Journal of emergency nursing : JEN : official publication of the Emergency Department Nurses Association
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This paper developed and used practice vignettes to understand sexual assault nurse examiners' perceptions of self-confidence to provide care for Black, Indigenous, and transgender sexual violence survivors. Sexual assault nurse examiners are uniquely positioned to provide patient-centered postsexual violence health care but not all sexual assault nurse examiners receive culturally specific and identity-affirming training. Black/African American, Indigenous, and/or transgender people disproportionately experience sexual violence but may receive poorer health care after sexual violence compared with white cisgender people. Understanding sexual assault nurse examiner confidence to provide this care is paramount to improving sexual assault nurse examiner training and patient outcomes. ⋯ Training and mentorship programs could improve sexual assault nurse examiner confidence to provide trauma- and violence-informed care for Black, Indigenous, and transgender survivors, and vignettes could be used to measure changes in confidence owing to training.
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Documentation templates supported the implementation of HIRAID, a validated framework that supports nurses in assessing and managing patients in emergency departments in rural Australia using a strategy informed by behavior change theory. The study aimed to determine whether the implementation of HIRAID improved the accuracy of nurses' documentation across a large rural health district. ⋯ Implementation of HIRAID demonstrated a sustained improvement in the quantity and quality of emergency nurse documentation. Improved documentation accuracy is key to informing and evaluating ongoing care and supporting communication and continuity of care, and is essential to patient safety.
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Cognitive impairment in older adults is underrecognized in emergency departments. Despite emergency nurses' central role in facilitating ED screening for clinical and social needs, little is known about their perspectives on implementing delirium and dementia screenings. Nurses can provide insights to promote the uptake of these screenings. ⋯ Emergency nurses conceptualize screenings in terms of patient safety, which may be the best way to frame initiatives to implement screenings for cognitive impairment. In light of ED crowding and boarding's impacts on patient safety, nurses highlighted screening for cognitive impairment as increasingly relevant. However, they found current working conditions of delivering patient care in waiting rooms and hallways not conducive to implementing screenings. Using the Consolidated Framework for Implementation Research framework helped identify workflow limitations that are barriers to ED screening.
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The literature highlights the importance of the needs of family members of critical patients in emergency departments. Understanding these needs helps to alleviate psychological distress and contribute to the patients' recoveries. This study aimed to examine the psychological distress and needs of family members of critical patients in emergency departments. ⋯ Providing the assessment and necessary support to alleviate psychological distress will help enhance the ability of the emergency department to meet families' needs.
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Distal radius fractures are common injuries managed frequently in emergency departments. While numerous studies focus on the surgical treatment of distal radius fractures, there is a lack of research about non-surgically treated patients' early experiences post-injury. The objective of this study was to explore adult patients' initial experiences following closed reduction treatment of distal radius fracture in the emergency department. ⋯ Effective pain management, both pharmacological and non-pharmacological, as well as comprehensive, clear communication, is crucial in the initial treatment phase of distal radius fracture. Acknowledging patients' broader concerns can enhance the quality of care and support improved recovery outcomes. These findings imply that future emergency nursing practice should prioritize swift and effective pain management, clear and empathetic communication, and a holistic approach to patient care to optimize recovery outcomes.