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

INTRODUCTION: Digital technology has enabled gamification methods to enhance triage education, reflecting an evolving healthcare landscape. OBJECTIVE: To 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. METHOD: The 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. RESULTS: The 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). CONCLUSIONS: The findings provide robust evidence for the effectiveness of gamification in triage training within emergency nursing.

Development of a Competency-Based Triage Education Application and Usability Testing for Triage Training Based on the Korean Triage and Acuity Scale.

BACKGROUND: Improving the quality of emergency nursing care requires enhancing triage competency through education programs that integrate the content of the Korean Triage and Acuity Scale, a triage system specifically developed for the Korean context. Thus, this study developed a competency-based triage education application (CTEA), based on the Korean Triage and Acuity Scale, and evaluated its effectiveness through usability testing. METHOD: The CTEA used various teaching methods and game mechanisms, including lectures, case studies, and video-based scenarios, to improve triage competency. RESULTS: In the usability testing phase, the CTEA was refined through expert heuristic evaluation and user interviews conducted with the think-aloud method. Six themes were derived from the interviews, highlighting the need for a well-structured program with realistic scenarios, easy accessibility, gamification, functional improvements, and future triage educational applications. CONCLUSION: These findings suggest that the CTEA is effective and satisfactory for users and can contribute to improving the triage competency of emergency nurses. [J Contin Educ Nurs. 2024;55(1):33-41.].

Construção e validação de cartilha educativa sobre suporte básico de vida para estudantes do ensino médio / Construction and validation of an educational booklet on basic life support for high school students / Construcción y validación de carpeta educativa sobre soporte vital básico para estudiantes de secundaria

O objetivo deste estudo é construir e validar uma cartilha educativa para estudantes do ensino médio sobre Suporte Básico de Vida nas escolas. Trata-se de uma pesquisa metodológica, realizada em três etapas. Na primeira etapa foi realizada revisão bibliográfica, na segunda etapa procedeu-se a elaboração da cartilha educativa e por fim, a validação do material por especialistas. Entre os resultados destaca-se que a cartilha aborda as principais recomendações acerca da segurança do socorrista e suporte básico de vida no adulto e possui 14 páginas. Conclui-se que todos os itens da cartilha educativa obtiveram índice de validade de conteúdo maior que 0,82 conseguindo a validação.

The objective of this study is to build and validate an educational booklet for high school students about Basic Life Support in schools. This is a methodological research, carried out in three stages. In the first stage, a bibliographic review was carried out, in the second stage, the educational booklet was elaborated and, finally, the material was validated by specialists in the subject. Among the results, it is highlighted that the booklet addresses the main recommendations regarding rescuer safety and basic adult life support and has 14 pages. It was concluded that all items in the educational booklet had a content validity index greater than 0.82, achieving validation.

El objetivo de este estudio es construir y validar una cartilla educativa para estudiantes de secundaria sobre Soporte Vital Básico en las escuelas. Se trata de una investigación metodológica, realizada en tres etapas. En la primera etapa se realizó una revisión bibliográfica, en la segunda etapa se elaboró la cartilla educativa y, finalmente, el material fue validado por especialistas en el tema. Entre los resultados, se destaca que la cartilla aborda las principales recomendaciones sobre seguridad del reanimador y soporte vital básico del adulto y tiene 14 páginas. Se concluyó que todos los ítems de la cartilla educativa tuvieron un índice de validez de contenido superior a 0,82, lográndose la validación.

Factors affecting the triage decision-making ability of emergency nurses in Northern China: A multi-center descriptive survey.

INTRODUCTION: The quality of triage decision-making is a prerequisite for priority treatment of critically ill patients and effective utilization of medical resources. Figuring out how to improve triage decision-making is still a topic around the global emergency department. Hence, this study aims to promote an understanding of triage priority care and clarify the elements influencing triage decision-making ability, offering reference for the future to improve the quality of triage decision-making. METHOD: A total of 404 emergency nurses from 11 tertiary hospitals in northern China were surveyed by questionnaire, of which 371 valid questionnaires were submitted (effective rate = 91.83 %). One hospital distributed the questionnaire face-to-face, and the other ten used online form. RESULT: Prior to occupying triage jobs, only a quarter of participants(25.30 %)were qualified. Less than half of emergency nurses (46.60 %) reported taking part in the triage training program. The emergency nurses' triage decision-making ability score was 166.50 ± 26.90(95 %CI 163.75,169.24) in northern China. Gender(P = 0.003), case discussion(P = 0.024), secondary assessment(P = 0.020)and knowledge of triage consensus(P = 0.027) are independent factors influencing triage decision-making ability. CONCLUSION: Emergency triage practices are less implemented in northern China. The triage decision-making ability of emergency nurses in northern China is at a low level. Providing emergency nurses with diverse opportunities to develop their triage skills, finding effective triage training content, form, and frequency, strengthening implement triage consensus, and wisely managing triage nurse resources would improve triage decision-making.

Evaluation of the factors affecting triage decision-making among emergency department nurses and emergency medical technicians in Iran: a study based on Benner's theory.

INTRODUCTION: Emergency department (ED) nurses and emergency medical technicians (EMTs) find themselves performing triage under time pressure and with limited information. Identifying an effective triage decision-making process can play a significant role in promoting patient safety. Experts are able to make faster and more effective decisions in emergencies than novices. OBJECTIVE: The current study aimed to identify the level of triage decision-making (TDM) and its' predictors in ED nurses and EMTs based on self-reported levels of nursing proficiency in Benner's theory from novice to expert. MATERIALS AND METHODS: Out of 821 ED nurses and EMTs who met the inclusion criteria, 320 ED nurses and 152 EMTs were included in this descriptive-analytical research. Data were collected by a demographic information form and triage decision-making inventory (TDMI) and analyzed by SPSSv.22 software using descriptive statistics, Pearson correlation test, t-test, ANOVA, and multiple linear regression. RESULTS: The total score of TDMI in the ED nurses and EMTs was higher in the expert nurses than in the proficient, competent, advanced beginner and novices. Multiple linear regression analysis showed that self-reported levels of nursing proficiency, age, work experience, marital status and triage training course were predictors of TDM in ED nurses (P < .05), and self-reported levels of nursing proficiency, service location, work experience, and triage training course were predictors of TDM in EMTs (P < .05). CONCLUSION: Understanding the predictors influencing TDM health professionals may facilitate the understanding of their training needs. The training needs of a novice and inexperienced person may be different from those of an expert person, it is recommended that the training methods be based on the experiences and professional levels of nurses so that the training provided is effective and quality. Moreover, to increase the TDM power and reduce TDM errors due to lack of experience, a system is suggested to be established to allow novice nurses in the first year to work with experienced nurses. Also it is suggested that the determining educational and training focus with regards to triage before entering the bedside be done based on predictors.

Forensic professional's thoughts on New Zealand emergency nurse's forensic science knowledge and practice.

INTRODUCTION: The clinical forensic nursing role in emergency departments is a recognised nursing speciality globally but there is no designated clinical forensic role in New Zealand nor is their adequate tertiary education despite New Zealand emergency nurses being expected to be able to complete these duties if required. The study sought to find out the perceptions of forensic professionals about 1) how well if at all forensic protocols and practices are adhered to by emergency nurses in New Zealand, 2) what areas of forensic practice if any do ED nurses need tertiary training in to effectively care for patients with health conditions related to violence, and, 3) what relationship exists between emergency nurses and forensic professionals. METHODS: Health professionals in forensic nursing roles were invited to complete an anonymous, online survey consisting of Likert scale questions and free text commentary. A descriptive, content analysis of the data was undertaken. RESULTS: Content analysis described, incorrect evidence collection, erroneous chain of custody errors, limited relationship between emergency nurses and forensic professionals and clear support for a postgraduate clinical forensic nursing programme. DISCUSSION: This study identified that forensic science knowledge and practices by emergency nurses are inadequate for the work they are required to undertake, suggesting that additional professional development is warranted in order to maintain best practice standards for forensic emergency care.

Delivering an online course in emergency nursing education during the pandemic: What are the effects on students' learning?

BACKGROUND: Online learning emerged as an auxiliary approach in 2013 when MOOCs were imported and popularized in Chinese universities, particularly in the duration of pandemic outbreaks worldwide. World health organization (WHO) had recommended online education to keep social distance which still needs further evaluation. This study aimed to examine whether an open online course is superior to conventional education in emergency nursing during the COVID-19 pandemic. METHODS: Two groups of conventional education students (CG) and two groups of students participating in an online course that utilized an application (called SuperStar) as the SuperStar Group (SSG) were studied to compare their abilities in the process of new knowledge acquisition. The SSG was divided into a blended group (S1) and an online group (S2). The emergency nursing course was scheduled in 16 independent classes, which contained stochastic tests at least eight times. RESULTS: The CG group showed better performance on the final exam than the SSG group, but there was no statistically significant difference. The CG group obtained better scores on the memory capacity tests while the SSG had better scores on the application capacity tests. The SSG group scored higher on the later tests during the process of education compared to the CG group. CONCLUSIONS: Comprehension of an emergency nursing course was stronger in the SSG group than in the CG group. Horizontal comparison of subentry tests discriminated between the groups, with a better trend for the SSG group in application ability. There are potential effects on chronological learning through the use of the online course for emergency nursing education, not only during COVID-19 but also in the post-pandemic era.

Development and Implementation of a Pediatric Telesimulation Intervention for Nurses in Community Emergency Departments.

The need for virtual education for nursing staff has dramatically increased because of social distancing measures after the coronavirus disease pandemic. Emergency departments in particular need to educate staff on caring for patients with coronavirus disease while concurrently continuing to ensure education related to core topic areas such as pediatric assessment and stabilization. Unfortunately, many nurse educators are currently unable to provide traditional in-person education and training to their nursing staff. Our inter-professional team aimed to address this through the rapid development and implementation of an emergency nursing telesimulation curriculum. This curriculum focused on the nursing assessment and initial stabilization of a child presenting to the emergency department in status epilepticus. This article describes the rapid development and implementation of a pediatric emergency nursing telesimulation. Our objectives in this article are (1) to describe the rapid creation of this curriculum using Kern's framework, (2) to describe the implementation of a fully online simulation-based pediatric emergency training intervention for nurse learners, and (3) to report learners' satisfaction with and feedback on this intervention.

Evaluating a new trauma and critical care management course for nurses.

A new practical-based course for nurses on the management of major trauma has been developed using high-level simulation and moulage to deliver education based on established trauma competencies. The Nurse Trauma and Critical Care course was developed by nurses with input from the Anaesthesia Trauma and Critical Care group and has been accredited by the Royal College of Surgeons. This article describes the development of the course and discusses the findings of a course evaluation that aimed to measure candidates' confidence and knowledge after completion.

Importance Ranking of Electrocardiogram Rhythms: A Primer for Curriculum Development.

INTRODUCTION: Electrocardiogram interpretation is an essential skill for emergency and critical care nurses and physicians. There remains a gap in standardized curricula and evaluation strategies used to achieve and assess competence in electrocardiogram interpretation. The purpose of this study was to develop an importance ranking of the 120 American Heart Association electrocardiogram diagnostic labels with interdisciplinary perspectives to inform curriculum development. METHODS: Data for this mixed methods study were collected through focus groups and individual semi-structured interviews. A card sort was used to assign relative importance scores to all 120 American Heart Association electrocardiogram diagnostic labels. Thematic analysis was used for qualitative data on participants' rationale for the rankings. RESULTS: The 18 participants included 6 emergency and critical care registered nurses, 5 cardiologists, and 7 emergency medicine physicians. The 5 diagnoses chosen as the most important by all disciplines were ventricular tachycardia, ventricular fibrillation, atrial fibrillation, complete heart block, and normal electrocardiogram. The "top 20" diagnoses by each discipline were also reported. Qualitative thematic content analysis revealed that participants from all 3 disciplines identified skill in electrocardiogram interpretation as clinically imperative and acknowledged the importance of recognizing normal, life threatening, and time-sensitive electrocardiogram rhythms. Additional qualitative themes, identified by individual disciplines, were reported. DISCUSSION: This mixed-methods approach provided valuable interdisciplinary perspectives concerning electrocardiogram curriculum case selection and prioritization. Study findings can provide a foundation for emergency and critical care educators to create local ECG educational programs. Further work is recommended to validate the list amongst a larger population of emergency and critical care frontline nurses and physicians.

Cost Savings of Frequent, Concise Skills Competency Training in the Emergency Department.

Nurse educators are confronted with ensuring skills competency and staff compliance to support the provision of safe and quality care. The ED setting presents additional challenges when conducting skills competency training. One military hospital's emergency department implemented a method of frequent, concise skills training sessions to overcome barriers unique to the ED setting; the same method was then implemented at a second military organization owing to the effectiveness of the training approach to increase staff compliance. This article outlines the methods for the implementation of frequent, concise skills training sessions, and it displays the cost savings and increased compliance experienced by the 2 health care organizations after the implementation of this frequent, concise skills training method.

External Female Urinary Catheter: Implementation in the Emergency Department.

The emergency department is a care environment in which indwelling urinary catheters are placed frequently; however, the significance of the role of the emergency department in catheter-associated urinary tract infection prevention has been overlooked. The use of an external female urinary catheter is an alternative to placing an indwelling urinary catheter for female patients in the emergency department who are incontinent of urine or are immobile. The purpose was to describe the implementation of an initiative to decrease the number of indwelling urinary catheters and increase the use of external urinary female catheters in non-critically ill women who visited the emergency department at a 451-bed Magnet-designated community hospital in the Southeast. For this clinical implementation project, the Plan, Do, Check, Act framework was used to develop the initiative, and outcome data were collected retrospectively and included an indirect calculation of the number of indwelling urinary catheters placed in the emergency department. A total of 187 external catheters were used in place of indwelling catheters in female patients over a 3-month period. No skin irritation or breakdown was observed. This project demonstrated the initial staff acceptability and feasibility of external female urinary catheter use in the ED setting.

Reversible causes of cardiac arrest: Nursing competency acquisition and clinical simulation satisfaction in undergraduate nursing students.

BACKGROUND: It is essential to determine and treat the reversible causes of cardiac arrest, so emergency nurses must acquire the competencies needed for its adequate management. METHOD: 106 undergraduate nursing students participated in a cross-sectional study, using a mixed-method. Simulated scenarios recreated critically ill patients with diagnoses of potentially reversible causes of cardiac arrest in an emergency room. An internally validated questionnaire was used to analyse students' satisfaction and perceptions about clinical simulation sessions. Nursing competencies were assessed using a verification list. Data were analysed using the IBM SPSS Statistics version 24.0 (quantitative data) and ATLAS-ti version 8.0 (qualitative data) software. RESULTS: Nursing students expressed a high level of satisfaction (most of the scores obtained were higher than 90%) and positive perceptions about clinical simulation sessions. Most of the students (85.6%) acquired the necessary nursing competencies for adequate management of the reversible causes of cardiac arrest. CONCLUSION: Clinical simulation methodology is a useful tool for the learning process and acquisition of nursing competencies related to emergency situations management. This methodology prepares nursing students for their clinical placements and future careers in emergency care. Therefore, it is recommended to extend clinical simulation training to emergency qualified nursing staff and advanced practitioners.

Specific Competencies of Prehospital Emergency Nursing: The Views of Spanish University Professors.

BACKGROUND: The guarantee of nursing competence in prehospital urgent care requires the identification and delimitation of the specific competencies. This work describes the importance attributed by professors of Spanish universities to the competencies of prehospital nursing positions and indicates the most appropriate training level required to achieve them. METHOD: The current work consisted of a survey with an online questionnaire. Sixty competencies over 10 domains were studied. RESULTS: The most valued domains were those of general and personal competencies. The competencies considered most important were "Recognizes the vital risk and knows how to perform basic and advanced life support maneuvers" and "Provides quality health care." The nursing degree is considered appropriate to train students to the required level in only eight competencies. CONCLUSION: The proposed competencies can be considered as specific competencies necessary in prehospital emergency nursing. Effective performance requires training to a higher level than a nursing degree. [J Contin Educ Nurs. 2020;51(12):556-567.].

Increasing Disaster Preparedness in Emergency Nurses: A Quality Improvement Initiative.

INTRODUCTION: Emergency nurses are on the frontlines of disaster response. Current research reveals low to moderate levels of disaster preparedness in this population and suggests education as an effective means of increasing preparedness. The purpose of this study was to measure, explore, and increase the preparedness levels among emergency nurses at an acute care community hospital in Southern California. METHODS: This was a single group pre/posttest of an educational intervention. The adapted Emergency Preparedness Information Questionnaire was administered to all emergency nurses at the practice site to assess disaster preparedness levels before and after a 6-month education intervention. The intervention was novel because the education was delivered through existing communication channels of daily shift huddles, regular e-mails, designated whiteboard, and staff meeting presentations. Descriptive statistics, Pearson correlation, and paired t tests were used to analyze the data. RESULTS: Moderate levels of disaster preparedness were reported. The number of years worked in the emergency department had the strongest correlation with perceived preparedness levels, followed by prior disaster education/training. A 16.9-point (23.5%) increase between the respondents' mean pre- and post-Emergency Preparedness Information Questionnaire scores (t(33) = -10.27, P ≤ 0.001) was observed. DISCUSSION: These results suggest that a tailored ED-specific disaster preparedness curriculum, delivered through established clinical communication channels, can effectively increase preparedness levels among nurses with little additional cost. The integration of concise, relevant disaster information can be implemented in any department interested in developing a more confident and prepared workforce.

The impact of adult trauma triage training on decision-making skills and accuracy of triage decision at emergency departments in Malaysia: A randomized control trial.

INTRODUCTION: Patients who visit emergency departments need to undergo a precise assessment to determine their priority and accurate triage category to ensure they receive the right treatment. AIM: To identify the effect of triage training on the skills and accuracy of triage decisions for adult trauma patients. METHOD: A randomized controlled trial design was conducted in ten emergency department of public hospitals. A total of 143 registered nurses and medical officer assistants who performed triage roles were recruited for the control group (n = 74) and the intervention group (n = 69). The skill and accuracy of triage decisions were measured two weeks and four weeks after the intervention group were exposed to the intervention. RESULTS: There was a significant effect on the skill of triage decision-making between the control and the intervention group p < 0.001, η2partial = 0.31. Concerning the accuracy of triage decisions, the effect was significantly different between the control group and the intervention group p < 0.001, η2partial = 0.66 across time. CONCLUSION: The triage training improved the skills of the participants and the accuracy of triage decision-making across time.