What is already known about this topic? The standard of the initial patient assessment is critical to the quality and safety of healthcare, particularly as emergency patients often have extended wait times for medical review. Currently, there is no widely used structured approach to patient assessment for emergency nurses and consequently there exists great variability in the quality and documentation of patient assessments.

What does this paper add to the currently published literature? HIRAIDTM is an acceptable and suitable emergency nursing framework for consideration for use by US emergency nurses.

What is the most important implication for clinical emergency nursing practice? HIRAIDTM could provide an evidence-based solution to improve the consistency and quality of emergency nursing in an increasingly inexperienced workforce. Successful uptake requires training and organizational support.

Patient assessment is a core component of nursing practice and underpins safe, high-quality patient care. HIRAIDTM, an evidence-informed emergency nursing framework, provides nurses with a structured approach to patient assessment and management post triage. In Australia, HIRAIDTM resulted in significant improvements to nurse-led communication and reduced adverse patient events.

First, to explore United States (US) emergency nurses’ perceptions of the evidence-informed emergency nursing framework, HIRAIDTM; second, to determine factors that would influence the feasibility and adaptability of HIRAIDTM into nursing clinical practice in EDs within the US.

A cross-sectional cohort study using a survey method with a convenience sample was conducted. A 4-hour workshop introduced the HIRAIDTM framework and supporting evidence at the Emergency Nurses Association’s (ENA) conference, Emergency Nursing 2022. Surveys were tested for face validity and collected information on nurse-nurse communication, self-efficacy, the practice environment and feedback on the HIRAIDTM framework.

The workshop was attended by 48 emergency nurses from 17 US States and four countries. Most respondents reported that all emergency nurses should use the same standardised approach in the assessment of patients. However, the greatest barriers to change were a lack of staff and support from management. The most likely interventions reported to enable change were face-to-face education, the opportunity to ask questions and support in the clinical environment.

HIRAIDTM is an acceptable and suitable emergency nursing framework for consideration in the US. Successful uptake will depend on training methods and organizational support. HIRAIDTM training should incorporate face-to-face interactive workshops.

Emergency nursing

Patient assessment

Education

Nursing

Patient outcomes

Implementation

Crown Copyright © 2023 Published by Elsevier Ltd.