ABSTRACT
Worldwide, nurses employed in the Emergency Department (ED) face many challenges that negatively influence their well-being and ability to provide high-quality patient care. Previous researchers have investigated these challenges regarding their causes, consequences, and how to deal with them. However, most of the previous research addressed these challenges using quantitative research. The current study is the first qualitative study that examined these challenges in the Jordanian context. A descriptive naturalistic qualitative design was used to explore the most critical challenges facing nurses employed in the ED and described the suggested solutions for these challenges from nurses' perspectives. Ten registered nurses employed in the most prominent ED in Jordan were selected through purposive sampling. Semi-structured interviews were used to collect data. Thematic analysis technique was used to analyze data. Six main themes emerged: the definition of challenge, challenges facing registered nurses in the emergency department (five sub-themes), preventive measurements, possible solutions (five sub-themes), effects of the challenges (two sub-themes), and future challenges. The outcomes of this study could be integrated into the educational curricula to prepare new nurses to deal with these challenges in the future after graduation and contribute to finding solutions and solving some significant problems facing registered nurses in the ED. The hospital administrators and the policymakers should develop effective interventions to overcome the challenges facing nurses in the ED to ensure a better work environment and high-quality patient care.
ABSTRACT
BACKGROUND: Non-typhoidal Salmonella (NTS) is a major foodborne zoonotic pathogen worldwide. In the current study, Various NTS strains were isolated from (cows, milk and dairy products in addition to humans) in New Valley and Assiut Governorate, Egypt. NTS were firstly serotyped and tested by antibiotic sensitivity test. Secondly, some virulence genes and Antibiotic resistance genes have been identified by using PCR. Finally, Phylogenesis was performed depending on the invA gene, for two S. typhimurium isolates (one of animal origin and the other of human origin for evaluating zoonotic potential). RESULTS: Out of 800 examined samples, the total number of isolates was 87 (10.88%), which were classified into 13 serotypes, with the most prevalent being S. Typhimurium and S. enteritidis. Both bovine and human isolates showed the highest resistance to clindamycin and streptomycin, with 90.80% of the tested isolates exhibiting MDR. The occurrence of the invA gene was 100%, while 72.22%, 30.56%, and 94.44% of the examined strains were positive for stn, spvC, and hilA genes, respectively. Additionally, blaOXA-2 was detected in 16.67% (6/ 36) of the tested isolates, while blaCMY-1 was detected in 30.56% (11of 36) of the tested isolates. Phylogenesis revealed a high degree of similarity between the two isolates. CONCLUSIONS: The high occurrence of MDR strains of NTS in both human and animal samples with high degree of genetic similarity, shows that cows, milk and milk product may be a valuable source of human infection with NTS and interfere with treatment procedures.
