Perceptions Of Emergency Nurses Research Articles

Emergency Nurses' Perceptions of Family Presence during Resuscitation: A Thematic Analysis

Purpose: This study examined the perceptions of emergency nurses regarding family presence during resuscitation (FPDR) in light of the international emphasis on family-centered care in the medical field and aimed to reach a progressive new understanding of family-centered care. Methods: Data were collected through in-depth interviews with 15 emergency room nurses with over 3 years of experience in participating in cardiopulmonary resuscitation from February to September 2021, and thematic analysis was employed for data analysis. Results: Four themes emerged: “unfamiliarity with FPDR,” “burden of accommodating family presence,” “realization of the significance of family presence,” and “overcoming the practical barriers to the realization of FPDR” along with 14 sub-themes. The participants felt that having family members present in the emergency setting was impractical and raised concerns about possible conflicts between families and nurses. However, despite these worries, they acknowledged the value of this experience in fostering unity and providing comfort during the therapeutic process. They also recognized the significance of taking practical steps to ensure effective family presence. Conclusion: Emergency nurses were unfamiliar with the concept of FPDR. While accommodating family presence in an emergency setting can pose burdens and challenges, they recognized the significant positive aspects of togetherness. Therefore, to effectively implement FPDR in a way that benefits healthcare professionals and families, it is necessary to establish specific protocols and education for FPDR.

Facilitators and barriers of appropriate and timely initial fluid administration in sepsis: A qualitative study

BackgroundSepsis is a medical emergency requiring prompt recognition, and early administration of intravenous fluids and antibiotics. While compliance with appropriate and timely administration of intravenous fluids has been found to be poor, the reasons are not well understood. Therefore, we have explored the experiences and perceptions of emergency nurses and medical officers from four hospitals to identify the associated facilitators and barriers. MethodsQualitative design incorporating six focus group discussions and thematic analysis of data. A hybrid approach using both inductive and deductive reasoning was used. FindingsFour key themes were developed: 1. Overcrowding and understaffing threaten appropriate fluid management in sepsis; 2. Variations in clinical practice results in suboptimal fluid management; 3. Challenges with clinical recognition of sepsis impedes timely fluid administration; 4. Top-down approach is necessary to improve fluid management. ConclusionThemes highlighted the specific challenges associated with fluid administration in sepsis in the emergency department setting providing potential strategies to be implemented to improve practice and ultimately patient outcomes.

Nurses’ perceptions of night shifts: A qualitative study

AimTo describe the experiences and perceptions of emergency nurses regarding the shortening of night shifts and identify aspects of nurses' preferences for night shifts. BackgroundShift work can be associated with distinct physical and psychological disadvantages for nurses, especially night nurses. Knowledge regarding the factors influencing their perceptions of night shifts is limited. MethodsA qualitative description design. Fifteen nurses from the emergency setting with 6 to 14 years of work experience participated in interviews. Semistructured interviews were conducted between November 2018 and March 2019. A thematic analysis was performed for the data analysis. FindingsThe following three themes emerged: (1) maintaining quality within quantity, (2) maintaining comfort within busyness, and (3) buffering the gap between ideal and reality. ConclusionsConsidering work intensity and patient safety, nurses believe that an 8 h night shift is the most suitable length for the emergency department. Long shifts are probably more suitable for other departments with lower night workloads.

Professional and psychological perceptions of emergency nurses during the COVID‐19 pandemic: A qualitative study

AbstractAimTo explore the changing roles and responsibilities, difficulties, feelings, and coping strategies of emergency nurses during the COVID‐19 pandemic.MethodsThis study was conducted as a qualitative study using a phenomenological approach. A total of 12 emergency nurses were recruited using purposive sampling from a COVID‐19‐designated hospital in Konya, Turkey for qualitative study. Data were collected through semi‐structured individual interviews in January 2021. The data were analyzed using the content analysis method with the MAXQDA 2020 software program. The study conforms to the consolidated criteria for reporting qualitative research checklist.ResultsFour theme categories emerged from the data analysis: (a) “Increasing roles and responsibilities as an emergency nurse”; (b) “Difficulties of working in pandemic conditions”; (c) “Emotional responses in the pandemic”; and (d) “Strategies for coping with the effects of the pandemic”. In this study, it was determined that emergency nurses had increased roles and responsibilities due to physicians being in the background, fulfilled their roles and responsibilities in a chaotic working environment, experienced many positive and negative feelings together or gradually, and applied individual coping strategies.ConclusionsThis study indicated that emergency nurses fulfilled their increasing roles and responsibilities on the frontlines in a chaotic working environment during the pandemic. Despite many negative feelings, it was determined that they tried to show psychological adjustment and resilience with a strong professional commitment and social support.

Perceptions of the Essential Components of Triage: A Qualitative Analysis

IntroductionTriage is an important process to determine severity of illness and prioritize patient emergencies while also ensuring patient safety. The emergency nurse must use critical thinking and decision-making to identify life-threatening emergencies and improve patient outcomes. However, the addition of risk screenings and quality improvement initiatives has extended the triage process time, which may increase interruptions and opportunities for errors. The purpose of this descriptive qualitative study was to determine emergency nurse perceptions of current triage processes and categorize essential and nonessential triage components. MethodsFocus groups of frontline emergency nurses who regularly conduct triage in the emergency department were conducted to discuss perceptions of triage assessments and questions. The 3 focus group discussions were digitally recorded and transcribed. Data analysis consisted of descriptive statistics of the sample and the conventional content analysis of the transcripts. ResultsA total of 12 emergency nurses participated in the study. The overall theme that emerged surrounding essential triage components was a perceived conflict between individualized care and maintaining systems and processes. This theme consisted of 4: (a) must ask, (b) actions of triage, (c) relevant but not urgent for triage, and (d) not perceived as relevant. ConclusionThis study identified the perceptions of emergency nurses surrounding the urgency of triage components in the emergency department. Emergency nurses perceived some assessments as essential to determining “sick versus not sick,” and other triage components were able to be delayed, streamlining the triage process.

The management of patients with acute abdominal pain in the emergency department: A qualitative study of nurse perceptions

BackgroundAcute abdominal pain is a common reason for presentation to the emergency department. Understanding the role of nurses involved in management of acute abdominal pain is important for improving patient care and outcomes. The aim of this study was to understand the perceptions of emergency nurses in the management of acute abdominal pain. MethodsUsing a qualitative design, a purposeful sample (n=9) of experienced registered nurses was recruited from the emergency department of a large tertiary public hospital in South Australia. Semi-structured interviews, informed by literature describing the management of acute abdominal pain, were used to identify the perceptions of emergency nurses when caring for patients with acute abdominal pain. ResultsThematic analysis of interviews identified four themes: Centrality of Diagnosis; Busyness and Patient Management; Systems Issues; and Communication Challenges. Of the four themes, the Centrality of Diagnosis was especially important to the nurses’ sense of contribution to patient care. Care was also affected by the busyness of the environment, the systems and processes in place to manage patients and communication in the emergency department. ConclusionsThe management of patients with acute abdominal pain is influenced by how nurses participate in the diagnostic process. Nurses identified their role in this process and described how this role impacted their delivery of fundamental care. Further studies of the nursing contribution to diagnosis, communication, and the systems that affect care delivery in the emergency department are required.

A qualitative descriptive study of the contextual factors influencing the practice of emergency nurses in managing emerging infectious diseases

ABSTRACT Purpose: Emergency nurses are engaged in the management of epidemic events that unfold along with the evolution of diseases. The goal of this study was to explore the contextual factors that inhibited the ability of emergency nurses to perform their duties in response to an outbreak. Methods: A qualitative descriptive design was used to explore the experiences and perceptions of emergency nurses. Participants were purposively recruited from 12 emergency departments in Hong Kong. Semi-structured face-to-face individual interviews were conducted with 26 emergency nurses. The audio-recorded interviews were transcribed verbatim and interpreted with a thematic analysis approach. Results: Four intertwined themes emerged from the analysis: resource constraints, threats of infection, ubiquitous changes and lingering uncertainties. These themes portrayed the constraints and challenges surrounding the work environment of emergency nurses. Conclusion: This study described the instabilities and vulnerabilities of the circumstances in which the emergency nurses were situated in during epidemic events. The findings shed light on the importance of hospitals and emergency departments in addressing both the technical problems and adaptive challenges that face emergency nurses during epidemic events.

Emergency Nurses’ Perceptions of Risk for Firearm Injury and its Effect on Assessment Practices: A Mixed Methods Study

IntroductionInjury from firearms is a significant problem in the United States, accounting for 73% of all homicides and 50% of all suicides that occurred among US residents. What is not known are the perceptions of emergency nurses regarding the impact of in-home access on the risk for firearm-related injury and death in their patient populations. The purpose of this study was to explore emergency nurses’ perception of patient risk for firearm injury and in which ways that perception affected the process of ED patient screening, assessment, counseling, and discharge education. MethodsWe employed a mixed methods, sequential, explanatory design using quantitative survey data and qualitative focus-group data. ResultsBetween 21.8 and 43.5% of respondents reported asking patients about access to in-home firearms, depending on presentation. Statistical analyses showed the single most significant factor correlated with nurses asking about the availability of a staff person who could further assess risk and offer assistance and safety counseling to patients. Another important influence was identified from focus-group discussions in which nurses reported that they felt challenged to bring up the topic of firearms in a way that did not seem confrontational. DiscussionAccess to firearms poses risk to patients, and patient safety and the continuum of care depends upon the emergency nurse assessing patient firearms risk and taking appropriate action. The findings from this study suggest that emergency departments (1) normalize and standardize the assessment of firearms, (2) designate an ED staff member on each shift to further assess risk if a positive response is elicited, and (3) continue to improve workplace safety.

Nurses' Perceptions of Victims of Human Trafficking in an Urban Emergency Department: A Qualitative Study

IntroductionHuman trafficking is estimated to surpass the drug trade as the leading illegal industry in the world. According to a recent study, over 87.8% of trafficking survivors came into contact with a healthcare professional while they were enslaved and were not identified as a victim of human trafficking. The aims of this study are to understand the perceptions of emergency nurses about human trafficking, victims of violence, and prostitution. MethodsA qualitative, descriptive study using a semi-structured interview approach was done with ten registered nurses in a large, urban Emergency Department in the northeastern U.S. Interviews were recorded and transcribed; thematic analysis was performed. ResultsSix themes emerged from the interviews including, “human trafficking exists in the patient population” yet no nurse has screened or treated a victim; human trafficking victims are perceived to be “young, female, and foreign born”; all of the emergency nurses reported having worked with or screened a victim of violence; victims of violence were viewed as patients who present as “sad and grieving”; prostitutes are seen as “hard and tough”; and emergency nurses did not have education on human trafficking victims’ needs or resources. DiscussionEmergency nurses should be more aware about victims of human trafficking. The media portrayal of human trafficking victims had influenced the nurses’ perceptions of this population. Victims of violence are perceived to be very different from prostitutes, but there is a desire for education about violence as well as information about specific resources open to victims.Image 1

Emergency nurse disaster preparedness during mass gatherings: a cross-sectional survey of emergency nurses' perceptions in hospitals in Mecca, Saudi Arabia

ObjectivesTo assess hospital emergency nurses' self-reported knowledge, role awareness and skills in disaster response with respect to the Hajj mass gathering in Mecca.DesignCross-sectional online survey with primary data collection and...

Family needs of critically ill patients in the emergency department

IntroductionFamily members’ experience a range of physiological, psychological and emotional impacts when accompanying a critically ill relative in the emergency department. Family needs are influenced by their culture and the context of care, and accurate clinician understanding of these needs is essential for patient- and family-centered care delivery. The aim of this study was to describe the needs of Taiwanese family members accompanying critically ill patients in the emergency department while waiting for an inpatient bed and compare these to the perceptions of emergency nurses. MethodsA prospective cross-sectional survey was conducted in a large medical center in Taiwan. Data were collected from 150 family members and 150 emergency nurses who completed a Chinese version of the Critical Care Family Needs Inventory. ResultsFamily members ranked needs related to ‘communication with family members,’ as most important, followed by ‘family member participation in emergency department care’, ‘family member support’ and ‘organizational comfort’; rankings were similar to those of emergency nurses. Compared to nurses, family members reported higher scores for the importance of needs related to ‘communication with family members’ and ‘family members’ participation in emergency department care’. ConclusionsFamily members place greater importance than emergency nurses on the need for effective communication.

Perceptions of emergency nurses during the human swine influenza outbreak: A qualitative study

IntroductionThe primary aim of this study was to explore the perception of Hong Kong emergency nurses regarding their work during the human swine influenza pandemic outbreak. MethodsIn this exploratory, qualitative study, 10 emergency nurses from a regional hospital in Hong Kong were recruited using purposive sampling. Semi-structured, face-to-face individual interviews were conducted. Qualitative content analysis was utilized to analyze the transcripts. ResultsThe three following categories emerged from the interview data: concerns about health, comments on the administration, and attitudes of professionalism. Nurses viewed the human swine influenza as a threat to their personal and families’ health. However, nurses perceived that the severity of the disease was exaggerated by the public. Improvements in planning the circulation of information, allocation of manpower, and utilization of personal protective equipment were indicated. The emergency nurses demonstrated a sense of commitment and professional morale in promoting a high quality of nursing care. DiscussionVarious factors affecting the perceptions of emergency nurses toward their professional duties during the influenza pandemic were identified. By understanding these perceptions, appropriate planning, policies, and guidelines can be formulated to meet the healthcare needs of patients during future pandemic outbreaks.

Perceptions of Participating Emergency Nurses Regarding an ED Seasonal Influenza Vaccination Program

Numerous professional organizations have recommended that emergency departments provide influenza vaccine to patients. However, no study has reported on the perceptions of participating emergency nurses regarding ED influenza vaccination programs. We conducted an anonymous Web-based survey to assess the post-participation perceptions of emergency nurses regarding an ED influenza vaccination protocol. The vaccination protocol occurred at an urban, academic emergency department and was designed to be performed by emergency nurses without added staffing resources by using ED Electronic Medical Record technology. Data from the Web-based survey were analyzed using descriptive statistics and χ(2) analysis to assess significant associations of where emergency nurses believed the protocol was time inefficient. The ED influenza vaccination protocol was in effect from October 1-25, 2009, with 3091 eligible ED visits and 613 patients receiving ED seasonal influenza vaccination. Fifty-eight of 59 participating emergency nurses (98%) responded to the survey. Significant findings were that 59% of responding emergency nurses found the protocol too time consuming and believed it was inappropriate in the ED setting. Responding emergency nurses reported that protocol efficiency could be improved by adding staff, simplifying screening and vaccination documentation requirements, and improving vaccine supply and stocking procedures in the emergency department. A majority of surveyed emergency nurses who had participated in an ED influenza vaccination program reported that the protocol was too time consuming and inappropriate for the ED setting. Surveyed emergency nurses expressed the opinion that such protocols required added staff, simplified patient consent/vaccination documentation requirements, and improved vaccine supply and stocking processes.

67: Perceptions of Participating Emergency Nurses Towards an Emergency Department Seasonal Influenza Vaccination Program

67: Perceptions of Participating Emergency Nurses Towards an Emergency Department Seasonal Influenza Vaccination Program

Chemical, biological and radiological incidents: preparedness and perceptions of emergency nurses

Despite their important role in chemical, biological and radiological (CBR) incident response, little is known about emergency nurses' perceptions of these events. The study aim was to explore emergency nurses' perceptions of CBR incidents and factors that may influence their capacity to respond. Sixty-four nurses from a metropolitan Emergency Department took part. The majority were willing to participate in CBR incidents and there was a positive association between willingness to participate and postgraduate qualification in emergency nursing. Willingness decreased, however, with unknown chemical and biological agents. One third of participants reported limitations to using personal protective equipment. Few participants had experience with CBR incidents although 70.3 per cent of participants had undergone CBR training. There were significant differences in perceptions of choice to participate and adequacy of training between chemical, biological and radiological incidents. The study results suggest that emergency nurses are keen to meet the challenge of CBR incident response.

Self-reported infection control practices and perceptions of HIV/AIDS risk amongst emergency department nurses in Botswana

This descriptive exploratory study investigated the reported practices and perceptions of emergency nurses related to infection control in the context of the Human Immunodeficiency Virus/Acquired Immune Deficiency Syndrome (HIV/AIDS) pandemic in Botswana. Quantitative and qualitative data were collected using a self-administered questionnaire. Forty questionnaires were distributed to nurses with emergency department experience in Botswana, with a response rate of 55% (n = 22). Quantitative data were analysed using descriptive statistics while qualitative data were subjected to thematic and content analysis. The majority of respondents reported compliance with universal precautions at the hospital emergency department. However, qualitative data highlighted resource constraints that may hinder compliance with universal precautions such as a lack of appropriate facilities, a shortage of equipment and materials, inadequate staffing and absence of sustainable in-service education programs. Further, the reported compliance with Universal Precautions had not removed the fear of exposure to HIV/AIDS and perceived risk of transmission to family. The authors recommend in-service education and practice initiatives to promote sustainable compliance with universal precautions and realistic risk perception among nurses. Further research is required to evaluate nurses' compliance with universal precautions in developing countries using observational methods or in-depth interviews. This would enable exploration of nurses' actions regarding compliance with universal precautions.