title: The impact of HIRAID on emergency nurses' self-efficacy, anxiety and perceived control: A simulated study.
abstract: BACKGROUND
  Emergency nurses must perform accurate and complete comprehensive patient assessments to establish patient treatment needs and expedite care.
  
  
  OBJECTIVE
  To evaluate the impact of a structured approach to emergency nursing assessment following triage, on novice emergency nurses' anxiety, self-efficacy and perceptions of control.
  
  
  METHODS
  Thirty eight early career emergency nurses from five Australian hospitals performed an initial patient assessment in an immersive clinical simulated scenario, before and after undertaking training in HIRAID, an evidence-informed patient assessment framework for emergency nurses. Immediately following each scenario the nurses completed a questionnaire scoring anxiety, self-efficacy and perceptions of control levels. Paired sample t-tests and effect sizes were calculated.
  
  
  RESULTS
  Participant anxiety levels were lower after HIRAID training compared to before undertaking the training (Mean (SD) = 53.26 (10.76) vs 47.46 (9.96), P = 0.002). Self-efficacy levels in assessment performance increased (189.32 (66.48) vs 214.06 (51.35), P = 0.001). There was no change in perceptions of control (31.24 (7.38) vs 30.98 (8.38), P = 0.829).
  
  
  CONCLUSIONS
  High levels of anxiety and low levels of self-efficacy are known to be negatively correlated with clinical reasoning skills and performance.
  
  
  CONCLUSIONS
  The effect of HIRAID training on reducing anxiety and increasing self-efficacy has the potential to improve emergency nurses' assessment performance and the quality and safety of patient care.
authors.affiliation: Sydney Nursing School, University of Sydney NSW, Australia; Emergency Department, The Wollongong Hospital, Wollongong, NSW, Australia. Electronic address: bmun1400@uni.sydney.edu.au.
authors.forename: Belinda
authors.initials: B
authors.lastname: Munroe
authors.affiliation: Sydney Nursing School, University of Sydney NSW, Australia.
authors.forename: Thomas
authors.initials: T
authors.lastname: Buckley
authors.affiliation: Sydney Nursing School, University of Sydney NSW, Australia; Emergency Department, The Wollongong Hospital, Wollongong, NSW, Australia; Trauma Service, St George Hospital, Sydney, NSW, Australia.
authors.forename: Kate
authors.initials: K
authors.lastname: Curtis
authors.affiliation: Sydney Nursing School, University of Sydney NSW, Australia; Emergency Department, Westmead Hospital, NSW, Australia.
authors.forename: Margaret
authors.initials: M
authors.lastname: Murphy
authors.affiliation: Emergency Department, Blacktown Hospital, NSW, Australia.
authors.forename: Luke
authors.initials: L
authors.lastname: Strachan
authors.affiliation: Sydney Nursing School, University of Sydney NSW, Australia.
authors.forename: Jennifer
authors.initials: J
authors.lastname: Hardy
authors.affiliation: Sydney Nursing School, University of Sydney NSW, Australia.
authors.forename: Judith
authors.initials: J
authors.lastname: Fethney
mesh_terms: D000328:Adult; D001007:Anxiety / Q000523:psychology*; D001315:Australia; D016529:Emergency Nursing / Q000193:education* / Q000379:methods; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009726:Nurses / Q000523:psychology*; D009730:Nursing Assessment / Q000379:methods*; D020377:Self Efficacy; D011795:Surveys and Questionnaires; D000078329:Workforce
keywords: Anxiety; Emergency; Framework; Nursing; Patient assessment; Perceptions of control; Self-efficacy