Effect of a structured framework on Thai emergency nursing workforce capability: A quasi-experimental study

To examine the effect of the HIRAID™ Emergency Nursing Framework ((History including Infection risk, Red flags, Assessment, Interventions, Diagnostics, reassessment and communication) on emergency nursing workforce capability in a Thai emergency department (ED).

In this quasi-experimental study, ED and observation unit nursing and medical staff were surveyed before and after HIRAID™ implementation at Chiangrai Prachanukroh Hospital, Thailand. Validated surveys were used to measure nurses' confidence in patient assessment and communication; nurses' satisfaction with nurse-to-nurse communication; medical staff satisfaction with nurse-to-doctor communication; and perceptions of the practice environment. Data were analysed using descriptive and inferential statistics.

Forty-nine nurses (49 pre/48 post: same sample) and 44 doctors (24 pre/20 post: different samples) completed the surveys. There were significant improvements in nurses' confidence in physical assessment, reassessment decisions, performing nursing handover, and nursing documentation. Nurses' satisfaction with nurse-to-nurse communication improved significantly across all measures, but medical staff satisfaction with nurse-to-doctor communication did not change. There were improved perceptions of resources, teamwork and respect for nursing.

The HIRAID™ Emergency Nursing Framework improved emergency nursing workforce capability, specifically nurses' confidence in assessment, reassessment decisions and communication; satisfaction with nurse-to-nurse communication, and perceptions of their practice environment.