Advancing Emergency Nursing Care Through International Collaboration and Behaviour Change Theory

Area of Science:

• Nursing Implementation Science
• Health Services Research
• Emergency Care Management

Background:

• Emergency care settings face challenges in implementing clinical interventions, particularly in resource-limited environments.
• A lack of standardized patient assessment and management approaches in emergency departments (EDs) hinders effective care delivery.
• The HIRAID framework (History, Infection risk, Red flags, Assessment, Interventions, Diagnostics, reassessment, communication) offers a structured approach to emergency nursing.

Purpose of the Study:

• To develop an evidence-informed, data-driven strategy for implementing the HIRAID emergency nursing framework in Thailand.
• To address the lack of standardized patient assessment and management in a resource-limited ED setting.
• To adapt and implement the HIRAID framework within the specific context of Thai emergency nursing.

Main Methods:

• An exploratory descriptive study utilizing the Knowledge-to-Action framework.
• Conducted in Chiangrai Prachanukroh Hospital, Thailand, employing feasibility assessments and co-design.
• Utilized surveys based on the Behaviour Change Wheel and Theoretical Domains Framework to identify barriers and enablers.

Main Results:

• 49 nurses completed practice environment and behavioral diagnostics surveys, identifying 19 enablers and 33 barriers to HIRAID implementation.
• Enablers and barriers were mapped to seven intervention functions and 19 behavior change techniques.
• Culminated in the development of an evidence-informed, data-driven HIRAID Thailand Implementation Strategy.

Conclusions:

• Understanding context-specific barriers and enablers, with active end-user engagement, is critical for successful implementation.
• Developing an evidence-informed strategy for limited-resource settings is achievable through robust theory application, stakeholder engagement, and multi-agency collaboration.
• The HIRAID Thailand Implementation Strategy provides a sustainable, context-specific model for improving emergency nursing care.