Practices and Challenges of Emergency Nurses in Saudi Arabia: A Cross-Sectional Survey

In modern healthcare, emergency nursing is a cornerstone of healthcare delivery and response to epidemics and disasters, providing immediate care to patients suffering from emergency or life-threatening conditions. The responsibilities of nurses in emergency departments focus on rapid triage of patients, immediate stabilization and coordination of multidisciplinary interventions. Therefore, emergency nursing roles require quick and accurate decision-making, advanced technical skills and flexibility in stressful and high-risk environments [1].

However, the world still faces numerous challenges and emergencies that place numerous challenges on emergency nurses, including a shortage of qualified nursing staff, overcrowded emergency departments and high patient turnover [2]. This leads to an increased risk of medical errors, longer hospital stays and poorer quality of healthcare, in addition to rising healthcare costs and emergency nurse burnouts [3,4]. Studies consistently report high prevalence of stress, burnout and musculoskeletal injuries among emergency nurses, in addition to frequent exposure to workplace violence [5,6]. Therefore, occupational hazards pose threats to nurses' health, increase turnover rates and impair the quality of health services.

Demand for emergency services in Saudi Arabia increases with the growing population, the Hajj and Umrah seasons, the spread of epidemics and the increasing burden of chronic diseases. However, while Saudi Arabia's Vision 2030 and the National Transformation Plan have contributed to the advancement of the healthcare sector and the development of healthcare infrastructure, emergency departments are struggling with high patient volumes and varying levels of nurse preparedness [7]. Recent studies in Saudi hospitals indicate gaps in preparedness and knowledge, a lack of training for nurses in disaster and emergency management and challenges related to workplace safety [8,9].

Evaluating the practices and challenges of emergency nursing specialists in Saudi Arabia is both timely and essential. Therefore, assessing the practices and challenges faced by emergency nurses is crucial as it contributes to health policy formulation and nursing workforce development. A clear understanding of these challenges can guide decision-makers in optimizing staffing, improving workplace conditions and strengthening training programs across emergency departments. Strengthening emergency nursing is essential to improving patient outcomes and achieving national goals of an efficient, high-quality healthcare system.

Therefore, this study aims to assess the knowledge, attitudes and practices of emergency nursing specialists in Saudi Arabia and to identify the major challenges they encounter in their professional practice.

Objectives

• Assess knowledge, attitudes and practices of emergency nurses in Saudi Arabia
• Identify main staffing, workload and training challenges in emergency departments
• Explore association between demographic characteristics and KAP outcomes

Study Design

This is a cross-sectional study design to assess the current practices and identify the major challenges faced by emergency nursing specialists in Saudi Arabia. The study was conducted between January and March 2024. The study was conducted Among the nurses at Hospital in Saudi Arabia.

Study Participants

The study included nurses working in emergency departments of selected Saudi hospitals. These participants were selected from various hospital nursing backgrounds to provide a diverse and comprehensive understanding of the topic. A convenience sampling method was used. Data were collected from three hospitals in the Hail region: King Salman Specialist Hospital, Sharaf Hospital and one secondary-care facility. The final sample consisted of 220 participants.

Inclusion Criteria

Nurses working at emergency department in Saudi Hospital; nurses working during the data collection period and nurses who voluntarily agreed to participate in the study.

Exclusion Criteria

The Exclusion Criteria included all non-nursing health professionals and volunteer nurses was excluded because they are not part of the formal emergency workforce and do not consistently participate in clinical decision-making, which may compromise data reliability.

Procedure

After obtaining ethical approval from the relevant institutional review board, official permissions were secured from the selected hospitals. Eligible emergency nurses were approached during their shifts and the study purpose was explained. Participation was voluntary and informed consent was obtained prior to data collection. A mixed data-collection approach was used, combining paper-based questionnaires with electronic forms to increase accessibility and response rates. The self-administered questionnaire was distributed in paper and electronic formats and participants were given sufficient time to complete it without disruption to their clinical duties. Completed questionnaires were collected immediately or submitted electronically through a secure link. All data were treated confidentially and anonymity was ensured throughout the process. This approach facilitated broad participation and facilitated data collection within the hospital.

Questionnaire

Data were collected using a self-administered questionnaire that was adapted and modified from previously validated instruments in emergency nursing research. The tool combined closed-ended questions (e.g., yes/no) with items measured on a 5-point Likert scale ranging from “strongly disagree” to “strongly agree.” The questionnaire consisted of four sections: (1) Demographic and professional information of the respondents, such as age, gender, educational level and years of experience; (2) Knowledge and practices of emergency nurses related to patient care, triage and teamwork; (3) Attitudes and perceived challenges regarding workload, staffing, occupational risks and workplace safety and (4) Reported practices and coping strategies in managing common challenges in emergency departments. Content validity was confirmed through expert review and a pilot test was conducted with a small group of nurses to ensure clarity and reliability before the final administration. The reliability of the questionnaire was assessed using Cronbach’s alpha, which demonstrated good internal consistency across all domains: 0.84 for the knowledge domain, 0.88 for the attitude's domain and 0.81 for the practice's domain.

Data Analysis

Statistical analysis was carried out using the Statistical Package for the Social Sciences (SPSS Inc., Chicago, IL, USA), version 26. Frequency and percentages were obtained for the categorical variables, while mean and Standard Deviation (SD) were calculated for the scale variables. In addition, The Shapiro Wilk test was applied to assess the normality of continuous variables prior to analysis. A significant level of p<0.05 was adopted for all statistical tests. The researcher used independent sample (t) test and one way ANOVA test was applied when comparing variables with three or more categories (e.g., education level, years of experience). This analytical approach was selected to match the number of comparison groups and ensure appropriate statistical interpretation.

Ethical Considerations

Ethical approval obtained from the Institutional Review Board (IRB) All participants provided informed consent, which ensured the privacy and confidentiality of their data. Participation was voluntary and written informed consent was obtained from each respondent. To ensure confidentiality and anonymity, no personal identifiers were collected and responses were coded for analysis. Data were stored securely and used solely for research purposes.