JMIR Publications

ABSTRACT

Background:

This study explores the competencies and needs of Emergency Departement (ED) nurses emergencies in managing trauma cases. Given the critical nature of the ED, their ability to quickly identify, analyze, and intervene is vital for patient outcomes, however, challenges like limited resources, high patient volumes, and insufficient training may hinder decision making.

Objective:

This study aims to explore the decision-making competencies of emergency department nurses in trauma care, identify factors influencing their clinical judgments, and examine the challenges impacting their ability to deliver timely and effective interventions in emergency settings

Methods:

This study applied a qualitative descriptive approach with an exploratory design. Data were collected through in-depth, semi-structured interviews using a pre-prepared list of open-ended questions with 16 ED nurses and 4 emergency doctors from major hospitals across three provinces in Indonesia. The interviews explored the experiences of both nurses and doctors in decision-making during emergency situations. Thematic analysis was used to identify key themes, and data triangulation from interviews, observations, and relevant documents was employed to ensure credibility.

Results:

The participants consisted of 16 ED nurses and 4 emergency doctors with diverse educational backgrounds and more than 5 years of experience in emergency care. Six key themes emerged from the data: (1) recognizing patient cues, (2) analyzing clinical conditions, (3) prioritizing interventions, (4) generating solutions based on clinical cues, (5) taking quick action, and (6) evaluating outcomes. Nurses' clinical experience, supported by continuous training and the use of medical technology, were found to be essential factors in enhancing decision-making capabilities in emergencies. However, challenges such as limited resources and inadequate training affected their performance

Conclusions:

Ongoing competency development for ED nurses is crucial to enhance their ability to manage critical conditions effectively. Continuous training, advanced medical technology, and structured support systems are vital to improving emergency care quality and patient outcomes. This study highlights that the clinical experience and decision-making competencies of both nurses and emergency doctors are essential in managing physical emergencies effectively. Key factors influencing decision-making include the ability to recognize patient cues, analyze clinical conditions, and act quickly. However, challenges such as limited resources and inadequate training significantly impact performance. Addressing these challenges is crucial to improving emergency care quality and patient outcomes. Clinical Trial: -