Beyond Triage: The Critical Role of Emergency Nurses in COPD Assessment and Management—Insights from Patients and Staff.

Background: Chronic Obstructive Pulmonary Disease (COPD) remains a leading cause of emergency department (ED) presentation, hospitalisation, and preventable healthcare utilisation worldwide. Although guidelines advocate coordinated, preventative, and community-based management, care within ED settin...

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Publicado en:Nursing Reports Vol. 16; no. 4; pp. 136 - 154
Autores principales: Moloney, Clint, Beccaria, Gavin, Mullens, Amy B.
Formato: research tables/charts Journal Article
Publicado: MDPI Apr2026
Acceso en línea:Ver este registro en EBSCOhost
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      dt: Apr2026
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      pub: MDPI
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        atl: Beyond Triage: The Critical Role of Emergency Nurses in COPD Assessment and Management—Insights from Patients and Staff.
      aug:
        au:
          Moloney, Clint
          Beccaria, Gavin
          Mullens, Amy B.
        affil: School of Nursing and Midwifery, University of Southern Queensland, Toowoomba, QLD 4350, Australia
      sug:
        subj:
          Patient Attitudes Evaluation
          Nurse Attitudes Evaluation
          Attitude of Health Personnel Evaluation
          Attitude to Illness Evaluation
          Pulmonary Disease, Chronic Obstructive Nursing
          Disease Exacerbation Nursing
          Acute Care
          Nursing Role
          Emergency Nursing
          Needs Assessment
          Comorbidity
          Emergency Service Queensland
          Funding Source
          Queensland
          Human
          Qualitative Studies
          Phenomenological Research
          Purposive Sample
          Semi-Structured Interview
          Thematic Analysis
          Holistic Nursing
          Patient Centered Care
          Health Screening
          Sleep Apnea, Obstructive
          Nursing Assessment
          Patient Education
          Middle Age
          Aged
          Male
          Female
          Audiorecording
          Continuity of Patient Care
          Self-Management Education
          Nurse-Patient Relations
          Middle Aged: 45-64 years
          Aged: 65+ years
          Male
          Female
      ab: Background: Chronic Obstructive Pulmonary Disease (COPD) remains a leading cause of emergency department (ED) presentation, hospitalisation, and preventable healthcare utilisation worldwide. Although guidelines advocate coordinated, preventative, and community-based management, care within ED settings often remains reactive and crisis-driven. Nurses occupy a central role in COPD management; however, the experiential dimensions of nursing practice and its contribution to improving patient outcomes are insufficiently understood. Objectives: To explore the lived experiences of patients, nurses and medical officers regarding COPD presentations to the ED, with particular focus on the nursing role in assessment, coordination, education, and identification of unmet and comorbid care needs. Methods: A qualitative phenomenological approach was undertaken across three regional Australian EDs. Purposive sampling recruited patients presenting with acute exacerbations of COPD and nursing and medical officers involved in their care. Semi-structured interviews were conducted and transcribed verbatim. Data were analysed using Braun and Clarke's thematic analysis framework, supported by reflexive discussion and audit trails to enhance rigour. Results: Six interrelated themes were identified: (1) nursing within a "crisis first" model of care; (2) holistic assessment and translation of complexity; (3) education and care coordination as preventative nursing work; (4) relational care and therapeutic connection; (5) nurses as sentinels for undiagnosed comorbidities, particularly obstructive sleep apnoea; and (6) system pressures constraining optimal nursing practice. Participants consistently described nurses as the clinicians who stabilised acute episodes, interpreted contextual risks, coordinated services, and provided relational and educational support, yet whose preventative contributions were limited by time and organisational demands. Conclusions: ED nurses function as critical integrators between acute stabilisation and chronic disease management for patients with COPD. Formalising nurse-led assessment, education, coordination, and sleep-disordered breathing screening may reduce avoidable ED presentations and enhance patient-centred outcomes. Investment in structured nursing models represents a key opportunity for improving COPD care delivery.
      pubtype: Academic Journal
      doctype:
        research
        tables/charts
        Journal Article
      ougenre: Article
    language: English
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