhancing Open Fracture Care in Emergency Nursing

This study assesses the knowledge and practices of emergency department nurses regarding the care of open fractures, highlighting significant disparities in competence. Conducted across five hospitals, the descriptive, cross-sectional survey included 103 nurses, analyzed using SPSS with results expressed through frequencies, percentages, and Chi-squared tests. Findings reveal that 42.7% of nurses, predominantly females, lack adequate knowledge and care skills, whereas 57.3%, mostly males, are proficient. The study suggests an urgent need for focused training programs to standardize and elevate emergency care for open fractures, aiming to improve patient outcomes through enhanced nursing education. Highlights: Discrepancy in Knowledge: Significant variations in the knowledge and care practices for open fractures among emergency nurses, with nearly 43% lacking sufficient skills. Gender Differences: A notable gender-based disparity in knowledge, with a higher proficiency observed among male nurses compared to female nurses. Need for Training: The urgent requirement for specialized training programs to address gaps and improve overall patient care in emergency situations. Keywords: Open Fractures, Emergency Nursing, Knowledge Gap, Nurse Training, Patient Outcomes

Prediction-Driven Surge Planning with Application to Emergency Department Nurse Staffing

Determining emergency department (ED) nurse staffing decisions to balance quality of service and staffing costs can be extremely challenging, especially when there is a high level of uncertainty in patient demand. Increasing data availability and continuing advancements in predictive analytics provide an opportunity to mitigate demand uncertainty by using demand forecasts. In this work, we study a two-stage prediction-driven staffing framework where the prediction models are integrated with the base (made weeks in advance) and surge (made nearly real-time) nurse staffing decisions in the ED. We quantify the benefit of having the ability to use the more expensive surge staffing and identify the importance of balancing demand uncertainty versus system stochasticity. We also propose a near-optimal two-stage staffing policy that is straightforward to interpret and implement. Last, we develop a unified framework that combines parameter estimation, real-time demand forecasts, and nurse staffing in the ED. High-fidelity simulation experiments for the ED demonstrate that the proposed framework has the potential to reduce annual staffing costs by 10%–16% ($2 M–$3 M) while guaranteeing timely access to care. This paper was accepted by David Simchi-Levi, healthcare management. Funding: J. Dong was partially supported by the Division of Civil, Mechanical and Manufacturing Innovation [Grant CMMI-1944209]. Supplemental Material: The data files are available at https://doi.org/10.1287/mnsc.2021.02781 .

Assessment of Nurse’s Knowledge Regarding Diabetic Ketoacidosis in Laâyoune City, Morocco

Background: Diabetic ketoacidosis represents a life-threatening complication of diabetes, standing as the foremost cause of mortality associated with the condition. The proficient management of patients suffering from diabetic ketoacidosis hinges upon the expertise and proficiency of nurses, who play a pivotal role in the comprehensive care and treatment of these individuals. Aim: The objective of this study was to assess the knowledge of nurses in the Department of Medicine and Intensive Care Unit at Moulay El Hassan Ben El Mehdi Hospital concerning the biological and clinical parameters, as well as the management protocols, for patients diagnosed with DKA. Methods: A self-administered questionnaire was distributed to nurses working in both the Department of Medicine (n=8) and the Intensive Care Unit (n=10) at Moulay El Hassan Ben El Mehdi Hospital in Laâyoune. The questionnaire included variables covering demographic characteristics, clinical information, and biological parameters. Results: The majority of nurses (88.8%) demonstrated adequate knowledge regarding the definition of DKA, with most nurses in both departments displaying familiarity with the biological and clinical manifestations of the condition. In terms of management practices, all nurses reported utilizing saline solution or glucose serum based on the patient's blood glucose levels. Conclusion: The study suggests the implementation of standardized educational programs within intensive care units to enhance nurse staffing, improve the level of patient care, and elevate the quality of care delivered to this patient demographic.

Attitudes, Beliefs, Barriers, and Facilitators of Emergency Department Nurses Toward Patients with Opioid Use Disorder and Naloxone Distribution.

As opioid overdose deaths continue to rise, the emergency department (ED) remains an important point of contact for many at risk for overdose. In this study our purpose was to better understand the attitudes, beliefs, and knowledge of ED nurses in caring for patients with opioid use disorder (OUD). We hypothesized a difference in training received and attitudes toward caring for patients with OUD between nurses with <5years and ≥6years of clinical experience. We conducted a survey among ED nurses in a large academic medical center from May-July 2022. All ED staff nurses were surveyed. Data entry instruments for the nursing surveys were programmed in Qualtrics, and we analyzed results R using a chi-square test or Fisher exact test to compare nurses with <5years and ≥6years of clinical experience. A P-value of < 0.05 was considered statistically significant. We distributed 74 surveys, and 69 were completed (93%). Attitudes toward naloxone distribution from the ED were positive, with 72% of respondents reporting they were "very" or "extremely" supportive of distributing naloxone kits to individuals at risk of overdose. While attitudes were positive, barriers included limited time, lack of system support, and cost. Level of comfort in caring for patients with OUD was high, with 78% of respondents "very" or "extremely" comfortable. More education is needed on overdose education and naloxone distribution (OEND) with respondents 38% and 45% "a little" or "somewhat" comfortable, respectively. Nurses with <5years of experience reported receiving more training on OEND in nursing school compared to those with ≥6years of experience (P = 0.03). There were no significant differences in reported attitudes, knowledge, or comfort in caring for patients with OUD. In this single-center survey, we found ED nurses were supportive of overdose education and naloxone distribution. There are opportunities for targeted education and addressing systemic barriers to OEND. All interventions should be evaluated to gauge impact on knowledge, attitudes, and behaviors.

Exposure to secondary traumatic stress and its related factors among emergency nurses in Saudi Arabia: a mixed method study

BackgroundEmergency department (ED) nurses are exposed to the risk of secondary traumatic stress (STS), which poses a threat not only to nurses’ health and psychological well-being but also adversely affects the execution of their professional duties. The quality and outcome of their nursing services are negatively affected by STS.PurposeThe purpose of this study is to comprehensively investigate the prevalence and intensity of Secondary Traumatic Stress (STS) among Emergency Department (ED) nurses. It aims to identify and analyze the socio-demographic, occupational, and psychological factors that influence the severity and variation of STS experienced by these nurses.MethodsThe study utilized a sequential explanatory mixed methods approach, including two phases. Phase 1 employed a cross-sectional study design, utilizing a convenience sample of 181 nurses to explore the levels of STS and the factors associated with it. Following this, Phase 2 was structured as a qualitative descriptive study, which involved conducting semi-structured interviews with a purposefully selected group of ten ED nurses. Data collection took place at three major hospitals in Saudi Arabia during the period from January to June 2022.ResultsA total of 181 participants were included in the study. The mean STSS score reported by the nurses was 51 (SD = 13.23) out of the maximum possible score of 85, indicating severe STS among ED nurses. Factors associated with an increase in the levels of STS among ED nurses included being female, older in age, married, possessing higher education and experience, having a positive relationship with colleagues, receiving organisational support, and dealing with a higher number of trauma cases. Several themes emerged from the qualitative interviews including: ED Characteristics: Dual Impact on STS, Emotional Resonance and Vulnerability, Personal Life Stressors, The Ability to Cope, and Social Support.Conclusion and implications for practiceFuture strategies and interventions targeting STS should be prioritized to effectively manage its impact on ED nurses. It is crucial to develop targeted interventions that address the specific factors contributing to STS, as identified in this study. Additionally, these findings aim to enhance awareness among nursing administrators, managers, and supervisors about the critical factors associated with STS. This awareness is essential for accurately assessing and developing interventions that mitigate STS among nursing staff.

Nurses' knowledge, attitudes and practices regarding the application of the injury severity score in emergency departments: A cross-sectional multicentre study.

To investigate knowledge, attitudes, and practices regarding the application of the Injury Severity Score (ISS) among emergency department nurses in China and the factors influencing these variables. ISS is the first trauma scoring method to be developed and the most widely used in clinical practice. The correct application of the ISS by emergency department nurses plays an important role in assisting in the diagnosis and treatment of trauma patients, and it is crucial to understand nurses' knowledge, attitudes and practices. A cross-sectional multicentre study. Nurses from the emergency departments of 25 grade II and grade III hospitals in Gansu Province, China participated in this study. Data was collected online using a self-administered questionnaire. Student's t-test or analysis of variance was performed to compare the differences between the groups. Multiple logistic regression analysis identified factors influencing nurses' knowledge, attitudes and practices regarding applying ISS. A STROBE checklist was used to report findings. Among 459 nurses, a good level of attitude and passing levels of knowledge and practice regarding applying the ISS were revealed. Nurses in higher hospital grades, who had been exposed to ISS and received training had higher levels of knowledge and practices. Previous exposure to the ISS and training related to it were factors that influenced nurses' attitudes. Chinese emergency department nurses' knowledge, attitudes and practices of applying the ISS still need to be improved. Hospitals and nursing managers should provide training opportunities for nurses about ISS knowledge and practices, while grade II hospitals should pay more attention to training and continuing education in this area. In hospitals, nursing managers may benefit from enhancing related education and training to promote the emergency department nurses' knowledge and practice of the ISS, by developing specific curricula and providing continuing education and training opportunities, while grade II hospitals should pay more attention to training and continuing education in this area. This study focused on emergency department nurses' knowledge, attitudes, and practices regarding the application of the ISS. The research questions and design were derived from clinical nursing practice, literature review, and expert panel review, and patients or the public are temporarily not involved.

Delegation of Medical Action Authority of Doctors to Nurses in Health Services in Emergency Departments: Empirical Legal

Purpose: This study aims to analyze the implementation of the delegation of authority of medical actions of doctors to nurses in the emergency department and explore the legal responsibility of the delegation of authority of medical actions of doctors to nurses in the emergency department in Indonesia. Theoretical Fremework: Theoretically, this research is expected to contribute intellectually and academically to the enhancement of understanding of healthcare laws for healthcare practitioners, institutional leaders, and to provide a sense of security and protection in carrying out healthcare services functions to the community, especially in the provision of medical procedures at healthcare facilities. Additionally, it is expected to provide practical insights for the goverment, hospital directors, and health departments in order to improve healthcare services to the public and ensure legal protection for healthcare workers in carrying out their professional duties. Method: The type of research method used is empirical legal research. Data primarily obtained from respondents using a list of questions (questionnaire) and direct interviews with the research object. In addition to that, it is also based on legal materials that are relevant to the discussion or problem being researched and other supplementary legal materials that can provide explanations. Results: The delegation of medical action authority from doctors to nurses in healthcare services at emergency rooms is regulated in Article 290 of Law Number 17 of 2023 concerning Health. Medical and healthcare services, consisting of both mandatory delegation. The scope of work delegated through partnership must be clearly and specifically defined in writing within the authority delegation letter and adjusted according to the level of competence of the nurse. The doctor as the delegator and the nurse as the recipient of medical authority there are also responsibilities of the hospital, as well as the central and local governments, especially in meeting the national needs for medical and healthcare personnel. In handling medical dispute cases, law enforcement agencies must prioritize the mechanism of restorative justice. If no agreement is reached, the dispute is then taken over by the professional disciplinary board under the Ministry of Health to determine whether there has been any violation of professional discipline by medical and healthcare personnel. Conclusions: 1) Delegation of authority for doctor’s medical actions to nurses in health services in emergency departments in Indonesia, regulated in Law No. 17 of 2023 concerning Health Article 290, Minister of Health Regulation No. 2052 of 2011 Article 23 and Minister of Health Decree No. HK.01.07-425 of 2020 concerning Nursing Professional Standards; 2) Responsibilities by doctors, nurses, and hospitals regarding the delegation of authority for doctors’ medical actions to nurses in health services in emergency departments must be carried out by laws.

Availability of Pediatric Services and Equipment in Emergency Departments: A Multicenter Study in Resource-Limited Settings.

This study was conducted to assess the availability of equipment and supplies in the emergency departments of the hospitals in the West Bank of Palestine. This study was conducted in a cross-sectional design using a data collection form that was specifically developed for this study. The standardized data collection form contained a detailed list of all essential pediatric emergency equipment and supplies. This study was conducted in a total of 30 hospitals all across the West Bank of Palestine. The median number of patients visiting the emergency department per day was 115.0, the median number of patients admitted to the hospital per day was 14.5, and the median number of pediatric patients visiting the emergency department per day was 6.0. The median number of pediatricians in the hospital was 4.0, the median number of pediatricians in the emergency department was 1.0, the median number of nurses in the hospital was 75.0, and the median number of nurses in the emergency department was 8.5. Both governmental and private hospitals lacked the equipment and supplies needed for monitoring, gaining vascular access, airway management, resuscitation medications, cervical immobilization equipment, and other equipment and supplies. Decision and policymakers might use the findings reported in this study to allocate resources to restock and increase the availability of pediatric emergency equipment and supplies. More studies are still needed to compare the outcomes of patients before and after restocking and increasing the availability of pediatric emergency equipment and supplies.