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                <text>International Emergency Nursing Vol. 69 July 2023&#13;
Taking or creating control: A qualitative study of uncertainty among novice nurses in ambulance care&#13;
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                <text>Introduction: In emergency nursing situations, uncertainty may lead to delays, or block a decision which can have devastating consequences for a patient. The ambulance service is a complex clinical environment that often challenges the decision-making capabilities of the professionals, especially novice nurses. Novice nurses’ uncertainty may also lead to unhealthy transitions and turnover. To increase the understanding of how uncertainty&#13;
affects novice nurses, this study explores novice nurses’ uncertainty during the first year of professional practice in the ambulance service.&#13;
Method: A qualitative descriptive design was applied using qualitative content analysis of thirteen individual face-to-face semi-structured deep interviews.&#13;
Result: From nine subcategories, three generic categories were derived: Reflections on contextual understanding, Strategies to create control, and Actions to take control. These were combined to form the main category Understanding what and dealing with how, while becoming a confident professional.&#13;
Conclusion: Uncertainty is exacerbated by situations that demand rapid decisions or actions. This is especially true of newcomers to a profession. Preparing novices through study programs and encouraging continuous reflection in professional practice may increase resilience and tolerance of uncertainty, as well as benefiting&#13;
professional development. </text>
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                <text>Anna Horberg, Britt-Marie Walivaara, Jonas Wihlborg </text>
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                <text>Sri Wahyuni</text>
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                <text>International Emergency Nursing Vol. 69 July 2023</text>
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&#13;
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                <text>International Emergency Nursing Vol. 69 July 2023&#13;
Nurses’ knowledge and self-assessment of their clinical experiences of&#13;
intraosseous access: A multicentre cross-sectional study</text>
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                <text>Background: Intraosseous access is an effective and safe option when difficult vascular access occurs. The knowledge, competence, and clinical experience of nurses are collectively essential for the successful implementation of this approach in clinical practice. Education and clinical learning are the main pillars supporting&#13;
this new practice to ensure patient safety. The aim of this study was to identify the nurses’ knowledge and clinical experience of intraosseous access and the factors associated with the adoption of this procedure.&#13;
Methods: A cross-sectional study was carried out from October to December 2020. A convenience sample of 432 nurses from four Italian hospitals were involved. A structured questionnaire was used to assess the nurses’knowledge of the intraosseous access guidelines and their clinical experience.&#13;
Results: Most participants were female (71.5%) with more than 10 years of experience (63.7%) working in an emergency (38.9%) and medical (37.7%) setting. Most of the participants demonstrated their knowledge of the use of a device e.g., it is used if vascular access is not rapidly achieved in a child (83.1%) and the boluses of liquids required in the intraosseous procedure (72.7%). A few participants reported having placed intraosseous access (3.5%). A higher level of educational preparation and working in emergency and paediatric settings were associated with increased knowledge.&#13;
Conclusions: Our findings highlighted a sub-optimal level of knowledge of the IO procedure, little experience of this practice in clinical contexts, also associated with a lack of adequate protocols and devices available to nurses.Nurses need to develop their knowledge and practice the skill clinically to embed this practice. University and nurse educators should emphasise the relevance of this practice in nursing education and training, so as to improve the nursing care practice and level of patient safety.</text>
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                <text>Giancarlo Cicolini, Dania Comparcini, Valentina Simonetti, Cinzia Anna Maria Papappicco, John Unsworth, Marco Tomietto</text>
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                <text>Sri Wahyuni</text>
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                <text>International Emergency Nursing Vol. 69 July 2023</text>
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&#13;
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                <text>International Emergency Nursing Vol. 69 July 2023&#13;
Missed nursing care in emergency departments: A scoping review(Review)&#13;
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                <text>Missed nursing care, Emergency service, hospital, Emergency care, Patient safety, Nurses, Emergency department, Quality health care, Nursing care left undone, Unfinished nursing care</text>
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                <text>Background: Patient safety is a global health priority. Errors of omission, such as missed nursing care in hospitals, are frequent and may lead to adverse events. Emergency departments (ED) are especially vulnerable to patient safety errors, and the significance missed nursing care has in this context is not as well known as in other contexts.&#13;
Aim: The aim of this scoping review was to summarize and disseminate research about missed nursing care in the context of EDs.&#13;
Method: A scoping review following the framework suggested by Arksey and O’Malley was used to (1) identify the research question; (2) identify relevant studies; (3) select studies; (4) chart the data; (5) collate, summarize, and report the results; and (6) consultation.&#13;
Results: In total, 20 themes were derived from the 55 included studies. Missed or delayed assessments or other fundamental care were examples of missed nursing care characteristics. EDs not staffed or dimensioned in relation to the patient load were identified as a cause of missed nursing care in most included studies. Clinical&#13;
deteriorations and medication errors were described in the included studies in relation to patient safety and quality of care deficiencies. Registered nurses also expressed that missed nursing care was undignified and unsafe.&#13;
Conclusion: The findings from this scoping review indicate that patients’ fundamental needs are not met in the ED, mainly because of the patient load and how the ED is designed. According to registered nurses, missed nursing care is perceived as undignified and unsafe.</text>
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                <text>Henrik Duhalde, Kaisa Bjuresater, Ingela Karlsson, Carina Bååth</text>
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                <text>Sri Wahyuni</text>
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&#13;
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                <text>International Emergency Nursing Vol. 69 July 2023&#13;
Subjective mental workload in Spanish emergency nurses. A study on predictive factors&#13;
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                <text>Introduction: Mental workload refers to the cognitive or intellectual requirements that a worker is subjected to in a workday. The objective of the present work was to discover the subjective mental workload of nursing staff at Hospital Emergency Units, and its relationship with sociodemographic, work, environmental factors at the workplace, and personality variables.&#13;
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questionnaires (sociodemographic, work conditions, environmental conditions, personality, and subjective mental workload). Descriptive statistics were obtained, and Pearson’s correlations and multivariate models (multiple linear regression) were performed. Results: The nurses had medium to high levels of mental workload.&#13;
The environmental conditions had a direct relationship with the mental workload, especially with respect to noise and lighting. The participants obtained high scores in kindness, responsibility, openness/intellect, and extraversion. Positive and statistically significant relations were found between neuroticism and mental workload. Being female, older, and having stable employment or a permanent contract were associated with a greater mental workload of emergency nurses. &#13;
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conditions in the workplace were the predictors with the most weight in the model. This study could be useful for defining aspects that need to be considered for the well-being of emergency nurses, such as lighting conditions or environmental noise in the workplace. It also invites reflection on the influence of personal factors (age, gender, personality) and work factors (type of contract, professional experience) on the mental workload of emergency nurses. </text>
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Patient involvement in decisions about discharge from the emergency department: A qualitative interview study of the healthcare professionals’ experiences&#13;
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                <text>Background: Patients in the emergency department are less involved in making decisions than they would like to be. Involving patients improves health-related outcomes, but success depends on the healthcare professional’s ability to act in a patient-involving manner, and therefore more knowledge is needed about the healthcare professional’s perspective of involving patients in the decisions.&#13;
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The effect of a video-based COVID-19 paediatric patient education on state anxiety in children with suspected COVID-19 admitted to hospital</text>
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