Hospital Personnel Research Articles

Declines in Influenza Vaccination Coverage Among Health Care Personnel in Acute Care Hospitals During the COVID-19 Pandemic - United States, 2017-2023.

Health care personnel (HCP) are recommended to receive annual vaccination against influenza to reduce influenza-related morbidity and mortality. Every year, acute care hospitals report receipt of influenza vaccination among HCP to CDC's National Healthcare Safety Network (NHSN). This analysis used NHSN data to describe changes in influenza vaccination coverage among HCP in acute care hospitals before and during the COVID-19 pandemic. Influenza vaccination among HCP increased during the prepandemic period from 88.6% during 2017-18 to 90.7% during 2019-20. During the COVID-19 pandemic, the percentage of HCP vaccinated against influenza decreased to 85.9% in 2020-21 and 81.1% in 2022-23. Additional efforts are needed to implement evidence-based strategies to increase vaccination coverage among HCP and to identify factors associated with recent declines in influenza vaccination coverage.

APPLICATIONS OF KNOWLEDGE DISCOVERY AND DATABASE (KDD) IN CLINICAL DECISION SUPPORT SYSTEM

Applications of Knowledge Discovery and Database (KDD) in Clinical Decision Support Systems) is a research work that aims to develop a medical system that has the ability to detect and suggest cure for an ailment with minimal effort. Healthcare system has been a major source of worry across the globe in recent time due to emergence of different types of diseases and epidemics. The number of health care personnel in various hospitals falls short of the number required most especially in terms of specialists. The medical system in Nigeria today suffers from lack of fast, accurate, reliable and intelligent software solutions that can help healthcare practitioners make decisions that would solve urgent, and in some cases, complex medical problems in real-time. Also, the cost of processing and analyzing large volumes of data in a medical environment is high most especially in terms of time consumption. So in this research design and implement clinical decision support system using knowledge discovery in database (KDD) was the major focus. The design required a computerized database for storing medical records as well as software for improved intelligence-based medical procedures that were going to be simpler to use, versatile, adaptable, savvy, and effortless at combining and evaluating medical data, allowing medical practitioners at all levels to make realistic, intelligent, and real-time decisions on critical health issues. The system was designed using the Object-Oriented Design and Analysis Methodology (OOADM).

A novel two-catheter method for urethral catheterization improves success rates of urethral catheterization in female dogs and cats weighing less than ten kilograms.

To compare the success rates for urethral catheterization in clinical patients using the traditional and 2-catheter techniques when placed by personnel of all experience levels. 38 female cats and dogs weighing less than 10 kg were prospectively enrolled. Enrolled animals were randomized to have a urethral catheter placed by the traditional technique or the 2-catheter method under sedation or general anesthesia. Any qualified hospital personnel of any experience level were allowed to place the catheter. If after 5 minutes the animal was not successfully catheterized, the alternate method was performed. The previous experience of the catheter placer, animal signalment, animal condition that necessitated catheter placement, time to successful placement, and which technique was successful was recorded. The 2-catheter technique was more successful than the traditional method (60.5% and 34.2%, respectively) for urethral catheterization when used by a variety of hospital personnel. The 2-catheter technique was successful in 63.3% of dogs and 66.6% of cats, while the traditional method was successful in 36.6% of dogs and 33.3% of cats. Eight of 9 (88.9%) novice catheter placers that placed their first urinary catheter in this study succeeded with the 2-catheter technique and only 1 was successful with the traditional method. The 2-catheter technique has a higher rate of success for placement of female urinary catheters in small patients that are unable to have concurrent digital palpation. This technique may also be helpful in the inexperienced catheter placer population to aid in guidance into the urethral papilla.

Training on Pivot Tables and Dashboard Creation for Medical Record Professionals at 'Aisyiyah General Hospital Padang

Pivot tables are one of the features found in Microsoft Excel. With pivot tables, data can be presented based on the selected categories. Data in a pivot table is presented in columns or rows. To make the data easily understandable for anyone reading it, the data can be displayed in the form of a dashboard. There is a lot of patient data stored in the database of 'Aisyiyah General Hospital Padang. This data can be utilized by medical record personnel as reports for management decision-making in the hospital. To ensure easy understanding, the data is presented in an attractive dashboard format. However, the professional medical record staff in the hospital and other medical personnel do not yet have the ability to create dashboards using pivot tables. Therefore, training is needed to implement this. The training will be held at 'Aisyiyah General Hospital Padang for two days, consisting of theoretical material as well as practical exercises based on data obtained from the hospital's database. The training conducted should proceed smoothly, and participants should be able to understand pivot tables, dashboards, and how to create them. Initially targeted at medical record personnel, the training program was also attended by other medical staff, including doctors, training department heads, and the hospital director. The training that has been conducted has expanded the participants' understanding of pivot tables, dashboards, and the significant benefits of Microsoft Excel's features. In the future, it is hoped that this training can be extended with a longer duration and cover other cases within the hospital.

A cognitive-behavioral skills building program improves mental health and enhances healthy lifestyle behaviors in nurses and other hospital employees.

Mental health outcomes in nurses have historically indicated a greater prevalence of anxiety, depression, and suicide than the general population. It is vital to provide programming for healthcare workers to gain the necessary skills to reduce burnout and improve their mental and physical health. The aims of this study were to evaluate mental health outcomes and healthy lifestyle beliefs and behaviors among nurses and other hospital employees who completed MINDBODYSTRONG, a cognitive-behavioral skill building program. A pre-experimental, pre- and poststudy design was used to examine mental health and well-being outcomes among 100 hospital personnel who participated in MINDBODYSTRONG, a program designed to improve coping and resiliency and decrease stress, anxiety, and depressive symptoms. Outcomes measured included healthy lifestyle behaviors, healthy lifestyle beliefs, anxiety, depression, stress, and burnout. One hundred hospital personnel, including 93 nurses, completed the pre- and post-survey. Among all participants, post- MINDBODYSTRONG scores for healthy lifestyle beliefs (p = .00; Cohen's d = 0.52) and healthy lifestyle behaviors (p = .00; Cohen's d = -0.74) increased significantly with medium effects, while depression (p = .00; Cohen's d = -0.51), anxiety (p = .00; Cohen's d = -0.54), stress (p = .00; Cohen's d = -0.33), and burnout (p = .00; Cohen's d = -0.37) decreased significantly with small and medium effects. The program produced even stronger positive effects on mental health outcomes for participants who started the study with higher levels of depression and anxiety. Anxiety, depression, stress, and burnout decreased significantly postintervention. Participants also significantly improved their healthy lifestyle beliefs and behaviors with the MINDBODYSTRONG program. MINDBODYSTRONG is an effective program that reduces anxiety, depression, burnout, and stress and improves healthy lifestyle beliefs and behaviors in hospital-based clinicians. It is of utmost importance to provide evidence-based programs to improve mental resiliency and decrease stress, anxiety, burnout, and depressive symptoms, which will ultimately improve the safety and quality of health care.

Estimation of mercury released into the environment from the uncontrolled dumping of broken medical thermometers in hospitals in Cameroon, Africa.

The yearly mercury released into the environment from discarded broken thermometers was estimated through questionnaires submitted to medical personnel in two major cities, namely Yaounde and Bertoua, in Cameroon. Eighty-three medical personnel made up of 17 assistant nurses, 56 nurses + midwives and 10 physicians responded to have handled a total of 3216 units of thermometers made up of 85% Hg-added and 15% digital during consultations. Six hundred twenty-four units, all Hg-added and making about 19% of thermometers got broken during health consultations. This breakage led to the average annual disposal of 0.646 Kg of mercury. The mean rates of mercury release from broken thermometers were assessed to 0.056, 0.005 and 0, and 0.009, 0.002 and 0 Kg per year, respectively, for assistant nurses, nurses + midwives and physicians in bigger and smaller cities, respectively. Assistant nurses alone disposed of 73%, 27% by nurses + midwives, and none released by physicians for the total estimated of 222.52 Kg of mercury disposed of from broken thermometers by medical personnel in hospitals in Cameroon. Out of the total mercury estimated, 63.71% and 36.21% were disposed of by medical personnel in bigger and smaller cities, respectively. The circumstances of the accidental broken of these mercury-added thermometers will expose medical personnel, patients, and the public to this toxic chemical.

Resilience, sense of danger, and reporting in wartime: a cross-sectional study of healthcare personnel in a general hospital

Background and AimsMaintaining healthcare services and ensuring the presence of healthcare personnel (HCP) during periods of conflict and high-intensity warfare in Israel including the significant security event that occurred on May 2021, pose significant challenges for hospitals in the range of missile attacks. The May 2021 event, marked by intense hostilities and military actions, brought about heightened security escalations and increased risks in the region. Despite the prevailing threat of missile attacks and ongoing security concerns, hospitals in the affected areas were required to sustain their services and uphold care standards. In light of these circumstances, this study aims to identify the factors that influence the percentage of HCP reporting for work during these intense periods of security escalations and wartime in Israel. Specifically, it explores the relationships between resilience, sense of danger, and HCP absenteeism in the context of the ongoing conflict. The findings of this study can provide valuable insights for designing interventions aimed at decreasing HCP absenteeism during security escalations, wartime, and emergency situations, ultimately contributing to the resilience and effectiveness of healthcare delivery in this challenging environment.MethodsDuring a relative calm period from December 2021 to January 2022, a cross-sectional study was conducted at a southern Israeli general hospital, situated within the range of missile attacks in the midst of a longstanding conflict. The study focused on HCP who were employed before May 21, which marked the end of the last war state at that time. The questionnaire, consisting of measures for resilience using the Conor-Davidson scale (CD-RISC 10) and the sense of danger assessed with the Solomon & Prager inventory, was administered online to all hospital employees at Assuta Ashdod Hospital, located in the southern city of Ashdod, Israel. This approach was chosen due to the challenging nature of conducting a study during an existing war, making it impractical to carry out the research during such periods of active war.ResultsIn total, 390 employees completed the survey (response rate of 24%). Of this sample, 77.4% reported fully to work during the last security escalations in May 2021. Most of the sample (84.1%) felt insecure on the way to work. The HCP who reported fully to work had a higher level of resilience than employees who reported partially or did not come to work at all (p = .03). A higher sense of danger in the workplace correlated with a 73% increase in absenteeism (p < .01). Absenteeism (partial or full) was higher among HCP with children who require supervision (p < .01). Hospital preparedness for emergencies as perceived by the employees increased HCP attendance at work (p = .03).ConclusionsHospital management should consider designing programs aimed at potentially strengthening the level of resilience and fostering a greater sense of security among hospital personnel, which might encourage greater attendance at work during wartime, crises, or emergencies.

COVID‑19 Pandemic: Effect of Specific and Non-Specific Prevention Measures on the Risk of SARS‑CoV‑2 Infection in Employees of Healthcare Organizations

From the very onset of SARS‑CoV‑2 spreading, active involvement in the COVID‑19 epidemic process made the healthcare professionals (HCPs) a vulnerable group with higher risks of contracting the disease, severe course and fatal outcome.The aim. We aimed at studying the impact of specific and non-specific preventive measures on the risk of SARS‑CoV‑2 infection among the HCPs in a large industrial region settings during the COVID‑19 pandemic.Materials and methods. We analyzed the data obtained using 1 905 questionnaires for the personnel of infectious hospitals for treatment of COVID‑19 patients and non-core healthcare facilities in a large industrial region during the COVID‑19 pandemic, 100 questionnaires on adherence of the employees to hand hygiene and antiseptics, the results of the tests for specific IgG to the SARS‑CoV‑2 nucleocapsid (2 200 samples), as well as the results of assessment of viral and bacterial contamination of the outer surface of the personal protective equipment for infectious hospital staff (108 specimens).Results and discussion. In the course of the study, an effect of failure in the implementation of some specific and non-specific preventive measures on an increase in the incidence of COVID‑19 in various healthcare professionals has been identified. The COVID‑19 pandemic once again emphasized the need to save lives and health of the HCPs as socially significant category of citizens under the spread of pathogens with high epidemic potential, applying a complex of specific and non-specific measures that are not mutually exclusive.

Essential Public Health Functions of Public Health Personnel in Subdistrict Health-promoting Hospitals, Thailand.

In Thailand, public health service roles have been defined by the Ministry of Public Health, while essential public health functions (EPHFs) were not assigned as necessity health-care service activities responding to the missions of primary care units. The aims were to determine the EPHFs and compare the necessity of performance and the actual performance according to the EPHFs of public health personnel in the subdistrict health-promoting hospitals (SHPHs). The exploratory sequential design of mixed methods was employed. The first phase consisted of three methods: a focus group discussion, a nominal group technique, and a cross-sectional survey used to determine the EPHFs. The second phase was to compare the necessity of performance and the actual performance according to the EPHFs of the personnel using a cross-sectional survey. The 285 SHPH directors in the second health region as samples were selected by random clusters. The findings revealed that 14 EPHFs and the necessity of performance average were higher than the actual performance average in the 14 EPHFs and 212 indicators with significance at a level of 0.05. The means of health assessment and primary medical care (EPHF3) presented the smallest difference, whereas Thai traditional and alternative medicines (EPHF11) indicated the largest average difference. EPHFs would be applied for setting a framework of working scope as policies and EPHFs could be recommended for use as individual guidelines or organizational assessment manuals to develop organizations efficiently.

The experience of a tertiary level hospital in the 2023 Turkey double earthquake zone; management of 1,092 musculoskeletal injuries in the first week.

The double earthquakes that occurred on February 6, 2023, are currently called the disaster of the century, in Turkey. This study is the first to report the experiences in the treatment of orthopedic emergency patients hospitalized in Adana City Training and Research Hospital (ACH), the largest tertiary hospital in the region. The study included the retrospective analysis of the files of the victims of the earthquakes admitted to the ACH between February 6, 2023, and February 13, 2023. The age, gender, time of admission, types and localization of injuries, treatment modalities of earthquake victims, and orthopedic surgical treatment data were recorded. In the first week of the quakes, 3,699 patients were admitted to the ER with earthquake-related injuries. A total of 1,092 patients with musculoskeletal injuries were hospitalized, and 827 (75.7%) received orthopedic surgery. Surgical procedures included wound debridement under anesthesia (n=392, 47.4%), large bone fractures and/or pelvic ring fractures (n=224, 27.1%), fasciotomies (n=327, 69.1%), and amputations (n=121, 14.6%). Although Orthopedics and Traumatology Clinic staff have the highest workload, all hospital personnel should be equipped with basic orthopedic approaches related to the disaster. We believe that taking a more active role in the follow-up of orthopedic patients will help improve the management of the chaotic processes and increase overall treatment success.

THE EFFECT OF KNOWLEDGE, COMMITMENT, DISCIPLINE AND WORKLOAD ON SERVICE PERFORMANCE WITH STRESS AND BURNOUT AS MEDIATION AND ACHIEVEMENT MOTIVATION AS MODERATION OF MEDICAL PRACTITIONERS IN GROBOGAN AND KUDUS REGENCIES, CENTRAL JAVA

Improving and developing the quality of services carried out by the human resources in the hospital is the key to achieving the goals desired by the hospital as a health service provider. The purpose of this study was to determine the effect of knowledge, commitment, discipline and workload on service performance with stress and burnout as mediation and achievement motivation as moderation of medical practitioners in Grobogan and Kudus Regencies, Central Java. This research was quantitative research used 133 respondents from type B Hospital medical staff in Grobogan and Kudus Regencies, Central Java. Data analysis using SMART PLS. Based on the results of the analysis, it shows that for medical staff at Hospitals in Kudus and Grobogan Regencies, Central Java, knowledge has no significant effect on stress levels or performance, but has a significant effect on burnout. Commitment has no significant effect on stress or performance but has a significant effect on Burnout. Discipline has no significant effect on stress or burnout but has a significant effect on service performance. Workload has no significant effect on stress or burnout, but has a significant effect on service performance. Burnout has no significant effect on service performance. Achievement motivation is not able to significantly moderate the effect of stress on service performance and is unable to significantly moderate the effect of burnout on service performance in medical personnel in Hospitals in Kudus and Grobogan Regencies. The suggestions that need to be considered for future researchers can be applied to research objects that are not services, and future researchers are expected to use the same research model but use a different theoretical perspective.

Evaluation of Vaccination and Polymerase Chain Reaction Test Positivity of Hospital Personnel During the COVID-19 Pandemic

Evaluation of Vaccination and Polymerase Chain Reaction Test Positivity of Hospital Personnel During the COVID-19 Pandemic

Design and implementation of a “crisis resource management” training program for the initial assessment of polytrauma patients

IntroductionTo describe the design and implementation of a Crisis Resource Management (CRM) training program for the initial assessment of polytrauma patients. MethodsProspectively implemented CRM training program in acute-care tertiary hospital by hospital personnel involved in the care of polytraumatisms. The program has a blended format and 23-h duration, including 11 h of online theoretical training followed by 12-h simulation modules and practical cases devoted to the roles of members of the trauma team, functioning of the polytrauma room, and key aspects of teamwork. The Human Factors Attitude Survey (HFAS) was used to assess attitudes related to non-technical skills, and the End-of-Course Critique (ECC) survey to evaluate satisfaction with training. We evaluated changes in the pre- and post-training assessments. ResultsEighty staff personnel (26% specialists, 16% residents, 29% nurses, 14% nursing assistant, 15% stretcher bearer) participated in three editions of the program. Theoretical knowledge improved from a mean (SD) of 5.95 (1.7) to 8.27 (2.1) (P < .0001). In the HFAS, statistically significant differences in 18 of 23 attitudinal markers were observed, with improvements in all items of “leadership” and “roles”, in 4 of 5 items of “situational awareness”, and in 4 of 8 items of “communication”. Mean values obtained in the ECC questionnaire were also very high. ConclusionsA CRM training model developed for the initial care of polytrauma patients improved theoretical knowledge and participants perceptions and attitudes regarding leadership, communication, roles, and situational awareness of members of the trauma team.

Digitalisasi Arsip Dokumen Pegawai RSUD Prof. Dr. Soekandar Kabupaten Mojokerto

Handling the management of Prof. dr. Soekandar Hospital Personnel Documents. with the high volume of employee documents managed. From this, several obstacles were encountered in the process of searching for employee documents, pension projections, projected salary increases and employee recapitulation. For that, we need an information system that can handle these problems. The activities carried out aim to provide an overview of procedures for digitizing archives by considering various aspects of decency, so as to guarantee storage efficiency and ease of access to archives (accessibility).

Acinetobacter Baumannii Detection Using A Bio-FET Device: Towards Healthcare Infection Management

Acinetobacter is a group of bacteria commonly found in the environment, like in soil and water. While there are many types, the most common cause of infections is Acinetobacter baumannii, which accounts for most Acinetobacter infections in humans.Acinetobacter baumannii could result in infections in the blood, urinary tract, in wounds of the body or lungs. Traditionally, medical technicians in hospital use the sample from patients (like stool, urine, or sputum) to streak on a plate or do bacteria culture test. It takes too much time and patients cannot wait so long. Therefore, it is vital that a new diagnostic technique can be used to detect Acinetobacter baumannii much faster than the traditional methods.The electrical double layer (EDL)-gated field-effect transistor-based biosensor (BioFET) is a fast and promising diagnostic technique because it is highly sensitive, quickly response, and high selective to the target analyte. Besides, a portable device could help the medical personnel detect the bacteria and treat the patients as early as possible. Here, we used a portable BioFET device from STARX co. (Model II) to detect the complementary Deoxyribonucleic acid (DNA) of Acinetobacter Baumannii via a specific DNA probe we designed. We utilized the portable device to examine the specificity and selectivity in various conditions, such as urine and blood. Thus, the results showed that the system with the portable device could give the hospital personnel a tool to control healthcare associated infection caused by Acinetobacter baumannii. Figure 1

Management of Mass-Casualty Incidents in Nepal: A Qualitative Case Study of Three District Hospitals in Nepal.

The frequency of disasters world-wide has significantly increased in recent years, leading to an increase in the number of mass-casualty incidents (MCIs). These MCIs can overwhelm health care systems, requiring hospitals to respond quickly and effectively, often with limited resources. While numerous studies have identified the challenges in managing MCIs and have emphasized the importance of hospital disaster preparedness, there is a research gap in the preparedness level and response capacities of district hospitals in Nepal. This study attempts to fill this gap by understanding the perception of hospital staff in managing MCIs in district hospitals of Nepal. A qualitative case study was conducted in three district hospitals in Nepal. Semi-structured interviews were conducted with the hospital personnel, using an interview guide. An inductive thematic analysis was carried out to understand their perception on the most recent MCI management. Three themes emerged from the data analysis: enablers in MCI management, barriers in MCI management, and recommendations for the future. Use of multiple communication channels, mobilization of entire hospital teams, mobilization of police in crowd control, presence of disaster store, and pre-identified triage areas were the major enablers that facilitated successful MCI management. Nonetheless, the study also revealed challenges such as a lack of knowledge on MCI response among new staff, disruptions caused by media and visitors, and challenges in implementing triage. This study emphasized the importance of hospital disaster preparedness in managing MCIs and highlighted the significance of overcoming barriers and utilizing enablers for an efficient response. The findings of this study can provide the basis for the Ministry of Health and Population Nepal and district hospitals to plan initiatives for the effective management of MCIs in the future.

Nurses' Perceptions on How Recovery-Oriented Mental Health Care Can Be Developed and Implemented.

This study explored how nurses working in inpatient mental health units perceived the development and implementation of a recovery-oriented mental healthcare programme (ROMHCP). The recovery-oriented mental healthcare approach (ROMHCA) in mental health is regarded as the future of mental health services and has been implemented in different countries worldwide. However, regarding developing and implementing the recovery approach, Africa appears to have been left behind by the rest of the continents. The study used a qualitative approach to describe how a recovery-oriented mental healthcare approach could be developed. Thirty nurses who worked in Botswana's four inpatient mental health facilities consented and voluntarily participated in the study. Data were collected from February to mid-March 2022 through online focus group discussions and analysed using thematic analysis. The COREQ checklist was used to report the findings. Two main themes emerged as follows: (i) developing and implementing a recovery-oriented mental healthcare programme is possible and (ii) certain elements are required to develop and implement ROMHCP. The participants believed that people diagnosed with mental illness could recover from the illness and suggested how it could be achieved. They also contended that the programme's success would lie mainly with multisectoral support from policymakers, facilities, hospital personnel, patients, and the community. Clinical Relevance. ROMHCP has the potential to benefit people with mental illness in the country. In addition, it would allow nurses to improve their knowledge and skills in managing mental illnesses. Patient or Public Contribution. The patients and the general public did not contribute to the study's concept, design, and outcomes. However, the nurses working in mental health facilities volunteered to participate in the study.

Perception of Health Care Personnel in Ain Shams University Hospitals toward COVID-19 Vaccine and the Intention for Vaccination

Background Vaccination has significantly decreased the burden of infectious diseases. Its role in disease control has been well recognized, countries prioritize vaccinating health care personnel against COVID-19 because of their susceptibility to the virus. However, vaccine hesitancy remains a barrier to reach that aim. Objective This study aimed to assess the perception of health care personnel (HCP) in Ain Shams University hospitals toward COVID-19 vaccine, intention to receive COVID-19 vaccine. Methods A cross sectional study was conducted at Ain Shams University hospitals from the first of April 2021 till end of August 2021. An anonymous self-administered questionnaire designed to cover topics wanted to be addressed in the study. Results Out of 337 health care personnel, 256(76.0%) of them had a positive attitude with the vaccination. Regarding the intention to receive the available COVID-19 vaccine, 228(67.7%) of health care personnel intended to receive the vaccine, 59(17.5%) do not intend to receive it while 50(14.8%) were unsure “hesitant”. Among 228 who intended to receive the available vaccine 136(59.6%) were physicians, 57(25.0%) were nurses, 35 (15.4%) were workers. Conclusion A high proportion of health care personnel declared their willingness to receive the COVID-19 vaccine, and hence, this will play a leading role in combating the pandemic.

Prevalence and Characteristics of Needle Stick and Sharp Injuries Among King Salman Armed Forces Hospital Personnel in Tabuk City: A Retrospective Hospital-Based Study.

This study aimed to determine the prevalence and associated characteristics of needle stickand sharp injuries (NSSIs) among King Salman Armed Forces Hospital (KSAFH) personnel. Data was collected by reviewing all reported NSSIs among KSAFH personnel between January 2020 to December 2022. The prevalence of NSSIs was 2.05%, with nurses being the most commonly affected. Most injuries occurred in patients' rooms/wardsand among health care workers (HCWs) aged < 40 years. Of the injured workers, 93.8% were immunized against hepatitis B virus (HBV). Educational and training programs targeting high-risk age groups and professions should be developed. Policies related to locations and situations where injuries occur frequently should be reviewed regularly to reduce the risk of NSSIs.

Emergency department nurses’ competences: implementing a personal dossier for nurses onboarding, skills maintenance, and quality audit

Emergency Departments (EDs) are among the most challenging clinical settings for nurses.EDs are complex settings, including patients with various clinical severity levels, every typology of medical and surgical specialties, fast organizational responses, a triage area to identify the clinical priorities to access a medical visitation, and simultaneous emergency codes to be managed.Therefore, the issue of acquiring and maintaining adequate competencies to manage the delivery of nursing care in a multifaceted setting such as ED is central.&#x0D; Orientation and onboarding programs with very different characteristics in terms of content, duration, and delivery methods are present worldwide. These programs can include clinical skills self-assessment, structured learning opportunities, e-learning, development of core skills, portfolios.&#x0D; The possibility of integrating different educational strategies to gain knowledge with time spent in specific clinical areas to increase experience is the winning way to obtain the growth and maintenance of ED nurses’ competencies.&#x0D; In this paper, we report on the experience (currently in progress) related to the ongoing performance evaluation of ED nurses’ activities during 12 months in the Emergency Department of Careggi University Hospital.In particular, a printed annual “Professional dossier” was designed with two-fold aim. The staff nurse holder of the booklet can handle a realistic summary of his/her activities, case mix, and time spent in the diverse clinical areas of the ED, comparing these data with opportune standards provided to make adequate comparisons and pinpoint the professional improvements that are needed. The nurse coordinator and nurse manager can use nurses’ personal dossiers to know the realistic competencies load in the ED, balance the work shifts with adequate skill mix, program the rotation of nurses in the different clinical areas during the year to ease the maintenance of experience and expertise, and have a photograph of some important performance indicators for hospital personnel evaluation.