Advanced Trauma Life Support/Advanced Trauma Care for Nurses: A systematic review concerning the knowledge and skills of emergency nurse related to trauma triage in a community

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

AIMS AND OBJECTIVES

To investigate knowledge, attitudes, and practices regarding the application of the Injury Severity Score (ISS) among emergency department nurses in China and the factors influencing these variables.

BACKGROUND

ISS is the first trauma scoring method to be developed and the most widely used in clinical practice. The correct application of the ISS by emergency department nurses plays an important role in assisting in the diagnosis and treatment of trauma patients, and it is crucial to understand nurses' knowledge, attitudes and practices.

DESIGN

A cross-sectional multicentre study.

METHODS

Nurses from the emergency departments of 25 grade II and grade III hospitals in Gansu Province, China participated in this study. Data was collected online using a self-administered questionnaire. Student's t-test or analysis of variance was performed to compare the differences between the groups. Multiple logistic regression analysis identified factors influencing nurses' knowledge, attitudes and practices regarding applying ISS. A STROBE checklist was used to report findings.

RESULTS

Among 459 nurses, a good level of attitude and passing levels of knowledge and practice regarding applying the ISS were revealed. Nurses in higher hospital grades, who had been exposed to ISS and received training had higher levels of knowledge and practices. Previous exposure to the ISS and training related to it were factors that influenced nurses' attitudes.

CONCLUSIONS

Chinese emergency department nurses' knowledge, attitudes and practices of applying the ISS still need to be improved. Hospitals and nursing managers should provide training opportunities for nurses about ISS knowledge and practices, while grade II hospitals should pay more attention to training and continuing education in this area.

RELEVANCE TO CLINICAL PRACTICE

In hospitals, nursing managers may benefit from enhancing related education and training to promote the emergency department nurses' knowledge and practice of the ISS, by developing specific curricula and providing continuing education and training opportunities, while grade II hospitals should pay more attention to training and continuing education in this area.

NO PATIENT OR PUBLIC CONTRIBUTIONS

This study focused on emergency department nurses' knowledge, attitudes, and practices regarding the application of the ISS. The research questions and design were derived from clinical nursing practice, literature review, and expert panel review, and patients or the public are temporarily not involved.

Generation of Trauma Rush Call in Managing Patients With Road Traffic Injuries Visiting the Emergency Department: A Retrospective Analysis

BACKGROUND

Road traffic injuries (RTIs) are currently the ninth most common cause of mortality and are expected to increase in the future. RTIs rank in the top three reasons why young people die. Because of the high incidence and mortality risk, proper trauma care has been prioritized for RTI patients who present to the emergency department. Making appropriate and prompt trauma emergency calls can save lives. Poor resource use and an increased burden of inquiry can result from the inappropriate development of trauma rush calls (TRCs). Therefore, this study aims to evaluate the appropriate generation of TRCs to manage patients with RTIs presenting to the emergency department (ED).

METHODS

A retrospective analysis was conducted at the ED of the private tertiary care hospital in Karachi, Pakistan. Patients with RTIs and TRCs generated for the management were included. Dead on arrival was excluded. A total of 322 patients were enrolled using convenient sampling. A standard Performa was developed to collect the data from medical records, including demographics, clinical characteristics, radiological findings, TRC characteristics, and disposition. Multivariable logistic regression analysis was applied to determine the TRC justified using odds ratios, considering a p-value ≤0.05 as significant.

RESULTS

Of the total 322 patients, the majority were males (n=266, 82.61%) between 21 and 40 years of age. Most patients reported injury/accident through high-speed vehicle crash (n=102, 31.68%). A Glasgow Coma Scale (GCS) score of <14 was recorded in 119 (36.96%) patients, and of 208 patients, 153 (73.55%) had positive computed tomography (CT) head findings, majorly subdural hematoma (n=43, 28.10%). CT cervical spine showed fractures in 14 patients (11.29%). Only one patient had both a positive CT abdomen and focused assessment with sonography in trauma (FAST), with a low systolic blood pressure (SBP) of 85 mmHg, and the CT abdomen showed a grade 3 spleen laceration. TRC was justified in 248 (77.01%) patients. Multivariable analysis showed that a GCS <14 [adjusted odds ratio (aOR) 3.03 (95% CI: 2.58-5.04)] and cervical collar [aOR 3.12 (95% CI: 1.63-5.98)] were the significant predictors for the TRC justified.

CONCLUSION

A GCS <14 and cervical collar significantly justify the generation of TRC. These findings are crucial in educating ED staff regarding optimal care delivery. The future deployment of resources depends on these findings for skill development.

Effect of rescue work training in nursing students with a novel device: A quasi-experimental study

AIMS

The aim of this study was to analyze the effectiveness of an intervention for the training of nursing students in rescue work of a traumatized patient using the Snaid® device.

METHODS

A quasi-experimental one group pretest-posttest study was carried out. A total of 107 nursing students participated. Data on self-efficacy, knowledge, ergonomics and skill were collected. The data were analyzed with SPSS version 29 statistical software.

RESULTS

Statistically significant differences were found between mean self-efficacy score and time of measurement (U = 2090.500; Z = -8.377; p < 0.001). Statistically significant differences were also found between the time of measurement and the knowledge score (U = 373.000; Z = -11.966; p < 0.001). Considering the results on ergonomics, it was found that the mean score given after the intervention was 9.37 (SD = 1.02). Regarding intervention time, the mean time was 47.76 s (SD = 4.74). Finally, considering skill, the mean score was 8.78 (SD = 1.23).

CONCLUSION

The results of the present study indicate that participants obtained a high level of self-efficacy, knowledge, skill and ergonomics after training in the rescue work of a patient through the Snaid® device. This device may contribute to improve trauma patient care.

Continuing Education Certificate in Trauma Skills Among Emergency Nurses: A National Sample Survey Analysis

BACKGROUND

Trauma population health indicators are worsening in the United States. Nurses working in trauma care settings require specialized training for patient care. Little is known about national enumeration of nurses who hold skill-based trauma certificates.

OBJECTIVE

The purpose of this project was to estimate (1) skill-based certificate status among U.S. nurses who primarily work with emergency or trauma patients, (2) demographic and work characteristic differences between those who report skill-based trauma certificates and those who do not, and (3) continuing education learning needs among nurses who hold skill-based trauma certificates.

METHODS

This was an applied epidemiologic analysis of the 2022 National Sample Survey of Registered Nurses.

RESULTS

The weighted analysis of 239,893 emergency nurses indicated 57% held skill-based trauma certificates with disparities by rural practice, racial identity, age, and marital status. Among those who held skill-based trauma certificates, the greatest need for continuing education was on topics of mental health, quality improvement, and substance use disorders. Approximately 87% of emergency nurses with trauma skill-based certificates only spoke English fluently.

CONCLUSIONS

Population health management interventions are needed to enhance workforce equity and continuing education opportunities for trauma nurses. Professional nursing organizations, emergency nursing employers, and academic settings should offer continuing education in mental health and quality improvement. These findings also support the need for ongoing activities to enhance language accessibility for non-English speaking patients in the trauma care system.

Mapping the evidence of emergency nursing research in who Afro-region states: A Scoping Review

Introduction

The introduction of emergency nursing in Africa has resulted in the establishment of several training schools across the continent. This has translated into a growing body of emergency care research being carried out by nurses; however, the breadth and extent of evidence remains unclear. The aim of the review was to map and collate the available literature on emergency nursing research in WHO Afro-region states.

Methods

The review adopted the methodology of the Joanna Briggs Institute (JBI) scoping reviews. The review protocol was registered on 27 June 2022 (osf.io/5wz3x). The Population (nurse), Concept (emergency nursing research), Context (WHO Afro-region) (PCC) elements guided the development of the inclusion and exclusion criteria. Papers were searched across seven electronic data bases and two search engines using a three-search strategy. The screening was performed initially on the abstract and title and lastly on full text. The reporting for the review was guided by the Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR).

Results

One hundred and thirteen papers were included in the review. Publication of emergency nursing research occurred from 2000 to 2022. The year 2017 and 2019 recorded the highest number of publications (n = 14). The country with the most publications was South Africa (n=50). Emergency nursing research used predominantly quantitative methodologies (n=58). The professional groups involved in research were nurses (n=69) as well as nurses and doctors (n=26). The identified papers focused primarily on emergency nursing education (n=23) and epidemiology (n=24).

Conclusion

There is a notable increase in the number of publications on emergency nursing research in WHO Afro-region states, however from only 11 countries. Since most of the research is still at descriptive level, there is need to encourage emergency nursing research on interventions and measuring outcomes and impact in the emergency care system.

Identifying the obstacles facing emergency nurses regarding treating CTAS1 and CTAS2 in Saudi Arabia

BACKGROUND

Emergency nurses play a pivotal role in delivering efficient emergency healthcare, yet they often encounter numerous challenges, especially while managing life-threatening cases, impacting both their well-being and patient satisfaction. This study seeks to identify the prevalent challenges faced by these nurses in Saudi hospitals when handling Canadian Triage and Acuity Scale (CTAS1 and CTAS2) cases, with the aim of mitigating or managing these issues in the future.

METHODS

This study incorporated a mixed-method approach to identify obstacles in Emergency Department (ED) nursing treatment of CTAS1 and CTAS2 cases in two major Saudi Arabian hospitals. The research began with qualitative focus group interviews with expert ED nurses, followed by a quantitative survey to measure and explore relationships among the qualitative findings. Data analysis leveraged qualitative thematic analysis and principal component analysis, ensuring rigorous examination and validation of data to drive meaningful conclusions.

FINDINGS

From expert interviews, key challenges for emergency nurses were identified, including resource management, communication, training compliance, and psychological factors. A survey of 172 nurses further distilled these into five major issues: patient care management, handling critical cases, administration support, patient care delay, and stress from patients' families.

CONCLUSION

Through a mixed-method approach, this study pinpoints five pivotal challenges confronting emergency nurses in Saudi hospitals. These encompass difficulties in patient care management, the psychological toll of handling critical cases, inadequate administrative support, delays due to extended patient stays, and the stress induced by the presence of patients' families, all of which significantly impede emergency department efficiency and compromise nurse well-being.

Trauma nursing competency in the emergency department: a concept analysis

OBJECTIVES

Despite numerous published concept analyses of nursing competency, the specific understanding of trauma nursing competency in emergency departments remains limited, with no clear definition. This study aimed to clarify the definitions and attributes of trauma nursing competencies in emergency departments.

DESIGN

Walker and Avant's method was used to clarify the concept of trauma nursing competency in emergency departments.

DATA SOURCES

PubMed, EMBASE, CINAHL and RISS were searched from inception to 23 April 2023.

ELIGIBILITY CRITERIA

Relevant studies that included combinations of the terms 'nurse', 'nursing', 'emergency', 'trauma', 'competency', 'capability' and 'skill' were selected. We restricted the literature search to English and Korean full-text publications, with no limit on the publication period; grey literature was excluded.

DATA EXTRACTION AND SYNTHESIS

This study uses defining attributes, antecedents and consequences extracted through data analysis. To aid comprehension of the model, related and contrary cases of the concept were created, and empirical referents were defined.

RESULTS

After excluding duplicates, irrelevant studies, incomplete texts and articles unrelated to the context and study population, 15 of the initial 927 studies were included. Five additional studies were added after a manual search of the references. The final concept analysis therefore included 20 studies. The attributes of trauma nursing competency for emergency nurses included 'rapid initial assessments considering injury mechanisms', 'priority determinations based on degrees of urgency and severity', 'clinical knowledge of trauma nursing', 'skills of trauma nursing', 'interprofessional teamwork' and 'emotional care'.

CONCLUSIONS

The concept analysis revealed that it is possible to promote the enhancement and development of trauma nursing competency in emergency departments across various contexts, such as clinical practice, education, research and organisational settings. This could ultimately improve trauma nursing quality and treatment outcomes.

Developing effective In-Service Education for intensive care nurses: Exploring the views of clinical stakeholders in the Kingdom of Saudi Arabia

BACKGROUND

Evidence-based in-service education (ISE) in the intensive care unit (ICU) is essential to maintaining nurse skill and competence in this complex clinical area. However, there has been limited research that has focused on developing and optimising the specialised training required by ICU nurses working in trauma care.

OBJECTIVES

To explore the perspectives of ICU clinical stakeholders regarding their needs and preferences for ISE to inform the future development and implementation of effective educational interventions.

DESIGN

A qualitative, multiple-case study supported by the "Empowering Education" theoretical framework, which emphasises the importance of stakeholder involvement in education development.

SETTINGS

Adult ICUs in three major hospitals located in two geographical areas in Saudi Arabia.

PARTICIPANTS

Forty clinical nurses, twelve nurse managers, nine nurse leaders and seven clinical educators participated.

METHODS

Data were collected through semi-structured interviews followed by focus groups. Framework analysis was used for data analysis.

FINDINGS

Stakeholders wanted ISE and training by subject experts characterised by: (i): relevant educational content; (ii): a range of educational techniques and (iii) flexible delivery and format. Nurses also identified factors that encouraged them to participate in ISE including adequate resources and a supportive work environment, whilst heavy workloads, cost and scheduling issues hindered engagement.

CONCLUSION

This paper highlights the importance of considering staff needs and local context when developing in-service ICU education to support nurses' competence. Further recommendations and a proposed framework to develop future ISE in the ICU are provided.

TWEETABLE ABSTRACT

The key to effective in-service education for ICU nurses is understanding stakeholders' needs and motivational drivers, whilst addressing barriers to successful implementation.