Duhalde Henrik, Bååth Carina, Hommel Ami, Bjuresäter Kaisa
J Emerg Nurs. 2025 Sep;51(5):840-849. doi: 10.1016/j.jen.2025.03.018. Epub 2025 May 8.
Missed nursing care in hospital wards is associated with patient safety risks and reduced quality of care. Emergency departments are high-risk settings; therefore, missed nursing care in these settings must be explored. Studies on missed nursing care in emergency departments show, for instance, that patient education, nutrition, and the maintenance of patient privacy are often missed. These findings are similar to those of previous studies conducted in hospital wards. However, crowding, boarding, and patients with acuity issues in emergency departments are examples of contextual differences with hospital wards. How emergency nurses perceive their nursing practices in relation to missed nursing care and their ability to maintain patient safety and quality of care is not well-known. This study aimed to explore emergency nurses' perceptions of nursing care in the emergency departments.
This study used a qualitative descriptive design and a purposive sampling strategy. Semi-structured interviews were conducted with 15 emergency nurses. A phenomenographic approach was used for the analyses.
The findings showed variations in the perceptions of emergency nurses regarding the quality of nursing care and missed nursing care. Subordinate to acute medical needs, fundamental care needs were addressed if there was sufficient time, which negatively affected older adult patients, particularly frail patients. Emergency nurses strived to maintain adequate patient flow throughout the emergency department and were attentive to all patients in their care; however, they were aware that missed nursing care was a recurring phenomenon.
Emergency nurses had various perceptions of nursing care. Demanding conditions, prioritization of medical needs, and maintenance of adequate patient flow challenged them in their efforts to meet patients' fundamental needs and fulfill their responsibilities.
医院病房中护理缺失与患者安全风险及护理质量下降相关。急诊科是高风险场所；因此，必须对这些场所的护理缺失情况进行探究。例如，关于急诊科护理缺失的研究表明，患者教育、营养以及患者隐私保护常常被忽视。这些发现与之前在医院病房进行的研究结果相似。然而，急诊科的拥挤、住院延迟以及急症患者等情况是与医院病房存在的背景差异。急诊护士如何看待其护理实践与护理缺失的关系，以及他们维持患者安全和护理质量的能力尚不清楚。本研究旨在探究急诊护士对急诊科护理的看法。
本研究采用定性描述设计和目的抽样策略。对15名急诊护士进行了半结构式访谈。采用现象学方法进行分析。
研究结果显示，急诊护士对护理质量和护理缺失的看法存在差异。在急性医疗需求之下，如果有足够时间，基本护理需求会得到满足，这对老年患者，尤其是体弱患者产生了负面影响。急诊护士努力维持整个急诊科的患者流量，并关注他们护理的所有患者；然而，他们意识到护理缺失是一个反复出现的现象。
急诊护士对护理有不同的看法。苛刻的条件、医疗需求的优先级以及维持足够的患者流量，在他们满足患者基本需求和履行职责的努力中对他们构成了挑战。
