الفهرس 
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Abstract
The emergency care department is a core unit of a hospital, and the experience of patients attending the emergency department significantly influences the patients’ and their families’ satisfaction. Its function is to receive, triage, stabilize and provide emergency management to the patients with a wide variety of critical and urgent conditions. Moreover, reception and management of disaster patients will be done as a part of its role within the disaster plan of any region. In addition to treatment areas, some departments may require additional specifically designed areas to fulfill special roles, such as: the management of pediatric major trauma, psychiatric, infectious patients, and patients following sexual assault, prisoners in custody, patients affected by chemical, biological or radiological incidents.
Caring is the essence of nursing. Since nursing performance in the emergency department is influenced by many factors: cultural, economic, and social factors, various diverse barriers exist in providing care in emergency department. More researches are required to provide high quality care that will improve the patients’ safety, especially from the health care provider perspective.
Aim of the study:
The aim of the current study is to identify barriers to the nursing performance from emergency care nurses’ perspective.
Materials and method:
To fulfill the aim of this study a descriptive research design was used to conduct this study. This study was carried out in five emergency care units in Emergency Tanta University Hospital, namely; emergency reception department, burns department, orthopedic department, medical emergency department, and trauma emergency department.
A sample of one hundred emergency care nurses including all the nursing categories who were involved in providing direct patient care in the previously mentioned settings were included in this study.
To accomplish the aim of the current study; one tool was used for data collection “Barriers to the nursing performance from emergency care nurses’ perspective structured interview schedule” which included two parts. The first part covered nurses’ characteristics that include the demographic data: age, sex, marital status, level of education, distance between work and home; and job related data: place of work, years of experience in ED, work schedule, working hours per day in ED, number of weekly vacations, and average monthly income. The second part covered barriers to the nursing performance from emergency care nurses’ perspectives that consist of nurses related barriers; organizational and unit related barriers, and patients/family related barriers.
- An official permission was obtained from the Faculty of Nursing Alexandria University to the Emergency Tanta University Hospital.
- An official approval to carry out the study was obtained from the hospital administrative authority to obtain the acceptance to collect the necessary data from the selected settings after explanation of the aim of the study.
- The study tool was developed in English by the researcher after reviewing the related literature and was translated into Arabic to suit all the nursing categories.
- The study tool was tested for content validity by five experts in the field of critical care & emergency nursing, and all the necessary modifications were done accordingly.
- Reliability of the study tool was tasted after translations into Arabic using the Cronbach’s coefficient alpha test and the result was accepted.
- A pilot study was carried out on 10% of ED nurses who were excluded from the studied sample to test the clarity, feasibility, and applicability of the research tool and modifications were not needed.
- Data were collected over a period of three consecutive months (from September to December\ 2017) as follows:
Data collection:
- Informed written consent was obtained from each nurse before participation in the study after explanation of the aim of the study, and the right to refuse participation in the study was emphasized.
- A structured interview was conducted with each nurse individually to collect the necessary data for about 20 minutes.
- Demographic data was obtained from each nurse using part I of the tool.
- Barriers to the nursing performance from emergency care nurses’ perspective (nurses related barriers; organizational and unit related barriers, and patients/family related barriers) were obtained from the nurses using part II of the tool.
- At the end of the interview, the nurses were asked about any other barriers in relation to nurses related barriers; organizational and unit related barriers, and patients and family related barriers.
The main results of the current study:
In light of the current study findings, it can be concluded that:
- The organizational and unit related barriers represented the highest mean score by the studied emergency care nurses; followed by the nurses’ related barriers; and then the patients\family related barriers.
- As for the organizational & unit elated barriers, it was found that eleven issues were considered as the most organizational &unit related barriers. These issues includes lack of wages for the amount of work, over-crowding , lack of equipment & supplies , lack of patient’s facilities , lack of family facilities, inadequate salary, inadequate nurses number & lack of nurses’ facilities. Lack of medications, lack of motivation, and weak environmental security were also among the reported issues
- Regarding the nurses’ related barriers, the current study demonstrated that ten issues were considered as the most nursing related barriers. Stress, fatigue, inadequate rest time and wok-load were reported by the majority of the studied nurses. Difficulty to take vacation, lack of concentration, nightshifts and long working hours were reported by about two thirds of the studied nurses. Dissatisfaction with the head nurse & working in the ED against desire were reported by more than half of the studied nurses.
The emergency care department is a core unit of a hospital, and the experience of patients attending the emergency department significantly influences the patients’ and their families’ satisfaction. Its function is to receive, triage, stabilize and provide emergency management to the patients with a wide variety of critical and urgent conditions. Moreover, reception and management of disaster patients will be done as a part of its role within the disaster plan of any region. In addition to treatment areas, some departments may require additional specifically designed areas to fulfill special roles, such as: the management of pediatric major trauma, psychiatric, infectious patients, and patients following sexual assault, prisoners in custody, patients affected by chemical, biological or radiological incidents.
Caring is the essence of nursing. Since nursing performance in the emergency department is influenced by many factors: cultural, economic, and social factors, various diverse barriers exist in providing care in emergency department. More researches are required to provide high quality care that will improve the patients’ safety, especially from the health care provider perspective.
Aim of the study:
The aim of the current study is to identify barriers to the nursing performance from emergency care nurses’ perspective.
Materials and method:
To fulfill the aim of this study a descriptive research design was used to conduct this study. This study was carried out in five emergency care units in Emergency Tanta University Hospital, namely; emergency reception department, burns department, orthopedic department, medical emergency department, and trauma emergency department.
A sample of one hundred emergency care nurses including all the nursing categories who were involved in providing direct patient care in the previously mentioned settings were included in this study.
To accomplish the aim of the current study; one tool was used for data collection “Barriers to the nursing performance from emergency care nurses’ perspective structured interview schedule” which included two parts. The first part covered nurses’ characteristics that include the demographic data: age, sex, marital status, level of education, distance between work and home; and job related data: place of work, years of experience in ED, work schedule, working hours per day in ED, number of weekly vacations, and average monthly income. The second part covered barriers to the nursing performance from emergency care nurses’ perspectives that consist of nurses related barriers; organizational and unit related barriers, and patients/family related barriers.
- An official permission was obtained from the Faculty of Nursing Alexandria University to the Emergency Tanta University Hospital.
- An official approval to carry out the study was obtained from the hospital administrative authority to obtain the acceptance to collect the necessary data from the selected settings after explanation of the aim of the study.
- The study tool was developed in English by the researcher after reviewing the related literature and was translated into Arabic to suit all the nursing categories.
- The study tool was tested for content validity by five experts in the field of critical care & emergency nursing, and all the necessary modifications were done accordingly.
- Reliability of the study tool was tasted after translations into Arabic using the Cronbach’s coefficient alpha test and the result was accepted.
- A pilot study was carried out on 10% of ED nurses who were excluded from the studied sample to test the clarity, feasibility, and applicability of the research tool and modifications were not needed.
- Data were collected over a period of three consecutive months (from September to December\ 2017) as follows:
Data collection:
- Informed written consent was obtained from each nurse before participation in the study after explanation of the aim of the study, and the right to refuse participation in the study was emphasized.
- A structured interview was conducted with each nurse individually to collect the necessary data for about 20 minutes.
- Demographic data was obtained from each nurse using part I of the tool.
- Barriers to the nursing performance from emergency care nurses’ perspective (nurses related barriers; organizational and unit related barriers, and patients/family related barriers) were obtained from the nurses using part II of the tool.
- At the end of the interview, the nurses were asked about any other barriers in relation to nurses related barriers; organizational and unit related barriers, and patients and family related barriers.
The main results of the current study:
In light of the current study findings, it can be concluded that:
- The organizational and unit related barriers represented the highest mean score by the studied emergency care nurses; followed by the nurses’ related barriers; and then the patients\family related barriers.
- As for the organizational & unit elated barriers, it was found that eleven issues were considered as the most organizational &unit related barriers. These issues includes lack of wages for the amount of work, over-crowding , lack of equipment & supplies , lack of patient’s facilities , lack of family facilities, inadequate salary, inadequate nurses number & lack of nurses’ facilities. Lack of medications, lack of motivation, and weak environmental security were also among the reported issues
- Regarding the nurses’ related barriers, the current study demonstrated that ten issues were considered as the most nursing related barriers. Stress, fatigue, inadequate rest time and wok-load were reported by the majority of the studied nurses. Difficulty to take vacation, lack of concentration, nightshifts and long working hours were reported by about two thirds of the studied nurses. Dissatisfaction with the head nurse & working in the ED against desire were reported by more than half of the studied nurses.