ArticleJournal of clinical nursing2025
The Barriers and Enablers to Implementing Nurse-Initiated Protocols in the Emergency Department: A Focus Group Study.
Article in Journal of clinical nursing, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
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Who cites it
3 citing papers in PubMed.
- Applying Behaviour Change Theory to Develop an Implementation Strategy for Nurse-Initiated Protocols in the Emergency Department.Journal of advanced nursing · 2026Article
- Same-Day Discharge After Atrial Fibrillation Ablation. A Scoping Review of Nurse-Led Care Model.Health science reports · 2026Article
- Take Fatigue or Fatigues into Account in Physiotherapy Interventions? A Rapid Scoping Review.Physical therapy research · 2025Review
Corrections and comments
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Authors and funding
3 authors.
Funding
Abstract
aimTo identify the barriers and enablers to implementing nurse-initiated protocols in an emergency department.
backgroundNurse-initiated protocols empower emergency nurses to autonomously initiate interventions, investigations and treatments based on predefined clinical guidelines. These protocols reduce waiting times and enhance staff and patient satisfaction. However, their uptake remains inconsistent, and the reasons for this variability are not well understood.
methodFocus groups were conducted with emergency nurses using an interview guide informed by the theoretical domains framework to explore perceived barriers and enablers to protocol implementation. Audio recordings were transcribed and analysed using inductive content analysis.
resultsSix focus groups with 34 participants identified seven categories influencing protocol implementation. Barriers were: (i) nurses' workload and psychological stress, (ii) lack of competence, confidence and experience, and (iii) documentation burden and limited access to resources. Enablers were: (i) education and clinical support, (ii) improved clinical practice, and (iii) positive healthcare outcomes. The nurses and doctor relationship was identified as both a barrier and an enabler.
conclusionEffective implementation of nurse-initiated protocols requires systemic changes that empower nurses within a well-supported, adequately resourced environment. Addressing structural and professional development challenges is crucial to ensuring these protocols are consistently integrated into emergency departments.
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Registered trials
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