Dawn Carpenter is an acute care nurse practitioner in the surgical intensive care unit and trauma service line at Guthrie Health Care System, Sayre, Pennsylvania, and an associate professor at Tan Chingfen Graduate School of Nursing, University of Massachusetts (UMass) Chan Medical School, Worcester, Massachusetts.
Alexander Menard is an assistant professor, Tan Chingfen Graduate School of Nursing, UMass Chan Medical School, and a surgical critical care nurse practitioner at UMass Memorial Medical Center, Worcester.
Crit Care Nurse. 2024 Oct 1;44(5):20-31. doi: 10.4037/ccn2024192.
From 2018 to 2022, mass shooting incidents in the United States increased by 67.7%. Health care-associated shootings also increased. The role of acute and critical care nurses during shootings is not well defined in the literature.
To identify roles of acute and critical care nurses during mass shooting incidents and provide best-practice recommendations for shooting incidents within a hospital.
The methods of Whittemore, Knafl, and Torraco informed this integrative review. Ovid MEDLINE, CINAHL, and Scopus databases were searched for publications related to acute and critical care nurses, mass shooting incidents, and hospital setting.
Of 13 589 articles retrieved, 27 were included; 63% were narrative reviews. The highest level of evidence was an expert consensus panel; next highest was a quasi-experimental study that simulated experiences to test mass casualty incident response. Third highest was a qualitative study that analyzed nurses' experiences during a mass casualty experience.
The evidence revealed 3 themes: prevention and preparedness, response to incident, and recovery phase. Education and training for acute and critical care nurses about mass shooting incidents are central to defining nurses' roles and best practices for these incidents. Nurses must know Stop the Bleed techniques and run-hide-fight protocols. Additionally, acute and critical care nurses need representation on hospital committees to develop and implement policies and procedures.
Hospitals are not immune to mass shooting incidents. Acute and critical care nurses require education including simulations and drills on mass shooting incidents to ensure safety of nurses and patients.
从 2018 年到 2022 年，美国大规模枪击事件增加了 67.7%。与医疗保健相关的枪击事件也有所增加。在文献中，枪击事件中急性和重症监护护士的角色尚未明确定义。
确定急性和重症监护护士在大规模枪击事件中的角色，并为医院内的枪击事件提供最佳实践建议。
Whittemore、Knafl 和 Torraco 的方法为本次综合回顾提供了信息。在 Ovid MEDLINE、CINAHL 和 Scopus 数据库中搜索了与急性和重症监护护士、大规模枪击事件和医院环境相关的出版物。
在检索到的 13589 篇文章中，有 27 篇被纳入，其中 63%为叙述性评论。最高证据级别为专家共识小组；其次是模拟经验以测试大规模伤亡事件应对的准实验研究。第三高是分析护士在大规模伤亡体验期间经历的定性研究。
证据揭示了 3 个主题：预防和准备、事件应对和恢复阶段。对急性和重症监护护士进行有关大规模枪击事件的教育和培训是定义护士在这些事件中的角色和最佳实践的核心。护士必须了解止血技术和逃跑-躲藏-战斗协议。此外，急性和重症监护护士需要在医院委员会中有代表，以制定和实施政策和程序。
医院不能免受大规模枪击事件的影响。急性和重症监护护士需要接受包括模拟和演练在内的大规模枪击事件教育，以确保护士和患者的安全。
