Empowering emergency nurses in crisis response - A quality improvement framework for enhanced preparedness and...

Emergency nurses face significant challenges in crisis response, including cognitive overload and institutional barriers, which compromise patient outcomes. This quality improvement (QI) initiative aimed to enhance crisis preparedness through evidence-based interventions, addressing gaps in risk perception, decision-making, and self-efficacy.

A pre/post-intervention study was conducted at two academic medical centers (Level I trauma centers)150 emergency nurses. Interventions included simulation-based training, AI-driven decision-support tools, and protocol reforms. Data were collected at baseline, post-intervention, and six-month follow-up. Primary outcomes included risk perception accuracy, decision latency, and self-efficacy, which were analyzed using paired t-tests, repeated measures ANCOVA, control charts, and chi-square tests.

Post-intervention, nurses demonstrated a 32 % improvement in risk perception accuracy (p < 0.01) and a 26 % reduction in decision-making time (p < 0.05). Self-efficacy scores nearly doubled, rising from 45 % to 89 %. ED-specific process outcomesincluded a 40 % reduction in triage errors and a 35 % decrease in missed deteriorations with AI support. Improvements were sustained at the 6-month follow-up.

The multimodal approach yielded statistically and clinically significant improvements, surpassing single-intervention studies. Sustainable implementation requires institutional support for technology integration and policy reforms. These findings advocate for widespread adoption of combined simulation, AI, and protocol strategies to empower nurses in crisis response.