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  1. Article ; Online: Factors that contribute to turnover and retention amongst emergency department nurses: A scoping review.

    McIntyre, Nicholas / Crilly, Julia / Elder, Elizabeth

    International emergency nursing

    2024  Volume 74, Page(s) 101437

    Abstract: Background: Internationally, the emergency nursing workforce shortage is of critical concern.: Aim: To synthesise the evidence and assess the scope of literature regarding factors that contribute to turnover and retention amongst emergency nurses.: ...

    Abstract Background: Internationally, the emergency nursing workforce shortage is of critical concern.
    Aim: To synthesise the evidence and assess the scope of literature regarding factors that contribute to turnover and retention amongst emergency nurses.
    Method: A scoping review using the Joanna Briggs Institute approach was undertaken. Fivedatabases (Embase, MEDLINE, PsycINFO, CINAHL, and Business Source Complete) were searched for papers published in English between January 2011 and June 2023 where the population was nurses, context was the emergency department, and the concept was turnover or retention. A quality appraisal was performed on included studies.
    Results: A total of 31 articles met the inclusion criteria. Twenty-six studies focussed on turnover and five studies focussed on retention. Factors that contribute to ED nursing turnover included workplace violence, personal aspects (e.g., burnout or depression), organisational characteristics, and environmental/ job characteristics. Factors that contributed to ED nursing retention included mentoring programs, the advancement in nursing skills, and the transition to practice speciality (emergency) programs.
    Conclusions: A large body of literature exists regarding ED nurses' reasons for leaving their area of practice, yet limited evidence exist on retention. Research exploring factors that promote retention of emergency nurses that leads to subsequent stability and growth in the emergency nursing workforce is needed.
    Language English
    Publishing date 2024-04-06
    Publishing country England
    Document type Journal Article ; Review
    ZDB-ID 2420747-0
    ISSN 1878-013X ; 1755-599X
    ISSN (online) 1878-013X
    ISSN 1755-599X
    DOI 10.1016/j.ienj.2024.101437
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  2. Article ; Online: The Impact of Alcohol-Related Presentations to Emergency Departments on Days with a Public Holiday or Sporting Event: A Retrospective Cohort Study.

    Hagan, Stephanie Rae / Crilly, Julia / Ranse, Jamie

    Prehospital and disaster medicine

    2024  , Page(s) 1–7

    Abstract: Introduction: The consumption of alcohol within the Australian community continues to rise, impacting care delivery in already over-burdened emergency departments (EDs).: Study objective: This study aimed to examine the impact of alcohol-related ... ...

    Abstract Introduction: The consumption of alcohol within the Australian community continues to rise, impacting care delivery in already over-burdened emergency departments (EDs).
    Study objective: This study aimed to examine the impact of alcohol-related presentations (ARPs) to EDs on days with a public holiday or sporting event.
    Methods: A retrospective cohort study was undertaken using routinely collected health data pertaining to patient presentations diagnosed with an alcohol-related disorder (ICD-10-AM code F10) to two EDs in Queensland, Australia from January 1, 2016 - December 31, 2020. Descriptive and inferential statistics were used to describe and compare ARPs on event days versus non-event days and uncomplicated versus other ARPs on event days only.
    Results: Of all 5,792 ARPs, nine percent (n = 529) occurred on public holidays or sporting event days. When compared by day type, type of presentation, mode of arrival, and day of week differed between event and non-event days. On event days, uncomplicated ARPs differed to other ARPs, with uncomplicated ARPs being younger, having shorter median length-of-stay (LOS), and less likely to be admitted to hospital.
    Conclusions: In this multi-site study, public holidays and sporting events had a noteworthy impact on ARPs to EDs. Focused refinement on the clinical management of uncomplicated ARPs is warranted to inform future resource allocation, including on event days.
    Language English
    Publishing date 2024-05-02
    Publishing country United States
    Document type Journal Article
    ZDB-ID 1025975-2
    ISSN 1945-1938 ; 1049-023X
    ISSN (online) 1945-1938
    ISSN 1049-023X
    DOI 10.1017/S1049023X24000232
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  3. Article ; Online: Review article: Impact of pandemics on rural emergency departments: A scoping review.

    Barnes, Amber / Crilly, Julia

    Emergency medicine Australasia : EMA

    2022  Volume 34, Issue 3, Page(s) 312–321

    Abstract: Pandemics can cause much distress to communities and present a major burden to the resources and functioning of hospitals. This scoping review aimed to identify, evaluate and summarise current literature regarding how pandemics impact rural EDs in terms ... ...

    Abstract Pandemics can cause much distress to communities and present a major burden to the resources and functioning of hospitals. This scoping review aimed to identify, evaluate and summarise current literature regarding how pandemics impact rural EDs in terms of staff wellbeing, structure, function and resources. A systematic search of six databases using search terms including pandemic, ED and rural and remote was undertaken. Articles were included if they were peer-reviewed, written in English, original research, published between January 2010 and October 2021 and discussed the impact of pandemics on rural EDs. Articles were critically appraised using the Mixed Methods Appraisal Tool (MMAT). Three articles, one from Canada and two from the United States, met the inclusion criteria. The articles included were quantitative in design and fulfilled most of the MMAT critical analysis criteria. Pandemics reported on included H1N1 and COVID-19. These pandemics impacted rural EDs in terms of functioning and resourcing; no description of staff wellbeing or structure was identified. Rural ED functioning was affected in terms of input; with an increase in patient presentations and time to physician assessment during H1N1, but a decrease in patient presentations and transfers during COVID-19. Rural ED resources were impacted in regard to staffing, difficulty in obtaining stocks of personal protective equipment and medication, and community response. Further research to understand and address the short- and long-term impacts pandemics may have on rural EDs is required.
    MeSH term(s) COVID-19/epidemiology ; Emergency Service, Hospital ; Humans ; Influenza A Virus, H1N1 Subtype ; Influenza, Human/epidemiology ; Pandemics ; Personal Protective Equipment ; Rural Health Services ; United States
    Language English
    Publishing date 2022-03-01
    Publishing country Australia
    Document type Journal Article ; Systematic Review
    ZDB-ID 2161824-0
    ISSN 1742-6723 ; 1742-6731 ; 1035-6851
    ISSN (online) 1742-6723
    ISSN 1742-6731 ; 1035-6851
    DOI 10.1111/1742-6723.13938
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  4. Article ; Online: Patient and public involvement in emergency care research: a scoping review of the literature.

    Muir, Rachel / Carlini, Joan / Crilly, Julia / Ranse, Jamie

    Emergency medicine journal : EMJ

    2023  Volume 40, Issue 8, Page(s) 596–605

    Abstract: Background: Establishing the benefits of patient and public involvement (PPI) in emergency care research is important to improve the quality and relevance of research. Little is known about the extent of PPI in emergency care research, its ... ...

    Abstract Background: Establishing the benefits of patient and public involvement (PPI) in emergency care research is important to improve the quality and relevance of research. Little is known about the extent of PPI in emergency care research, its methodological and reporting quality. This scoping review aimed to establish the extent of PPI in emergency care research, identify PPI strategies and processes and assess the quality of reporting on PPI in emergency care research.
    Methods: Keyword searches of five databases (OVID MEDLINE, Elsevier EMBASE, EBSCO CINAHL, PsychInfo, Cochrane Central Register of Controlled trials); hand searches of 12 specialist journals and citation searches of the included journal articles were performed. A patient representative contributed to research design and co-authored this review.
    Results: A total of 28 studies reporting PPI from the USA, Canada, UK, Australia and Ghana were included. The quality of reporting was variable, with only seven studies satisfying all Guidance for Reporting Involvement of Patients and the Public short form reporting criteria. None of the included studies adequately described all the key aspects of reporting the impact of PPI.
    Conclusion: Relatively few emergency care studies comprehensively describe PPI. Opportunity exists to improve the consistency and quality of reporting of PPI in emergency care research. Further research is required to better understand the specific challenges for implementing PPI in emergency care research, and to determine whether emergency care researchers have adequate resources, education and funding to undertake and report involvement.
    MeSH term(s) Humans ; Patient Participation ; Emergency Medical Services ; Canada ; Australia ; Ghana
    Language English
    Publishing date 2023-06-06
    Publishing country England
    Document type Review ; Journal Article
    ZDB-ID 2040124-3
    ISSN 1472-0213 ; 1472-0205
    ISSN (online) 1472-0213
    ISSN 1472-0205
    DOI 10.1136/emermed-2022-212514
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  5. Article ; Online: People brought to the emergency department under involuntary assessment orders: A scoping review.

    Alcock, Julia / Ranse, Jamie / Crilly, Julia / Wardrop, Rachel

    International emergency nursing

    2023  Volume 69, Page(s) 101290

    Abstract: Background: Some people with mental health problems arrive to the Emergency Department (ED) under involuntary assessment orders (IAOs) and can have complex medical and socioeconomic factors, which may impact on the delivery of care in the ED. Therefore, ...

    Abstract Background: Some people with mental health problems arrive to the Emergency Department (ED) under involuntary assessment orders (IAOs) and can have complex medical and socioeconomic factors, which may impact on the delivery of care in the ED. Therefore, this scoping review aimed to identify, evaluate and summarise the current literature regarding the demographic characteristics, clinical characteristics and outcomes for people brought to the ED under IAOs.
    Method: A scoping review was undertaken guided by the Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) Guidelines and the Arksey and O'Malley framework.
    Results: In total 21 articles were included in this review. People under IAOs most commonly present to EDs with suicidal ideation/intent, with interagency involvement noted when responding to these people in the pre-hospital setting. Most people arriving to ED under IAOs were reported to experience length of staylonger than four hours.
    Conclusion: This review highlights the limited information pertaining to people brought to EDs under an IAO. High levels of mental health problems and extended length of stay for people under IAOs suggests the need for interagency collaboration to inform the development and implementation of models of care that incorporates social determinants of health and are tailored to this complex population.
    MeSH term(s) Humans ; Emergency Service, Hospital ; Involuntary Treatment, Psychiatric
    Language English
    Publishing date 2023-06-07
    Publishing country England
    Document type Systematic Review ; Journal Article ; Review
    ZDB-ID 2420747-0
    ISSN 1878-013X ; 1755-599X
    ISSN (online) 1878-013X
    ISSN 1755-599X
    DOI 10.1016/j.ienj.2023.101290
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  6. Article ; Online: Characteristics and outcomes of patient presentations to the emergency department via police: A scoping review.

    Wardrop, Rachel / Ranse, Jamie / Chaboyer, Wendy / Crilly, Julia

    Australasian emergency care

    2023  Volume 26, Issue 3, Page(s) 239–248

    Abstract: Background: As emergency department (ED) presentations continue to rise, understanding the complexities of vulnerable populations such as people brought in by police (BIBP) is crucial. This review aimed to map and describe the research about people BIBP ...

    Abstract Background: As emergency department (ED) presentations continue to rise, understanding the complexities of vulnerable populations such as people brought in by police (BIBP) is crucial. This review aimed to map and describe the research about people BIBP to the ED.
    Design and method: A scoping review, guided by the Joanna Briggs Institute process, was undertaken. The databases CINAHL, Embase and PubMed were searched between November 2017 and July 2022. The Patterns, Advances, Gaps, Evidence for practice, Research recommendations (PAGER) framework was used to guide the analysis.
    Results: A total of 21 studies were included in the review, originating mainly from westernised countries. Examination of patterns across studies revealed four themes: routinely collected data is used to describe people BIBP to the ED; a focus on mental health care; the relationship between care delivery and outcomes; and the role of police in providing emergency care.
    Conclusion: There is some understanding of the demographic characteristics, clinical characteristics, and outcomes of people BIBP to the ED. Knowledge gaps surrounding sociodemographic factors, prehospital and ED care delivery for people BIBP require further investigation to optimise outcomes for this vulnerable cohort of presenters.
    MeSH term(s) Humans ; Police ; Delivery of Health Care ; Emergency Service, Hospital
    Language English
    Publishing date 2023-02-13
    Publishing country Australia
    Document type Journal Article ; Review
    ISSN 2588-994X
    ISSN (online) 2588-994X
    DOI 10.1016/j.auec.2023.01.004
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  7. Article ; Online: Alcohol-Related Presentations to Emergency Departments on Days with Holidays, Social, and Sporting Events: An Integrative Literature Review.

    Hagan, Stephanie Rae / Crilly, Julia / Ranse, Jamie

    Prehospital and disaster medicine

    2023  Volume 38, Issue 6, Page(s) 764–773

    Abstract: Introduction: Events, specifically those where excessive alcohol consumption is common, pose a risk to increase alcohol-related presentations to emergency departments (EDs). Limited evidence exists that synthesizes the impact from events on alcohol- ... ...

    Abstract Introduction: Events, specifically those where excessive alcohol consumption is common, pose a risk to increase alcohol-related presentations to emergency departments (EDs). Limited evidence exists that synthesizes the impact from events on alcohol-related presentations to EDs.
    Study objective: This integrative review aimed to synthesize the literature regarding the impact events have on alcohol-related presentations to EDs.
    Methods: An integrative literature review methodology was guided by the Preferred Reporting Items of Systematic Reviews and Meta-Analysis (PRISMA) Guidelines for data collection, and Whittemore and Knafl's framework for data analysis. Information sources used to identify studies were MEDLINE, CINAHL, and EMBASE, last searched May 26, 2021.
    Results: In total, 23 articles describing 46 events met criteria for inclusion. There was a noted increase in alcohol-related presentations to EDs from 27 events, decrease from eight events, and no change from 25 events. Public holidays, music festivals, and sporting events resulted in the majority of increased alcohol-related presentations to EDs. Few articles focused on ED length-of-stay (LOS), treatment, and disposition.
    Conclusion: An increase in the consumption of alcohol from holiday, social, and sporting events pose the risk for an influx of presentations to EDs and as a result may negatively impact departmental flow. Further research examining health service outcomes is required that considers the impact of events from a local, national, and global perspective.
    MeSH term(s) Humans ; Data Collection ; Emergency Service, Hospital ; Holidays ; Length of Stay ; Sports
    Language English
    Publishing date 2023-10-25
    Publishing country United States
    Document type Journal Article ; Review ; Systematic Review
    ZDB-ID 1025975-2
    ISSN 1945-1938 ; 1049-023X
    ISSN (online) 1945-1938
    ISSN 1049-023X
    DOI 10.1017/S1049023X23006507
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  8. Article ; Online: Providing end of life care in the emergency department: A hermeneutic phenomenological study.

    Burnitt, Ellie / Grealish, Laurie A / Crilly, Julia / May, Katya / Ranse, Jamie

    Australasian emergency care

    2024  

    Abstract: Background: Registered nurses report the experience of delivering end of life care in emergency departments as challenging. The study aim was to understand what it is like to be a registered nurse providing end of life care to an older person in the ... ...

    Abstract Background: Registered nurses report the experience of delivering end of life care in emergency departments as challenging. The study aim was to understand what it is like to be a registered nurse providing end of life care to an older person in the emergency department.
    Methods: A hermeneutic phenomenological study was conducted in 2021, using semi-structured interviews with seven registered nurses across two hospital emergency departments in Queensland, Australia. Thematic analysis of participants' narratives was undertaken.
    Findings: Seven registered nurses were interviewed; six of whom were women. Participant's experience working in the emergency department setting ranged from 2.5-20 years. Two themes were developed through analysis: (i) Presenting the patient as a dying person; and (ii) Mentalising death in the context of the emergency department.
    Conclusions: Nurses providing end of life care in the emergency department draw upon their personal and aesthetic knowing to present the dying patient as a person. The way death is mentalised suggests the need to develop empirical knowing about ageing and supportive medical care and ethical knowing to assist with the transition from resuscitation to end of life care. Shared clinical reflection on death in the emergency department, facilitated by experts in ageing and end of life care is recommended.
    Language English
    Publishing date 2024-02-02
    Publishing country Australia
    Document type Journal Article
    ISSN 2588-994X
    ISSN (online) 2588-994X
    DOI 10.1016/j.auec.2024.01.002
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  9. Article ; Online: Clinicians' experiences of caring for people brought in by police to the emergency department: A qualitative interpretive study.

    Wardrop, Rachel / Ranse, Jamie / Crilly, Julia / Stubbs, Nicole / Chaboyer, Wendy

    Journal of advanced nursing

    2023  Volume 80, Issue 5, Page(s) 1955–1966

    Abstract: Aim: To explore nurses' and doctors' experiences of providing care to people brought in by police (BIBP) to the emergency department (ED).: Design: A qualitative interpretive study using in-depth individual interviews.: Methods: Semi-structured ... ...

    Abstract Aim: To explore nurses' and doctors' experiences of providing care to people brought in by police (BIBP) to the emergency department (ED).
    Design: A qualitative interpretive study using in-depth individual interviews.
    Methods: Semi-structured interviews were conducted with nurses and doctors who worked in various EDs in one Australian state and were involved in the care of people BIBP. Interviews were undertaken between May and October 2022 and focused on the structures (i.e., what), processes (i.e., how) and outcomes of care for people BIBP. Data were analysed using deductive and then inductive content analysis.
    Results: Nine nurses and eight doctors were interviewed. Structures described by participants included human structures (staff) and organizational structures (areas for assessment, involuntary assessment orders, investigations, chemical/physical restraints). For processes, participants described practices including risk/mental health assessments, legal considerations, and increased/decreased levels of care compared to other presentations. Communication processes were largely between police and health care staff. Service outcomes pertained to discharge location (custody, community, hospital admission) and length of stay.
    Conclusion: The current care delivery for people BIBP to the ED is unique and complex, often occurring in high traffic, resource-intensive areas. There is a need to strengthen structures and processes, to improve service outcomes.
    Implications for the profession: Understanding the care requirements for people brought into ED by police enables the delivery of targeted care alongside appropriate resource allocation.
    Impact: This study provides a comprehensive understanding of the health care requirements for people BIBP to EDs. Interventions delivered in the ED to support health care delivery for people BIBP and foster clinician and police relationships are required to optimize patient and health service outcomes.
    Reporting method: This study adheres to the COREQ checklist (Table S1) of the EQUATOR guidelines.
    Patient or public contribution: This study focused on ED staff experiences.
    MeSH term(s) Humans ; Australia ; Police ; Delivery of Health Care ; Palliative Care ; Emergency Service, Hospital ; Qualitative Research
    Language English
    Publishing date 2023-11-22
    Publishing country England
    Document type Journal Article
    ZDB-ID 197634-5
    ISSN 1365-2648 ; 0309-2402
    ISSN (online) 1365-2648
    ISSN 0309-2402
    DOI 10.1111/jan.15944
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  10. Article ; Online: Predictors of Emergency Department service outcome for people brought in by police: A retrospective cohort study.

    Wardrop, Rachel / Ranse, Jamie / Chaboyer, Wendy / Crilly, Julia

    International emergency nursing

    2022  Volume 63, Page(s) 101188

    Abstract: Background: People brought in by police (BIBP) to the emergency department (ED) can present with complicated health conditions that may impact care delivery. We sought to identify factors predictive of an ED length of stay (LOS) ≥4 hours and hospital ... ...

    Abstract Background: People brought in by police (BIBP) to the emergency department (ED) can present with complicated health conditions that may impact care delivery. We sought to identify factors predictive of an ED length of stay (LOS) ≥4 hours and hospital admission for presentations BIBP.
    Methods: This retrospective cohort study comprised a sample of all adults (aged ≥ 18 years old) BIBP to public hospital EDs across Queensland, Australia between 1 January 2018 and 31 December 2020. Univariate and multivariate logistic regression were used to identify predictors of an ED LOS ≥4 hours and hospital admission for presentations BIBP.
    Results: Of the 42,502 presentations BIBP, independent predictors of an ED LOS ≥4 hours included higher priority triage categories, hospital transfer/admission, evening/night shift arrival, an Emergency Examination Authority (EEA), (i.e. an involuntary presentation), and a non-descript mental health diagnosis. Independent predictors of hospital admission included higher priority triage categories, increasing age, day/evening shift arrival, a 'mental or behavioural issues' diagnosis, and an ED LOS ≥4 hours.
    Conclusions: Noted predictors of a LOS ≥4 hours and hospital admission indicate further need to support intra and inter-agency interventions to optimise patient outcomes.
    MeSH term(s) Adolescent ; Adult ; Emergency Medical Services ; Emergency Service, Hospital ; Humans ; Length of Stay ; Police ; Retrospective Studies ; Triage
    Language English
    Publishing date 2022-07-04
    Publishing country England
    Document type Journal Article
    ZDB-ID 2420747-0
    ISSN 1878-013X ; 1755-599X
    ISSN (online) 1878-013X
    ISSN 1755-599X
    DOI 10.1016/j.ienj.2022.101188
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