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                <text>International Emergency Nursing Vol. 53 November 2020&#13;
Self-compassion mediates the association between conflict about ability to&#13;
practice end-of-life care and burnout in emergency nurses</text>
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                <text>Introduction: End-of-life care (EOLC) is necessary for patients who are not expected to live long. Nurses have positive attitudes toward EOLC, but they encounter difficulties in practice. That situation creates conflict, which can affect burnout. It is essential to manage nurses’ conflict about their ability to practice EOLC by enhancing their individual strengths. Focusing on the role of self-compassion may help to prevent burnout related to the conflict about ability to practice EOLC.&#13;
Objective: The study aim was to assess the mediating effect of self-compassion on the association between conflict about ability to practice EOLC and burnout. &#13;
Methods: A correlational study was conducted with emergency department nurses who practiced EOLC. Self-report measures of conflict about ability to practice EOLC, burnout, and self-compassion were obtained. &#13;
Results: Negative aspects of self-compassion mediated the relationship among conflict, emotional exhaustion, and depersonalization (burnout). Self-compassion did not mediate the association between conflict and reduced personal accomplishment (burnout).&#13;
Conclusions: Negative aspects of self-compassion mediated the relationship between conflict and burnout (excluding reduced personal accomplishment). To prevent burnout, it is necessary to screen for nurses with low self-compassion and to provide opportunities to change their cognitive recognition and disclose their conflicts. </text>
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&#13;
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                <text>International Emergency Nursing Vol. 53 November 2020&#13;
Safety attitudes and working climate after organizational change in a major emergency department in Sweden</text>
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                <text>Background: Medically complex patients present challenges to the health care system, particularly in the emergency department (ED) setting. Specifically, teamwork is thought to affect staff safety climate, which in&#13;
turn impacts patient safety.&#13;
Aim: This study aimed to evaluate the effect of organizational changes to interprofessional team assessment processes on staff perception of teamwork and safety attitudes in the ED.&#13;
Methods: This prospective observational study used cross-sectional design and measured ED staff perception of patient safety related domains at two time-points (before and after an organizational intervention), using the Safety Attitude Questionnaire.&#13;
Results: Statistically significant changes were seen among the overall sample (n = 112 at time point one and n = 121 at time point two) for the safety climate, working conditions, and stress recognition domains. Nurses and doctors showed different baseline attitudes and different responses to the intervention between the two time points.&#13;
Conclusion: The results reflect improved positive attitudes overall though there were differences in responses between the nursing and medical professions. The findings highlight opportunities to improve attitudes among ED team members through defined organizational change and learning from one another. Organizational change can affect staff perceptions of the safety climate and interprofessional teamwork, which may improve the ED working environment.</text>
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Editorial Board</text>
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                <text>International Emergency Nursing Vol. 53 November 2020&#13;
Long emergency department length of stay: A concept analysis</text>
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                <text>Introduction: Emergency Department (ED) Length of stay (LOS) has been associated with poor patient outcomes, which has led to the implementation of time targets designed to keep EDLOS below a specific limit. The cut-offs defining long EDLOS varies across settings and seem to be arbitrarily chosen. This study aimed to clarify the meaning of long EDLOS. &#13;
Methods: A concept analysis using the Walker and Avant approach was conducted. It included a literature search aiming to identify all uses of the concept, resulting in a set of defining attributes and a way of measuring the concept empirically.&#13;
Results: Long EDLOS was primarily used as proxy for other phenomena, e.g. boarding or crowding. The definitions had cut-offs ranging between 4 and 48 h. The attributes defining long EDLOS was waiting, a crowded ED&#13;
environment and an inefficient organization.&#13;
Discussion: Time targets are probably more suitable when directed towards and tailored for specific sub-groups of the ED population. </text>
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