Emergency Nurses Association Research Articles

Educational Needs of U.S. Emergency Nurses Related to Forensic Nursing Processes.

Forensic nursing is a specialty deployed in patient care areas, including emergency departments, intensive care units, labor and delivery suites, and psychiatric units treating persons who have suffered trauma from a violent or criminal act. The recognition of violence-related injuries in patients presenting to health care facilities is critical to an appropriate care trajectory. These patients require specialized resources beyond the treatment of physical injuries to include psychosocial and legal care that supports patient recovery and pursuit of criminal justice. The purpose of this study is to obtain a broad view of current forensic knowledge and training for emergency nurses working in U.S. emergency departments and to identify gaps in nursing skills and practice such that appropriate education can be developed for this nursing specialty. The study was conducted using a quantitative exploratory, descriptive approach via an emailed cross-sectional survey sent to a convenience sample of U.S. emergency nurses. A total of 43,775 emails were sent out to members of the Emergency Nurses Association. Of that group, 2,493 recipients opened the email, and 1,824 completed the survey, resulting in a total response rate of 4% and a 73% response rate from those who opened the email. Few respondents self-reported competence in the care of patients who experienced child abuse (13.1%), elder abuse (12.4%), interpersonal violence (17.6%), sexual assault (19.2%), human trafficking (7.4%), developmental challenges (7.2%), strangulation (12.5%), or who were suspected of committing a violent crime (11.4%). There is a compelling need to expand forensic education to advance knowledge and skill acquisition in emergency nursing practice and provide staff with additional resources that support a holistic trauma-informed approach to patient care.

Collaboration between Labor and Delivery and Emergency Department to Reduce Severe Maternal Morbidity

Rates of severe maternal morbidity (SMM) continue to increase and one-third of maternal deaths occur in the postpartum period. Postpartum women often present for care to the emergency department (ED). Delays in identification and appropriate management of obstetric complications may occur due to lack of knowledge of obstetric complications and protocols. Recently, AWHONN and the Emergency Nurses Association issued a Consensus Statement regarding the importance of collaboration between the two specialties to promote timely access to obstetric care to prevent SMM.

Weighing All Patients in Kilograms.

The American Academy of Pediatrics has endorsed the following publication: Emergency Nurses Association. Position Statement: Weighing All Patients in Kilograms. Schaumburg, IL: Emergency Nurses Association; 2021. Available at: https://www.ena.org/docs/default-source/resource-library/practice-resources/position-statements/weighingallpatientsinkilograms.pdf?sfvrsn=9c0709e_6.All statements of endorsement from the American Academy of Pediatrics automatically expire 5 years after publication unless reaffirmed, revised, or retired at or before that time.

The Impact of the Coronavirus Pandemic on US healthcare workers: A Discursive Analysis of Frontline Secondary Traumatic Stress Using Twitter Data

The demands of the COVID-19 pandemic have resulted in an increased physical, clinical, and emotional workload for healthcare workers. Both the Veterans Affairs system and the Emergency Nurses Association have recognized the specific hazards and health risks of providing frontline care in this unprecedented global emergency including an increase in multiple factors associated with post-traumatic stress disorder (PTSD). The purpose of this study was to explore real time PTSD in US healthcare workers using Twitter posts and to describe the impact on healthcare workers as the pandemic unfolds across the US. 1000 tweets were randomly selected from a larger dataset of 443,918 tweets by 281,021 unique authors posted using the hashtags #getmePPE and #getusPPE. Directed content analysis and discourse analysis were used to analyze the tweets and place them into a larger conversation about the pandemic. Healthcare workers and others, using a digital community setting delineated by the hashtags #GetUSPPE and #GetmePPE created a conversation centering around fear of illness, alarm at pandemic spread, and frustration at the label of “hero”, which is unsupported by resources at the local or Federal level. healthcare workers as a group have grave concerns, and high stress levels about inadequate material support (specifically personal protective equipment, or “PPE”) during the first 3 months of the Covid-19 pandemic. Real time analysis using social media posts as a dataset is a useful and feasible methodological approach for explicating the healthcare discourse within the social and political context of this pandemic. Keywords: emergency care; secondary traumatic stress; Covid-19; discourse analysis; emotional workload

Suicide Screening and Risk Assessment in the Emergency Department: Case Review of a Suicide Attempt Survivor

One in 10 of those who die by suicide are seen in an emergency department within the 2 months before their death. Despite national guidelines and resources (including from the Joint Commission and Emergency Nurses Association) for suicide screening, risk assessment, and follow-up care, suicidal ideation and behavior continue to go undetected in emergency departments, leading to gaps in care. This case review was conducted as part of a larger electronic medical record review of emergency department practices and aims to highlight potential gaps in care and identify missed opportunities for suicide screening and risk assessment. In addition to highlighting these missed opportunities, this case review provides recommendations for suicide screening and risk assessment resources with options for evidence-based follow-up care for suicidal patients.

The Impact of Burnout on Emergency Nurses’ Intent to Leave: A Cross-Sectional Survey

IntroductionEmergency nurses work in one of the busiest and most stressful departments in a hospital and, as such, may experience burnout more often than nurses working in other nursing units. This study examined the relationship among orientation, burnout (emotional exhaustion, depersonalization, and low sense of personal accomplishment), and intent to leave. MethodsA cross-sectional survey design was used. Emergency nurses who were members of the Emergency Nurses Association were invited to participate in an anonymous survey. The Maslach Burnout Inventory tool was used to explore emotional exhaustion, depersonalization, and sense of personal accomplishment. Emergency nurses’ intent to leave was assessed with the Turnover Intention Scale. A logistic regression analysis was used to investigate the odds of intent to leave for those who scored at or above versus below the median on each burnout subscale. ResultsThe findings revealed that a formal orientation enhanced emergency nurses’ sense of personal accomplishment and was associated with lower intent to leave. The odds of intent to leave were almost 9 times greater for participants with 5 or more years of experience, approximately 13 times greater for those with above-median emotional exhaustion, and more than 6 times lower for those with above-median sense of personal accomplishment. DiscussionEmotional exhaustion and low sense of personal accomplishment were key factors influencing emergency nurses’ intent to leave. Emergency nurse leaders may find that a formal orientation program enhances sense of personal accomplishment and decreases intent to leave. Creating work environments to help emergency nurses find joy in their work may be critical to work–life balance and staff retention.

Implementing a Novel Nursing Site Manager Role in the Pediatric Emergency Department for Patient and Staff Safety During the COVID-19 Pandemic

Implementing a Novel Nursing Site Manager Role in the Pediatric Emergency Department for Patient and Staff Safety During the COVID-19 Pandemic

A Regional Intervention to Appoint Pediatric Emergency Care Coordinators in New England Emergency Departments.

The aim of this study was to describe our expansion of a Massachusetts grassroots initiative-to increase the appointment of pediatric emergency care coordinators (PECCs) in emergency departments (EDs)-to all 6 New England states. We conducted annual surveys of all EDs in New England from 2015 to 2020 regarding 2014 to 2019, respectively. Data collection included ED characteristics. The intervention from 2018 to 2019 relied on principles of self-organization and collaboration with local stakeholders including state Emergency Medical Services for Children agencies, American College of Emergency Physician state chapters, and Emergency Nursing Association state chapters to help encourage appointment of at least 1 PECC to every ED. Most ED leadership were contacted in person at regional meetings, by e-mail and/or telephone. We reached out to each individual ED to both educate and encourage action. Survey response rates were greater than 85% in all years. From 2014 to 2016, less than 30% of New England EDs reported a PECC. In 2017, 51% of EDs in New England reported a PECC, whereas in 2019, 91% of New England EDs reported a PECC. All other ED characteristics remained relatively consistent from 2014 to 2019. We successfully expanded a Massachusetts grassroots initiative to appoint PECCs to all of New England. Through individual outreach, and using principles of self-organization and creating collaborations with local stakeholders, we were able to increase the prevalence of PECCs in New England EDs from less than 30% to greater than 90%. This framework also led to the creation of a New England-wide PECC network and has fostered ongoing collaboration and communication throughout the region.

Access to Optimal Emergency Care for Children.

Every year, millions of pediatric patients seek emergency care. Significant barriers limit access to optimal emergency services for large numbers of children. The American Academy of Pediatrics, American College of Emergency Physicians, and Emergency Nurses Association have a strong commitment to identifying these barriers, working to overcome them, and encouraging, through education and system changes, improved access to emergency care for all children.

Emergency Nurses’ Knowledge, Attitudes, and Practices Related to Blood Sample Hemolysis Prevention: An Exploratory Descriptive Study

IntroductionThe aim of the study was to identify emergency nurses’ knowledge, attitudes, and practices related to blood sample hemolysis prevention and explore associations between these factors and demographic characteristics. The current state is unknown. Understanding baseline knowledge, attitudes, and practices addresses a gap in the literature. MethodAn exploratory, descriptive design with cross-sectional survey methodology employing a study-specific instrument was used. ResultsRequest for participation email was sent to a random sample of 5000 Emergency Nurses Association members, and 427 usable surveys were returned (response rate = 8.5%). Mean years in nursing was 13.85 (standard deviation = 10.78), and 226 (52.9%) were certified emergency nurses. Only 85 participants (19.9%) answered all 3 knowledge questions correctly. Answering the 3 knowledge questions correctly was significantly associated with being a certified emergency nurse (χ2 = 7.15, P < .01). Participant responses to attitude items about the sequelae of blood sample hemolysis were skewed toward agreement, and most attitude items were associated with whom participants reported as being primarily responsible for phlebotomy. Emergency nurses remain primarily responsible for phlebotomy as well as addressing hemolyzed samples, but few reported that blood sample hemolysis was addressed at a departmental level. DiscussionFindings suggest that emergency nurses lack some knowledge related to blood sample hemolysis prevention best practices. Attitudes toward phlebotomy practices may be 1 reason practice has not changed. Every effort should be made to prevent hemolyzed blood samples to decrease delays and costs in emergency care.

Disinfection of Ultrasound Transducers Used for Percutaneous Procedures: Intersocietal Position Statement.

Disinfection of Ultrasound Transducers Used for Percutaneous Procedures: Intersocietal Position Statement.

Establishing Research Priorities for the Emergency Severity Index Using a Modified Delphi Approach

IntroductionThe accuracy of an initial ED triage decision has been reported to drive the clinical trajectory for ED patients, and, therefore, this assessment is critical to patient safety. The Emergency Severity Index—a 5-point score assigned by a triage nurse and based on disease acuity, patient potential for decompensation, and anticipated resource use—is used both in the United States and internationally. In the US, the Emergency Severity Index is used by up to 94% of the academic medical center emergency departments. In 2020, the Emergency Nurses Association acquired the intellectual property rights to the Emergency Severity Index and is responsible for its maintenance and improvement. ObjectiveThe purpose of this study was to establish a research agenda for the improvement of individual and institutional understanding and use of the Emergency Severity Index. MethodsModified Delphi process was used with 3 rounds of data collection. ResultsRound 1 yielded 112 issues, which were collapsed into 18 potential research questions in 4 general categories: education and training (6 questions), workplace environment (3 questions), emergency care services (7 questions), and special populations (2 questions). These questions were used in round 2 to establish importance. Round 3 yielded a rank ordering of both categories and research questions. DiscussionThe research priorities as set through the use of this modified Delphi process align well with current gaps in the literature. Research in these areas should be encouraged to improve the understanding of educational, environmental, and process challenges to emergency nurses’ triage decisions and accuracy of Emergency Severity Index assignments.

Deciding to post a manuscript preprint

Deciding to post a manuscript preprint

Preparedness of members of the Indonesian emergency and disaster nurses association

Disaster is a global issue all around the world, and Indonesia has shifted its disaster mitigation strategies from emergency response to disaster management preparedness. This research analysed factors influencing the preparedness of members of the Indonesian emergency and disaster association (IEDNA) in the face of natural disasters in Indonesia. This research is analytical-observational with a cross-sectional approach. Sampling was performed on a population of 510 member nurses of the IEDNA by the probability sampling technique. Out of the 510 member nurses of the IEDNA, 107 were enrolled in this research. The Fisher’s exact test results show that knowledge had p= 0.001 (p&amp;lt; 0.05), while facilities and infrastructures availability p= 0.000 (p&amp;lt; 0.05), in their effects on nurse preparedness. The multivariate analysis yielded Exp(B) of 0.022 for knowledge and Exp(B) of 0.003 for facilities and infrastructures availability, while the Nagelkerke’s R-squared obtained was 66%. The variable preparedness was largely good, and there were significant relationships of knowledge and facilities and infrastructures availability to the preparedness of members of the IEDNA. The strongest factor was knowledge.

Evaluation of a Nurse Pediatric Emergency Care Coordinator–Facilitated Program on Pediatric Readiness and Process of Care in Community Emergency Departments After Collaboration With a Pediatric Academic Medical Center

Each year, more than 30 million ill and injured children are cared for in 5,000 emergency departments in the United States, of which most children access care in 1 of 4,500 community emergency departments (CEDs) that are not solely prepared to care for children.1,2 These CEDs vary in terms of the total volume of pediatric patients where many of them care for fewer than 5 children a day. In 2006, the Institute of Medicine described pediatric emergency care in the US as “uneven.”3 In response to this report, key stakeholders—including the American Academy of Pediatrics, the American College of Emergency Physicians, and the Emergency Nurses Association—developed Joint Policy Statement Guidelines (JPSG) for the emergency care of children.

Advancing Emergency Nurses’ Leadership and Practice through Informatics

Collection of data in healthcare is vitally important to inform healthcare resource planning and monitor effectiveness of care. The Canadian Emergency Department information System and Canadian Triage Acuity Scale are primary tools for collecting such data. Although emergency nurses use these tools to collect significant patient and healthcare data on daily basis, their understanding of the purposes and implications for collecting these data is sub-optimal. Furthermore, emergency nurses’ awareness about informatics, and the limited representation in information and communication technology strategic initiatives and research within Canadian emergency nursing are some barriers preventing nurses from realizing the full benefits of information and communication technology to improve patient and system outcomes, and nursing knowledge development. The National Emergency Nurses Association is well positioned to provide the leadership required to move nurses from being data collectors, to information users by maximizing their potential to advance Canadian emergency nursing practice through informatics.

Exploring National Nursing Readiness for a Radiological or Nuclear Incident: A Cross-Sectional Study

IntroductionAs the largest component of the United States health care workforce, nurses will play a critical role in radiological or nuclear disaster medical response. Despite this, the United States’ schools of nursing are not currently providing radiation content (75% teach zero or <1 hour), and much of the current nursing workforce may not have received adequate response education and training. Nurses working in emergency departments and those who work at hospitals within the Radiation Injury Treatment Network will be relied on heavily, but little is known about whether these nurses possess the knowledge and skills needed to care for and protect patients after a radiation emergency. Current federal and state radiological/nuclear preparedness plans may be built on false assumptions of readiness, which would have serious implications for national preparedness and the National Health Security Strategy. The purpose of this study was to assess nurses' knowledge and skill in emergency radiological or nuclear response and determine their willingness to use mobile technology for education and training in response to a large-scale radiation event. MethodsDescriptive cross-sectional survey of registered nurse members of the Emergency Nurses Association and/or those employed at Radiation Injury Treatment Network centers. ResultsKnowledge scores were low for all respondents. Prior attendance at a Radiation Emergency Medical Management course, use of online resources, and having a preparedness plan were associated with higher scores. Experience with a radiation emergency was associated with the highest score. Nurses are willing to use mobile technology during a radiological or nuclear disaster response. DiscussionKey nurses may not possess adequate knowledge or clinical competence to participate in radiation response activities. The results of this assessment identified educational gaps and areas to strengthen nursing education and clinical skills.

Violence Towards Nurses Staff at Teaching Hospitals in Mosul City

Background: Defining violence is one of the most common types of abuse at work in health care systems. The U.S. The Emergency Nurses Association found that workplace violence in the health service (3.8) is greater than privacy abuse, and also that the emergency room was especially susceptible. Objectives: To determine the violence against nurses in (ED)at teaching hospital in Mosul city/Iraq Method: To accomplish the study a retrospective research approach (2 years) was used. Sample study (218) nurse, (100) female, while male (118). The instrument developed by (Brislin, 1970) The questionnaire consist of (3) parts: part I includes demographic characteristics (6) variable such as (age, sex, qualification,working place, experience years and experience of ED). Part II: includes the main causes of the physical violence (eight items).Part III: include nonphysical violence (eight items). Results: The study found more than one-third of nurses was subject to physical abuse almost (37.61%), most of them exposure to nonphysical violence (73.3%). that mean the assault direction nurses in ED are widespread. Conclusion: The researcher concluded that the assault direction nurses who work in ED are widespread epically nonphysical violence, the most of the perpetrators of the assault direction the nurses in the EU are the relatives.

Emergency Department Nurses Attitudes Toward Barcode Medication Administration

Abstract&#x0D; Background: Barcode medication administration (BCMA) has been widely implemented in the inpatient setting of hospitals throughout the United States, resulting in lower medication administration errors. Understanding nurses’ attitudes toward BCMA in the Emergency Department (ED) may assist administrators with creating implementation strategies that will improve medication administration process turnaround time and remove barriers to use ensuring increased compliance and improved patient safety.&#x0D; Methods: The aim of this descriptive research study was to identify Emergency Department nurses’ attitudes towards acceptance of this technology, based on the Unified Theory of Acceptance and Use of Technology (UTAUT). Data collection was carried out using an online, cross-sectional survey of nurses (n=55) who were members of the National Emergency Nurses Association of Canada.&#x0D; Results: The results demonstrated that two-thirds of those surveyed had approximately one year of experience with using BCMA technology. More positive attitudes were found in the following domains: behavioral intent, anxiety, and self-efficacy. Neutral attitudes were perceived regarding facilitating conditions, social influence, and effort expectancy. The most negative attitudes were expressed regarding attitude toward technology and performance expectancy.&#x0D; Conclusions: The results of this study allow us to conclude that the ED nurse perceived BCMA as easy to master and use and not intimidating or anxiety producing; however, they do not perceive it as useful nor do they perceive it to improve their proficiency or productivity. It is recommended that future studies be conducted on larger samples and also on participants that have had more experience using this technology.&#x0D; Keywords: Barcode Medication Administration, Emergency Department, Medication Administration, Attitudes.&#x0D; &#x0D;

A Cross-Sectional Examination of the Factors Related to Emergency Nurses’ Motivation to Protect Themselves Against an Ebola Infection

IntroductionThe 2014-2016 West African Ebola outbreak impacted the United States. Owing to the sporadic occurrence of the Ebola infection, there is insufficient research regarding how US emergency nurses provide care to patients potentially infected with the Ebola virus and the nurses’ motivation to protect themselves when providing care to these patients. This study aimed to investigate the predictors of emergency nurses’ protection motivation. MethodsA cross-sectional design was employed. A survey developed based on a modified Protection Motivation Theory was administered to randomly selected members of the Emergency Nurses Association. Descriptive statistics, nonparametric Kruskal-Wallis H test (as well as post hoc Dunn-Bonferroni test), Spearman rho correlation, and stepwise multiple linear regression were conducted for data analysis. ResultsProtection motivation was found in 2 components: proactive and passive protection motivation. Regression analysis indicated that response efficacy (β = 0.27, P < 0.001) and self-efficacy (β = 0.17, P < 0.01) significantly predict emergency nurses’ proactive protection motivation, whereas perceived vulnerability (β = 0.26, P < 0.001), response cost (β = 0.19, P = 0.001), and knowledge (β = −0.15, P < 0.01) significantly predict emergency nurses’ passive protection motivation. DiscussionThe results indicate the need for interventions to improve emergency nurses’ response efficacy, self-efficacy, and knowledge, while simultaneously reducing the nurses’ perceived vulnerability and response cost. Such interventions would be expected to proactively motivate nurses to protect themselves when providing care to patients who exhibit the signs and symptoms of an Ebola infection and reduce their passive protection motivation.