Emergency nurses’ perceived competence and confidence in performing a needle thoracostomy

Abstract

Background: Tension pneumothorax (TPT) is a life-threatening condition that is often missed at the scene of an accident in patients who sustain a traumatic chest injury. Although uncommon, its rapid progress to become a fatal condition renders it an emergency requiring immediate action to reverse it immediately. This condition can be reversed or prevented from developing further by a Needle Thoracostomy (NT), conserving life while the patient is transported to the hospital for definitive resuscitation care. Locally, emergency nurses working in the pre-hospital setting are encountering patients with TPT. However, no specific NT tool is available for them to use. Objectives: This study addressed the perceived competence and confidence of NT performance by emergency nurses working in the Malta pre-hospital setting and the factors that enhance or hinder emergency nurses' perceptions of NT. Design: A descriptive, cross-sectional study design was implemented. Data collection was carried out using a specifically developed, self-administered questionnaire that was distributed online. Method: Questionnaires were distributed online via email, through an intermediary, to the whole population of emergency nurses working in the pre-hospital setting in Malta (n = 81). Data collection lasted one month, with the collected data transferred and analysed using SPSS version 28 after the data collection phase. Results: The response rate of 38.5% (n = 29) of the population was considered adequate. Results indicated that emergency nurses are knowledgeable and perceive themselves as competent and confident in chest trauma and TPT. However, they must perceive themselves as competent and confident in performing a NT. The need for further training and implementing a specific NT tool was identified. Conclusion: Further training and implementing a specific NT tool are essential in boosting emergency nurses' perceptions of performing such a life-saving skill, but ultimately, they will save more lives.