Emergency Room Nurses Research Articles

The Effect of Occupational Safety and Health Counseling on the Use of Personal Protective Equipment at the Special UPTD of the Medan Hajj Hospital

The development of occupational safety and health science in the work environment can be seen with the development of advanced science and technology as well as the emergence of new innovations in the work environment and encouraging companies to improve the knowledge and skills of their human resources. The purpose of this study is to determine the Influence of Occupational Safety and Health Education (K3) on the Behavior of Using Personal Protective Equipment at the Special UPTD of Haji Medan Hospital. This research includes quasi-experimental research. This study uses a one group pretest and pottest design. The population in this study is emergency room nurses at the Special UPTD of Haji Medan Hospital which totals 50 nurses in June-August 2024. The sampling technique in this study is total sampling. The measuring tool in this study uses a univariate and bivariate distribution of non-parametric data with the Wilcoxon test. The results of the Wilcoxon statistical test of both knowledge and attitude obtained a P-value of 0.000. This means that at alpha 5% there is a significant difference in median score between before and after counseling. Meanwhile, in the aspect of action, there was an increase in the number of PPE users between before and after counseling. Because the results of Asymp.Sig of knowledge, attitudes and actions are less than 0.05, H0 is rejected so that there is an influence of occupational health and safety counseling (K3) on the behavior of using PPE. In conclusion, there is an influence of Occupational Safety and Health Counseling (K3) on the behavior of using personal protective equipment at the Special UPTD of Haji Medan Hospital. The suggestions are expected to increase the frequency of counseling and provide information on the importance of using personal protective equipment in the workplace, provide strict sanctions against nurses who do not use personal protective equipment at work, increase the frequency.

Analysis of knowledge sharing culture and competence on performance mediated by commitment (Study on Emergency Room Nurses at Citra Medika Hospital Sidoarjo)

Analysis of knowledge sharing culture and competence on performance mediated by commitment (Study on Emergency Room Nurses at Citra Medika Hospital Sidoarjo)

Nurse Occupational Stressor Affect Their Clinical Performance and Mediating Role of Emotional Intelligence

This study aimed to investigate the mediating role of emotional intelligence between the relationship of occupational stressors and clinical performance among nurses. This quantitative research was completed through correlational research design. Survey was conducted as a method of data collection with the help of questionnaires. Population was consisted of nurses from the public health sector in Punjab province, Pakistan. A sample of 864 nurses were recruited using convenience sampling technique. Three research instruments were used; Nurses’ Occupational Stressor Scale (Chen et al., 2020), Six Dimension Scale of Nursing Performance (Schwirian in 1978), and Emotional Intelligence Scale (Mehta & Singh, 2013). Findings of study reveal that there was negative relationship between occupational stressor and clinical performance. Moreover, emotional intelligence was negatively correlated with occupational stressor among nurses. In addition, there was a positive correlation between emotional intelligence and clinical performance among nurses. Results depict that occupational stressor are the significant negative predictors of clinical performance. Furthermore, the relationship between occupational stressor and clinical performance was partially mediated by emotional intelligence. Findings evident that nurses who were working in emergency room showed a greater level of occupational stressor as compared to nurses of intensive care unit. Similarly, the married nurses found stressful at workplace as compared to unmarried. Additionally, the nurses who were illiterate of computer skills showed a greater level of occupational stress than who have computer skills. Meanwhile, occupational stress level was greater among the nurses who were on night shift duty as compared to day shift duty. Results suggest that nurses of intensive care unit were found emotionally intelligent and their clinical performance was better as compared to emergency room nurses. The nurses who have the computer skill perform clinically better as compared to those who did not know the computer skill. Furthermore, the findings of the study reveal that the level of emotional intelligence was reported higher among those nurses who had the computer skill. In addition, there was no significant mean score difference was found on clinical performance between unmarried and married nurses. Furthermore, nurses who were unmarried and on day shift duty showed the greater level of emotional intelligence and clinical performance as compared to married and night shift duty. Findings of the study reveal that level of education and age of nurses plays an important role to determine their occupational stressor, clinical performance and emotional intelligence. Stress management training, simulation training should be provided to nurses to enhance their clinical performance in public health sector.

Indication-based and patient-based hand hygiene performance among nurses working at a university hospital.

The traditional method of monitoring hand hygiene (HH) based on specific indications does not ensure that HH is performed for all required indications during patient care. This study aimed to compare HH performance rates (HHPRs) based on specific indications versus overall patient care among nurses at a university hospital. The study retrospectively analyzed HH monitoring data for 1398 indications from 543 patients and 190 nurses. Observations were conducted continuously, tracking a single healthcare worker from before patient contact until the end of the contact within a 30-min period. The indication-based HHPR was found to be 89.1%, while the patient-based HHPR was 78.1%. In the context of patient-based HHPR, the lowest rates were observed among nurses in the emergency room (48.3%) and those with less than 1 year of work experience (66.7%). Moreover, the largest discrepancy between indication-based and patient-based HHPR was noted among emergency room nurses with less than 1 year of experience. This significant difference underscores the need for patient-based HH monitoring, particularly for nurses in emergency settings and those with limited experience.

Feasibility and acceptability of a serious game to study the effects of environmental distractors on emergency room nurse triage accuracy: A pilot study

BackgroundEmergency triage, which involves complex decision-making under stress and time constraints, may suffer from inaccuracies due to workplace distractions. A serious game was developed to simulate the triage process and environment. A pilot study was undertaken to collect preliminary data on the effects of distractors on emergency nurse triage accuracy. MethodA 2 × 2 factorial randomized controlled trial (RCT) was designed for the study. A sample of 70 emergency room nurses was randomly assigned to three experimental groups exposed to different distractors (noise, task interruptions, and both) and one control group. Nurses had two hours to complete a series of 20 clinical vignettes, in which they had to establish a chief complaint and assign an emergency level. ResultsFifty-five nurses completed approximately 15 vignettes each during the allotted time. No intergroup differences emerged in terms of triage performance. Nurses had a very favorable appreciation of the serious game focusing on triage. ConclusionThe results show that both the structure of our study and the serious game can be used to carry out a future RCT on a larger scale. The lack of a distractor effect raises questions about the frequency and intensity required to find a significant impact on triage performance.

Linking patient safety, caring behaviours and professional self-efficacy with missed nursing care among Filipino emergency room nurses: A structural equation model study.

To investigate the interrelationships of patient safety, caring behaviours, professional self-efficacy and missed nursing care among emergency room nurses. Cross-sectional, correlational study. Filipino emergency room nurses (n = 345) participated via convenience sampling from September 2023 to January 2024. Four validated self-report scales were used to collect data and were analysed using Spearman rho, covariance-based structural equation modelling, mediation and path analyses. The emerging model of study variables displayed satisfactory fit indices. Patient safety directly influenced caring behaviours and professional self-efficacy, while negatively influencing missed nursing care. Caring behaviours directly and indirectly affected professional self-efficacy and missed nursing care, respectively. Professional self-efficacy negatively influences missed nursing care. Finally, caring behaviours and professional self-efficacy were significant mediators between the association of patient safety and missed nursing care. Caring behaviours and professional self-efficacy of emergency room nurses demonstrated mediating effects that can potentially improve patient safety practices thereby minimizing unfinished or missed nursing care. Nurses and healthcare organizations should commit to consistently maintain a workplace culture that fosters patient safety, caring behaviours and professional self-efficacy to minimize avoidable injuries and omitting nursing care tasks. STrengthening the Reporting of OBservational studies in Epidemiology (STROBE). No Patient or Public Contribution.

Influence of Grit, Emotional Labor and Job Embeddedness on Retention Intention among Emergency Room Nurses

Influence of Grit, Emotional Labor and Job Embeddedness on Retention Intention among Emergency Room Nurses

응급실 신규간호사의 응급간호 역량별 교육 요구도 분석

Objectives The purpose of this study was to identify the education needs and priorities for emergency nursing competencies of newly employed emergency room nurses, with the aim of using the findings as foundational data for the development of an educational plan to enhance the emergency nursing competencies of newly employed emergency room nurses. Methods This study is descriptive survey research. Subjects were new nurses in emergency room working at re-gional emergency medical centers, local emergency medical centers and local emergency medical service in-stitutions at 26 institutions, and 110 people who understood the purpose of the study and agreed to participate in the study. The data collection period was from June 15 to July 31, 2023, conducted through an online survey through a QR code, and a total of 97 copies were used in the final analysis(88.2% collection rate). As a research tool, a structured self-report questionnaire was used and consisted of a total of 77 questions, including 9 general characteristics, 34 required competency level for emergency nursing competency, 34 perceived competency level for emergency nursing competency. The collected data were analyzed using frequency and percentage, mean and standard deviation, paired t-test, Borich's needs assesment, and The Locus for Focus Model. The priority items from Borich's formula for demand and the items in quadrant 1 of The Locus for Focus Model were examined to determine any redundancy and to establish the priority order of educational needs, distinguishing between top priority and secondary priority. Results The educational needs for reinforcing emergency nursing competencies of newly employed emergency room nurses revealed four top priority items out of 34 (Clinical indicators of deterioration in cardiovascular patient status, Seizure management, Ventilator management, Clinical indicators of deterioration in neurological patient status). Additionally, ten secondary priority items were identified. Conclusions This study identified four top priority items by analyzing the ranking of educational needs to strength-en the emergency nursing competency of new nurses in the emergency room. Accordingly, it is necessary to de-velop strategies for education on top priority items and long-term education on second priority items in order to strengthen the emergency nursing competency of new nurses in emergency rooms.

Factors of Increasing Intention to Use Information Systems

This research is based on information from the IT division regarding non-performance of implementation since the use of HIS at RSU Bhakti Asih began in 2005 until 2022, which has changed three times and none of the implementation achievements for the three HIS have ever reached 100 percent. The aim of this research is to empirically reveal the influence of training and utility on intention to use HIS with work motivation as a mediating variable. This type of research is quantitative with a causality design. The population used is health workers consisting of outpatient nurses, inpatient nurses, emergency room nurses, pharmacy departments, laboratory departments and radiology departments. The sampling technique used proportional sampling, with calculations using the Slovin formula with an error rate of 5 percent, so that the sample size was determined to be 175 respondents. Data collection analysis techniques use survey methods, and data analysis techniques use SEM with the help of the Lisrel program and three box method analysis. The results of the analysis prove that training and utility influence the intention to use HIS with work motivation as a mediator, training influences utility, training and utility influence work motivation and intention to use HIS, and work motivation influences intention to use HIS and is also able to provide positive intervention on the influence training and utility on intentions to use HIS, so that with work motivation, the effectiveness of training and utility will be higher in increasing intentions to use HIS.

Quality of Life of Emergency Department Nurses in Makassar Hospitals on Work Stressors and Job Satisfaction

Hospitals as organizations can place clients and caregivers under a serious burden of stress, which then affects their physical and emotional health. Working conditions in nursing show that work stress can have a big impact on the quality of life of nurses. The aim of this research was to determine the relationship between work stress, job satisfaction and individual characteristics with the quality of life of nurses in the Emergency Unit at Makassar General Hospital. The research method is descriptive using a cross sectional design with a quantitative approach. The results of the study concluded that there was a relationship between age (p value = 0.04), marital status (p value = 0.02), work stress (p value = 0.004) and job satisfaction (0.04) with the quality of life of nurses. However, there was no relationship between gender (p value = 1.00) and level of education (p value = 0.9) with nurses' quality of life. The most dominant factor related to quality of life is work stress. Work stress will affect the quality of life of nurses who work in the emergency room. Work stress affects the quality of life of emergency room nurses. Job satisfaction is related to the quality of life of emergency department nurses. The nurse's age is related to the quality of life of emergency department nurses. The gender of the nurse is not related to the quality of life of emergency department nurses. Nursing education is related to the quality of life of emergency department nurses. Nurses' marital status is related to the quality of life of emergency department nurses.

응급실을 내원한 약물중독 자살시도자의 응급실 기반 자살시도자 사후관리사업 참여 영향요인

Purpose: The purpose of this study was to identify factors that affect the participation of drug intoxication suicide attempters in emergency room-based post-suicide attempt care program for suicide attempters, which is implemented by the country to prevent re-attempts by suicide attempters. Method: This study targeted suicide attempters who attempted suicide by drugs intoxication and visited an emergency room from January 1, 2020 to December 31, 2021. This was a retrospective study that compared the general characteristics, drug intoxication-related characteristics, and treatment-related characteristics of participants and non-participants in an emergency room-based post-suicide attempt care program. Results: There were 416 subjects who visited the emergency room due to suicide attempt drug intoxication. 246 (59.1%) participated in the emergency room-based post-suicide attempt care program and 170 (40.9%) did not participate. Between participants and non-participants in emergency room-based post-suicide attempt care program was significant difference mental illness was significant difference mental illness (χ2=124.91, p<.001), hospital visit time (χ2=8.92, p=.030), systolic blood pressure (χ2=4.71, p=.030), and moderate severity (χ2=12.42, p=.006). Conclusion: Based on the results of this study, in order to increase the participation rate of drug intoxicated suicide attempters in the emergency room-based post-suicide attempter care program, it is necessary to strengthen the capacity of emergency room nurses who initially interview suicide attempters and provide discharge education to respond to suicide attempters. We also suggest developing strategies to prevent suicide re-attempts, such as the development of an administrative system that allows suicide attempters to connect with community counseling organizations after being discharged from the emergency room.

THE RELATIONSHIP BETWEEN TRIAGE ACCURACY AND SERVICE RESPONSE TIME IN THE EMERGENCY ROOM (IGD) AT RSIA BUNDA JAKARTA IN 2023

Background: RSIA Bunda Jakarta's medical record data in 2022 saw an average of 60% of emergency room visits, and in 2023 it will increase to 84%. Emergency Room (ER) nurses and doctors have a very big role and responsibility, namely carrying out triage of patients who will be admitted to the ER. Apart from that, the speed and accuracy of response time in providing assistance to patients greatly determines patient treatment. Purpose: Knowing the relationship between triage accuracy and service response time in the Emergency Room. Methods: Analytical with cross sectional design. The sample in this study was all 30 health workers working in the emergency room at RSIA Bunda Jakarta in January 2024. The sampling technique uses total sampling. Results: The frequency distribution of triage accuracy is mostly appropriate (76,6%) and the response time of nurses and doctors in the ER is mostly correct (80,0%). There is a relationship between the accuracy of triage and the response time of emergency services at RSIA Bunda Jakarta (p value 0,001). Conclusion: There is a relationship between the accuracy of triage and the response time of emergency services. It is hoped that health workers on duty in the emergency room can improve services in accordance with hospital standards so that triage accuracy and fast response time can be created.

Optimization of Nursing Scheduling in Emergency by Using Genetic Algorithm

Scheduling nurse duty is one of the problems in health organizations that is quite complicated to solve. Starting from the uncertain number of patients, serious patient illnesses, characteristics of organizational groups, requests for nurses to take time off, and the qualifications and specialization of the nurses themselves are why scheduling in the ER is difficult to optimize. The same thing is being experienced by one of the health institutions, RSUD Dr. Pirngadi. Preparing schedules or determining the number of nurses on duty is still done manually, resulting in a lack of optimization in scheduling and the number of nurses who must be on duty, especially in the emergency department. In solving this problem, an appropriate method is needed so that the process of scheduling and optimizing the number of nurses can be formed properly. This research applies the Genetic Algorithm in optimal emergency department (IGD) nurse duty scheduling. Genetic algorithms, also called search algorithms, are based on the mechanisms of natural selection and genetics. Genetic algorithms are one of the appropriate methods for solving complex optimization problems. This method is good enough to optimize shift scheduling for the Emergency Room Nursing Service in a Hospital. This Genetic Algorithm can be a solution to multi-criteria and multi-objective problems modeled using biological and evolutionary processes. So, the concept of this method can be applied in optimizing the Nursing Service schedule. The results of calculations using the Genetic Algorithm show quite significant comparisons, including several nurses losing their positions and being eliminated by mutation because they could not compete with several other strong individuals.

Enhancing triage accuracy in emergency nurses: The impact of a game-based triage educational app

IntroductionDigital technology has enabled gamification methods to enhance triage education, reflecting an evolving healthcare landscape. ObjectiveTo evaluate the effectiveness of a Gamification Triage Education App (GTEA) as a learning tool for emergency nurses, with a focus on creating an engaging and educationally effective platform for triage training. MethodThe GTEA was developed using no-code based software and expanded upon previous iterations, with added features such as points, rankings, instant feedback, and quest-based stories. From December 2021 to March 2022, 27 emergency room nurses from three hospitals in Korea were instructed to use GTEA for 100 min over the course of a week. The effects were measured before and after the intervention. ResultsThe results demonstrated a significant increase in triage accuracy from 4.3 ± 2.00 to 5.33 ± 1.47 (t = −2.18, p = 0.039), along with a substantial reduction in overtriage (t = 3.11, p = 0.004). Additionally, increases in critical thinking disposition, triage competency, and triage knowledge were observed (t = −3.11, p = 0.004; t = −2.72, p = 0.011; t = −3.14, p = 0.004, respectively). ConclusionsThe findings provide robust evidence for the effectiveness of gamification in triage training within emergency nursing.

Assessing the Level of Electrocardiographic Interpretation Competency among Emergency Nurses in Palestine.

The use of electrocardiograms (ECGs) is widespread among emergency room (ER) nurses for diagnosis and triage, making it crucial for them to have the appropriate level of competency in interpreting ECGs. This can lead to better healthcare and patient outcomes. This study aims to assess the competency level of emergency nurses in Palestine in interpreting normal ECG and certain cardiac arrhythmias, and to explore the association between socio-demographic characteristics and their ECG interpretation competency. The study used a cross-sectional descriptive design, and 196 ER nurses were conveniently recruited to fill out a self-administered questionnaire based on previous literature. The data collected were analyzed using SPSS with strict adherence to ethical considerations. The results showed that 70.9% of the nurses were males, 65.3% held a bachelor's degree in nursing, 46.9% had 1-5 years of experience, and 60.7% had received previous courses on ECG interpretation. The mean competency level of the ER nurses was satisfactory at 60.714%, but 38.8% had a poor level of competency. This was significantly higher among nurses with higher educational levels (p-value < 0.001), those who had taken previous ECG courses (p-value = 0.045) and life support (p-value < 0.05), and those who were exposed to more ECG interpretations per day (p-value = 0.001). There is a need to focus more on ECG competency levels in Palestinian literature and compare them between different departments. It is also essential to evaluate nurses' needs for continuous education.

Analysis of Knowledge and Nurse Competencies Related to Advanced Care for Trauma Patients in the Emergency Room in South Sulawesi

The Emergency Room is a unit that provides initial treatment for trauma patients. Trauma cases contribute to disability and suffering, making it the fourth leading cause of death worldwide. In 2021, the prevalence of trauma-related deaths was approximately 4.4 million people globally, with 8% of cases resulting in death. This phenomenon highlights the importance of health workers, possessing specialized knowledge and competence in emergencies, including triage, primary,and secondary assessment. The purpose of this study is to analyze the relationship between knowledge and nurse competence in providing follow-up care for trauma cases at the ER in South Sulawesi.The research method utilized in this study is quantitative, employing a cross-sectional approach with a total sample of 37 respondents selected through the total sampling technique. The research was conducted at Ibnu Sina Hospital and Bayangkara Hospital in Makassar. Data were collected through questionnaires and competency observation sheets, and subsequently tested using a correlation test.The results of the univariate test indicate that nurses possess good knowledge in various aspects of follow-up care, including triage, primary survey, and secondary survey. Additionally, their competencies in these areas are also well-developed. The correlation test revealed significant relationships between knowledge and triage competence (p-value of 0.01), knowledge and primary survey competencies (p-value of 0.047), as well as knowledge and secondary survey competencies (p-value of 0.04). These findings suggest that a higher level of knowledge among Emergency Room nurses regarding follow-up care corresponds to better competence in managing trauma cases in the emergency room. In this study, it can be concluded that there exists a relationship between nurses' knowledge regarding follow-up care and their competence in three aspects: triage, primary survey, and secondary survey. Based on these findings, it is recommended that nurses can enhance their competencies through training and can apply high-quality cardiopulmonary resuscitation to improve patient safety.

Emergency room nurses' caring ability and its relationship with patient safety outcomes: A cross-sectional study

IntroductionNurse caring ability plays a crucial role in providing quality care and ensuring patient safety. However, further research is warranted to understand the specific impact of caring ability on patient safety in the emergency department. AimThis study has two-fold purposes: (a) to examine the association between nurses’ demographic characteristics and their perceptions of their caring ability, and (b) to explore the relationship between nurses’ caring ability and nursing care quality, as well as its impact on adverse patient events and missed care. MethodsThis cross-sectional study included a convenience sample of emergency room nurses working in select hospitals in the Philippines. Descriptive statistics and regression analyses were performed to analyze the data. ResultsA total of 164 out of the 200 emergency nurses invited responded to the survey. The mean score for the caring ability inventory was 67.89 out of 80. Nurses' demographic characteristics, including job status (working part-time) and hospital size (working in small and medium-sized hospitals), were associated with higher levels of caring ability. Higher levels of nurses' caring ability were associated with better nursing care quality (β = 0.259, p <.001), a reduction in adverse events (β = -0.169, p <.05), and a decrease in instances of missed care (β = -0.158, p <.01). ConclusionThis study emphasizes the significance of nurses’ characteristics in influencing nurse caring abilities. Additionally, the results underscore the importance of nurse caring ability in the emergency department and its association with nursing care quality and patient safety outcomes. Organizational strategies directed toward promoting and enhancing nurse caring ability in the emergency department can have positive implications for nursing practice, including improved nursing care quality, reduced adverse events, and decreased instances of missed care.

Prevalence of Non-specific Lower Back Pain among Nurses Working in Medical Wards and Emergency Units

The current study aimed to find out the prevalence of nonspecific lower back pain among the nurses of medical wards and emergency units. For this purpose, a cross-sectional study was conducted in various public and private hospitals in Okara, Pakistan. A sample size of 150 female nurses was considered for the study. Moreover, convenient sampling technique and questionnaires were used along with the Oswestry Disability Index to evaluate the lower back pain and the Numeric Pain Rating Scale was used to gauge its severity. Data analysis was performed using SPSS version 22 software.Among 150 female nurses, 44.7% were between 20-30 years old, 36.0% were aged 31-40, and 19.3% were aged 41-50. Out of these 150 female nurses, 61 worked in the medical ward and 89 were working in the emergency department. Statistical analysis with a p-value &lt; 0.05 indicated a significant difference in the occurrence of lower back pain between these two groups. The medical ward had a lower prevalence of 42.3% as compared to the emergency department that had 63.1%, respectively. Conclusively, it was observed that a significant work-related health concern is the incidence of non-specific lower backaches among nurses working in hospital wards and emergency rooms. As compared to nurses in medical wards, emergency room nurses appeared to experience more intensified lower back discomfort due to prolonged working hours.

The Effect of Anthropometric Shoes on Lactic Acid Reduction in Nurses: A Mixed-Methods Study from Indonesia.

The mobilization characteristics of nurses' work, such as standing, walking, and transferring patients for a long time, can increase the risk of musculoskeletal disorders. Repetitive activities nurses perform can cause foot problems such as discomfort and insecurity, characterized by increased lactic acid levels. Anthropometric shoes are specifically designed to reduce complaints on nurses' feet. This study aimed to determine the effect of individual anthropometric shoes on lactic acid levels in nurses at the hospital. This study used a mixed-method study design. This study involved 71 nurses in the quantitative study and 15 nurses in the qualitative study. Nurses in Emergency Room, Central Surgical Installation, Inpatient Room, Intensive Care Unit, and Outpatient Installation were randomly selected using a stratified random sampling technique. The instruments used were the Accutrend Lactacyd tool, demographic questionnaire and interview questionnaire. Bivariate data analysis was using Statistical Package for Social Sciences (SPSS) and qualitative data analysis using thematic analysis. This mixed-method study shows that anthropometric shoes can reduce nurses' lactic acid levels. In the quantitative study; there was a significant difference in lactic acid levels of nurses before and after using anthropometric shoes with the average results of measuring lactic acid levels, namely pre-test (22.48 mg/dL) and post-test (16.27 mg/dL), with a p-value (0.000). The qualitative study data revealed positive results related to increased nurse knowledge, positive views on the effect of shoes on nurse performance, and the impact of using anthropometric shoes in providing comfort and safety, such as decreased muscle fatigue and pain. The findings of this study highlight the effect of individualized anthropometric shoes on lactic acid levels in nurses in Indonesian hospitals. It is essential to conduct further research and evaluate the results in a broader setting to ensure that anthropometric shoes can directly affect lactic acid levels.

Designing of a High-Quality CPR Simulation Game Clinical Scenario for Nursing Students: A Qualitative Study

Cardiopulmonary resuscitation (CPR) is an important skill for nursing students. The process of learning high-quality CPR with a simulation-based learning method can be developed into a simulation game. In order to develop a CPR HQ simulation game, a clinical scenario that can be used as a guide in carrying out storyboards is needed. This research aims to formulate a simulation scenario that will serve as the basis for developing a high-quality CPR simulation game to increase nursing students' competency. This qualitative research uses a Participatory Action Research (PAR) approach by inviting 15 respondents from the prospective user population, namely Emergency Nursing Lecturers, Emergency Room Nurses, BLS Trainers, and nursing students, to carry out Focus Group Discussions. The study's results revealed clinical scenarios that were arranged based on 4 themes, including 1) suitability of the competency being tested, 2) minimum competency for 5 cycles of CPR, 3) settings in the pre-and intrahospital scope, and 4) choice of patient outcome. These components are crucial when designing simulation scenarios that support students’ cognitive processes to achieve High-Quality CPR in nursing students. Thus, the results of this research can then be used as a guide in developing the HQ-CPR game as a learning medium for nursing students.