Determining Emergency Severity Index Acuity: Key Triage Elements Identified by Emergency Nurses.

Introduction: The conflation of mandated screening question data collection with patient assessment at the initial triage encounter challenges the ability of the emergency nurse to identify patients at risk for deterioration rapidly and accurately. Further, inexperienced triage nurses are generally challenged in differentiating between questions that establish stability and questions that meet other requirements. The aims of the study included exploration of how triage nurses identified critical data elements to facilitate more rapid and accurate patient triage and Emergency Severity Index acuity assignment, perceptions of appropriate location of assessment elements, and identifying common triage processes.

Establishing Triage Competencies and Verification Processes: A Survey Study.

Introduction: Although the ED triage function is a critical means of ensuring patient safety, core competencies for ED triage are not well defined in the literature. The purpose of the study was to identify and validate emergency triage nursing competencies and to develop a competency verification process.

Methods: A sample of 1181 emergency nurses evenly divided between roles with oversight of triage training and competency assessment (manager-level and staff nurses performing triage) completed an online survey evaluating competency elements that comprised the following in terms of frequency and importance, training modalities, and evaluation methods: expert assessment, clinical judgment, management of medical resources, communication, and timely decisions.

Validation of Emergency Nurse Practitioner Competencies: Patient Complexity and Clinical Decision Making.

Introduction: Over the past 15 years, the emergency nurse practitioner has been recognized as a nursing specialty role with dedicated scope and standards of practice. However, a paucity of objective data exists to validate the actual practice of emergency nurse practitioners in the emergency care setting. The purpose of this pilot study was to describe the initial acuity of patients assigned to emergency nurse practitioners, actions, decisional complexity, and disposition decisions of advanced practice nurses as they function in emergency departments in a single system.

AMP-dependent kinase stimulates the expression of αKlotho.

Renal αKlotho along with fibroblast growth factor 23 regulates phosphate and vitamin D metabolism. Its cleavage yields soluble Klotho controlling intracellular processes. αKlotho has anti-inflammatory and antioxidant effects and is nephro- and cardioprotective.

Moral courage of emergency nurses in care-limited environments: A mixed-methods study.

Background: Professional ethics in nursing exist to guide care and allow for decision-making to be patient-centered. In the current medicolegal landscape post-Roe and in light of bans on gender-affirming care, the decision-making processes of emergency nurses in the clinical environment of care as informed by both professional and personal ethics are an important area of inquiry.

Aim: The aim of this study was to examine the contribution of moral courage to decision-making by emergency nurses.

Elements of an Advanced Trauma Education Program for Emergency Nurses: A Modified Delphi Approach.

Background: Basic trauma education for emergency department (ED) staff is available, but there are currently no advanced trauma nursing practice standards for ED nurses.

Objective: The purpose of this study was to identify consensus-based elements of an advanced trauma nursing program for ED nurses.

Methods: We used a modified Delphi process with three rounds of online survey data collection to ensure a large group of geographically diverse experts.

Ensuring Throughput: Development and Validation of Charge Nurse Competencies for United States Emergency Care Settings.

Introduction: Charge nurses are shift leaders whose role includes managing nursing resources and facilitating appropriate patient care; in emergency departments, the charge nurse role requires both clinical and leadership skills to facilitate the flow of patients, while ensuring patient and staff safety. Literature on orientation and specific training is notably sparse. This study aimed to evaluate the content and process of core competency training and identify evaluation and implementation strategies necessary to improve charge nurse performance in United States emergency departments.

Individual Attributes and Environmental Conditions of Registered Nurses Working in Freestanding Emergency Departments in the United States: A Descriptive Exploratory Study.

Introduction: Freestanding emergency departments (FSEDs) are emergency facilities not connected to inpatient services. The percentage of FSEDs of all EDs grew from 1% in 2001 to 12% in 2017, making FSEDs a substantial subset of US emergency care. The purpose of this study was to describe the individual attributes and environmental conditions of registered nurses working in FSEDs in the US.

Frailty assessment tools in the emergency department: A geriatric emergency department guidelines 2.0 scoping review.

Objective: Given the aging population and growing burden of frailty, we conducted this scoping review to describe the available literature regarding the use and impact of frailty assessment tools in the assessment and care of emergency department (ED) patients older than 60 years.

Methods: A search was made of the available literature using the Covidence system using various search terms. Inclusion criteria comprised peer-reviewed literature focusing on frailty screening tools used for a geriatric population (60+ years of age) presenting to EDs.

Emergency nurses' perceptions of the utility, adaptability and feasibility of the emergency nursing framework HIRAID for practice change in US: An exploratory study.

Background: Patient assessment is a core component of nursing practice and underpins safe, high-quality patient care. HIRAID an evidence-informed emergency nursing framework, provides nurses with a structured approach to patient assessment and management post triage. In Australia, HIRAID resulted in significant improvements to nurse-led communication and reduced adverse patient events.

The Relationship Between Accurate Triage and Core Measures Compliance for Acute Myocardial Infarction and Heart Failure in Older Adults Presenting to the Emergency Department.

Background: Accurate emergency department (ED) triage in the geriatric population is an important nurse-sensitive quality indicator; however, few quality indicators are verified for impact.

Purpose: To examine the relationship between triage accuracy in adults older than 65 years and Core Measures for acute myocardial infarction (AMI) and heart failure (HF).

Methods: A correlational approach was used to determine strength and direction of the relationship between variables.

PKC regulates αKlotho gene expression in MDCK and NRK-52E cells.

Particularly expressed in the kidney, αKlotho is a transmembrane protein that acts together with bone hormone fibroblast growth factor 23 (FGF23) to regulate renal phosphate and vitamin D homeostasis. Soluble Klotho (sKL) is released from the transmembrane form and controls various cellular functions as a paracrine and endocrine factor. αKlotho deficiency accelerates aging, whereas its overexpression favors longevity.

The Effect of Mandatory Triage Questions on Triage Processes: A Qualitative Exploratory Study.

Introduction: The study purpose was to obtain an understanding of both the types of questions mandated for the triage encounter in emergency departments across the United States and how emergency nurses perceive the relevance of these questions to the triage process.

Methods: A qualitative descriptive exploratory study using focus group data was used. Data were collected at an in-person emergency nursing conference held in September 2022.

What if It Were Me? A Qualitative Exploratory Study of Emergency Nurses' Clinical Decision Making Related to Obstetrical Emergencies in the Context of a Post-Roe Environment.

Introduction: Previous research describes a significant knowledge deficit in obstetrical care in emergency settings. In a post-Roe environment, additional medicolegal challenges are documented across the obstetrics and gynecology landscape, but an understudied care setting is the emergency department, where patients may present to a practice environment where there is limited or no obstetrical care available. It is unknown how emergency nurses make decisions around these types of presentations.

Current Practice and Practice Competencies of Clinical Nurse Specialists Working in US Emergency Care Settings: A Survey Study.

Purpose/aims: The aim of this study was to investigate the current practice of clinical nurse specialists working in US emergency care settings to (1) explicate the application of the Emergency Nurses Association core competencies and define the specialized clinical nurse specialist role in emergency care and (2) align current clinical nurse specialist practice in emergency settings with the National Association of Clinical Nurse Specialists core competencies and the identified substantive areas of clinical nurse specialist practice.

Design: This study used a quantitative exploratory descriptive approach using survey data.

Methods: A purposive convenience sample was recruited from the Emergency Nurses Association and the National Association of Clinical Nurse Specialists.

Determining Clinical Judgment Among Emergency Nurses During a Complex Simulation.

Introduction: Clinical judgment is imperative for the emergency nurse caring for the acutely ill patients often seen in the emergency department. Without optimal clinical judgment in the emergency department, patients are at risk of medical errors and a failure to rescue.

Methods: A descriptive observational approach using the Lasater Clinical Judgment Rubric evaluated nurses during a task that required recognition of clinical signs of deterioration and appropriate clinical care for simulated patients.

The Experiences of United States Emergency Nurses Related to Witnessed and Experienced Bias: A Mixed-Methods Study.

Introduction: The purpose of this study was to obtain a broad view of the knowledge, attitudes, beliefs, and lived experiences of emergency nurses regarding implicit and explicit bias.

Methods: An exploratory, descriptive, sequential mixed-methods approach using online surveys and focus groups to generate study data. Two validated instruments were incorporated into the survey to evaluate experiences of microaggression in the workplace and ethnocultural empathy.

The Food and Drug Administration's (FDA's) Drug Safety Surveillance During the COVID-19 Pandemic.

Introduction: On 4 February, 2020, the Secretary of the Department of Health and Human Services declared a public health emergency related to coronavirus disease 2019 (COVID-19), and on 27 March, 2020 declared circumstances existed to justify the authorization of the emergency use of drug and biological products (hereafter, "drugs") for COVID-19. At the outset of the pandemic with uncertainty relating to the virus, many drugs were being used to treat or prevent COVID-19, resulting in the US Food and Drug Administration's (FDA's) need to initiate heightened surveillance across these drugs.

Objective: We aimed to describe the FDA's approach to monitoring the safety of drugs to treat or prevent COVID-19 across multiple data sources and the subsequent actions taken by the FDA to protect public health.