På akutmottagningen möter akutsjuksköterskor dagligen utmaningen att bedöma och vårda patienter med tidskritiska tillstånd, en central kompetens för deras yrkesroll. Forskning pekar på flera förutsättningar som hämmar deras förmåga att göra vårdande bedömningar, där hela människans behov tillgodoses. Syftet med denna studie var att undersöka tillgänglig vetenskaplig litteratur om förutsättningar som påverkar akutsjuksköterskans vårdande bedömning av patienter med tidskritiska tillstånd på akutmottagning. Genom en systematisk och integrativ analys av fjorton vetenskapliga artiklar med varierande forskningsmetoder, inklusive kvantitativa, kvalitativa och mixad metod med ursprung från olika delar av världen, identifierades flera förutsättningar som påverkar akutsjuksköterskans förmåga att göra vårdande bedömningar. Dessa förutsättningar presenterades i två huvudkategorier: “Förutsättningar för en balanserad bedömning” och "Förutsättningar för en korrekt bedömning", med ytterligare fyra underkategorier, vars innehåll består av bland annat förutsättningar som stress, emotionella påfrestningar, vilja, engagemang, erfarenhet och vårdmiljö. Studiens resultat understryker behovet av att förhålla sig till dessa förutsättningar för att förbättra akutsjuksköterskors bedömningsförmåga. Trots vetskapen om akutmottagningens behov av förändring saknas effektiva insatser till förbättring som kan underlätta akutsjuksköterskans arbete. För att säkerställa patienternas välbefinnande och att upprätthålla hög vårdkvalitet är det avgörande att akutsjuksköterskor gör både balanserade och korrekta bedömningar. / At the emergency department, emergency nurses face the daily challenge of assessing and caring patients with time-critical conditions, a central competency for their professional role. Research indicates several conditions that inhibits their ability to make caring assessments, addressing the holistic needs of individuals. The aim of this study was to review existing scientific literature on conditions influencing emergency nurses' caring assessment of patient with time-critical conditions in emergency departments. Through a systematic and integrative analysis of fourteen scientific articles employing various research methods, including quantitative, qualitative, and mixed methods from different parts of the world, several conditions affecting emergency nurses' ability to make caring assessments were identified. These conditions were categorized into two main categories: "Prerequisites for a balanced assessment" and "Prerequisites for an accurate assessment", with an additional four subcategories, including conditions such as stress, emotional strain, will, commitment, experience, and the healthcare environment. The study's findings emphasize the need to address these conditions to improve emergency nurses' assessment capabilities. Despite awareness of the need for change in emergency departments, effective improvement interventions to facilitate emergency nurses' work are lacking. To ensure patient well-being and maintain high-quality care, it is crucial for emergency nurses to make both balanced and accurate assessments.

Indiana University-Purdue University Indianapolis (IUPUI) / Caring relationships established between nurse managers and staff nurses promote positive work environments. However, research about staff nurses' perceptions of nurse manager caring behaviors is limited. A 94-item Caring Assessment Tool-Administration (CAT-adm©) was developed to measure staff nurses' perceptions of nurse managers' caring behaviors; however, it lacked robust psychometric testing. This study was undertaken to establish the CAT-adm© survey as a reliable and valid tool to measure staff nurses' perceptions of nurse managers' caring behaviors. The Quality-Caring Model® (QCM®) served as the theoretical framework. Specific aims were to 1) evaluate construct validity of the CAT-adm© survey by describing factors that account for variance in staff nurses' perceptions of nurse manager caring, 2) estimate internal consistency, and 3) conduct item reduction analysis. Four research questions were: 1) Will the factor structure of observed data fit an 8-factor solution? 2) What is the internal consistency reliability of the CAT- adm©? 3) What items can be reduced while maintaining an acceptable factor structure? and 4) What are staff nurses' perceptions of nurse manager caring behaviors? A cross-sectional descriptive design was used. A sample of 703 staff nurses from Midwestern, Midatlantic and Southern Regions of the U.S. completed the CAT-adm© survey electronically. Analysis included Confirmatory Factor Analysis (CFA), Exploratory Factor Analysis (EFA), univariate analysis, and descriptive statistics. CFA did not support an 8-factor solution. EFA supported a two-factor solution and demonstrated significant shared variance between the two factors. This shared variance supported a one-factor solution that could conceptually be labeled Caring Behaviors. Random selection reduced the scale to 25-items while maintaining a Cronbach's Alpha of .98. Using the new 25-item scale, the composite score mean of staff nurses' perceptions of nurse manager caring behaviors indicated a moderately high level of caring. Suggestions for nursing administration, nurse manager practice, leadership, education and for future research were given. The new 25-item CAT-adm© survey has acceptable reliability and validity. The 25-item CAT-adm© survey provides hospital administrators, nurse managers, and researchers with an instrument to collect valuable information about the caring behaviors used by nurse managers in relationship with staff nurses.