Barriers and enablers to nurse-initiated care in emergency departments: An embedded mixed methods survey study.

Autor: Gawthorne J; Faculty of Medicine and Health, The University of Sydney Susan Wakil School of Nursing and Midwifery, Camperdown, NSW, Australia; St Vincents Health Network, Sydney. Victoria St., Darlinghurst, NSW, Australia. Electronic address: julie.gawthorne@svha.org.au., Curtis K; Faculty of Medicine and Health, The University of Sydney Susan Wakil School of Nursing and Midwifery, Camperdown, NSW, Australia; Emergency Services, Illawarra Shoalhaven Local Health District, Wollongong Hospital, Crown St, Wollongong, NSW, Australia., Fry M; University of Technology Sydney Faculty of Health, NSW, Australia; Northern Sydney Local Health District, NSW, Australia., Mccloughen A; Faculty of Medicine and Health, The University of Sydney Susan Wakil School of Nursing and Midwifery, Camperdown, NSW, Australia., Fethney J; Faculty of Medicine and Health, The University of Sydney Susan Wakil School of Nursing and Midwifery, Camperdown, NSW, Australia.
Jazyk: angličtina
Zdroj: Australasian emergency care [Australas Emerg Care] 2024 Nov 04. Date of Electronic Publication: 2024 Nov 04.
DOI: 10.1016/j.auec.2024.10.003
Abstrakt: Background: Increased demand, wait times and length of stay have seen many emergency departments implement nurse-initiated protocols In New South Wales, Australia, 74 nurse-initiated protocols have been developed for implementation. The aim of this paper is to identify the barriers and enablers to nurses' use of these protocols to inform and maximise future implementation.
Methods: Data were collected via surveys informed by the theoretical domains' framework and the Practice Environment Scale of the Nursing Work Index (PES-NWI). Descriptive statistics summarised quantitative data and content analysis was performed on qualitative data. Results were integrated and classified as barriers or enablers to nurses' use of protocols.
Results: The nurses' response rate was 82 % (n = 76) and doctors 72 % (n = 34) Six categories were generated; one barrier (lack of resources), three enablers (patient and organisational benefits, nurses' motivation, nurses' desire to develop their practice) and two were both a barrier and enabler ( nurse confidence and the work environment).
Conclusion: Emergency nurses are highly motivated to use nurse-initiated protocols to positively impact patient outcomes. However, a lack of resources, time, access to education and confidence are barriers to use that need to be addressed when designing implementation.
Competing Interests: Declaration of Competing Interest We declare author Prof Kate Curtis is an Associate Editor and Prof Margaret Fry is a Senior Editor for the Australasian Emergency Care.
(Copyright © 2024 The Authors. Published by Elsevier Ltd.. All rights reserved.)
Databáze: MEDLINE
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