Auditing the status of prioritization of nursing actions in the trauma emergency department.

INTRODUCTION: Patient assessment is considered as one of the key actions of nurses to provide professional services. Prioritizing the care needs based on the assessment could save patients' lives. Nurses should be able to prioritize patients' care needs and then, based on this prioritization, plan for patient life-threatening situations one after the other. The aim of this study was to audit the status of prioritization of nursing care for trauma patients in the trauma emergency department of Kowsar Hospital in Sanandaj. METHODS: This study was a quasi-experimental study (pre- and post-training) conducted using simple random sampling during the February to June 2021, in the emergency department of Kowsar Hospital in Sanandaj. The data collection tool was a standardized checklist for prioritizing nursing care, which contained a total of 53 items. At the beginning of the study, 64 nurses (32 in the experimental group and 32 in the control group) entered the study and the experimental group was evaluated based on a standardized prioritization checklist. Then, the data were collected and after statistical analysis, based on the obtained results and examining the weaknesses, the intervention group nurses participated in an educational course for one month. The checklist assessment was performed again and the results were compared with the results of the first assessment (before the intervention). RESULTS: The number of items requiring training in the experimental group before the intervention was 258 cases which decreased to 53 cases after training and this decrease was statistically significant (p < 0.05). However, in the control group, the number of measures requiring training in the first stage was 220 cases, which in the second stage of assessment fell to 213, but this decrease was not statistically significant (p > 0.05). CONCLUSION: By auditing the status of nursing care prioritization in the trauma emergency department and providing training related to focusing on the identified weaknesses, nurses' skills to prioritize patients' care needs as well as the quality of nursing care delivery increased.

Nurses' perception of disruptive behaviors in emergency department healthcare teams: A qualitative study.

INTRODUCTION: In an emergency setting, the occurrence of disruptive behaviors hinders team participation and cooperation. Exploring nurses' perception of disruptive behaviors can lead to a better identification of these behaviors in emergency departments and the provision of better recommendations. This study aimed to explore nurses' perception of disruptive behaviors among emergency healthcare teams in hospitals affiliated to the Hamadan University of Medical Sciences, Hamadan, Iran. METHOD: The study was carried out using qualitative content analysis in 2018-2019. Twenty participants from emergency departments of five hospitals in Hamadan, Iran, were enrolled using purposive sampling. Data were collected using semi-structured interviews that continued until data saturation. Data analysis was performed using Erlingsson and Brysiewicz's qualitative content analysis approach. RESULTS: Three main themes emerged including observable disruptive behaviors, hidden disruptive behaviors, and trigger factors. Observable disruptive behaviors consisted of two main categories: violence and incivility. Hidden disruptive behaviors included troubling behaviors, poor communication, and irresponsibility. Finally, the trigger factors of disruptive behaviors involved two categories: professional incompetency and workplace discrimination. CONCLUSION: Exploring nurses' perception showed that trigger factors such as professional incompetency and workplace discrimination could cause the occurrence of observable and hidden disruptive behaviors in emergency healthcare teams.