The Development of Emergency Nurses Competencies in Caring for Patients with Severe Chest Trauma

Abstract

This research and development study aimed to develop and examine the effects of enhancing professional nurses’ competencies in caring for patients with severe thoracic trauma in emergency departments. The study was guided by Soukup’s concept, accident and emergency nursing standards, competency frameworks for emergency nursing, and advanced trauma life support principles (ATLS). The process comprised four phases: 1) situational and problem analysis through focus group discussions with 29 nurses, in-depth interviews with 5 administrators, and medical record/incident reviews by 10 experts; 2) development of competency enhancement tools (such as online lessons, video media, and simulation-based practice) and outcome evaluation instruments; 3) pilot testing of the tools with 29 nurses and 10 patients/relatives in two rounds, followed by refinement; and 4) evaluation of outcomes with 29 nurses and 35 patients/relatives. Data were analyzed using descriptive statistics and paired t-tests.

The results revealed that after the competency development, the mean scores of emergency nurses’ knowledge increased from 78.57% to 85.43%. The nursing role performance increased from 69.39% to 95.07%. The nurses’ satisfaction with the competency development program was very high (95.66%). The service quality outcomes showed that the risk incidents related to triage, communication, and patient referral were reduced, while patient relatives’ satisfaction with services was high (95.33%).

Conclusion and Recommendations: The competency development program effectively helps promoting nurses’ knowledge, strengthening nurses’ competencies in providing safe and efficient cares for patients with severe thoracic trauma in emergency department. Future studies should include a long-term follow-up (6–12 months) to assess sustainability of competencies and continuity of service quality.