Beyond the Crisis Response: A Narrative Review of Nurse-Led Psychological First Aid in Emergency Departments
Abstract
Background: Emergency department (ED) nurses are frontline responders to psychological trauma, yet their role in delivering immediate mental health support remains undertheorized and inconsistently implemented. Psychological First Aid (PFA)—an evidence-informed approach comprising safety, calming, connectedness, self-efficacy, and hope—offers a framework for addressing this gap.
Aim: This narrative review aims to synthesize evidence on nurse-led PFA in emergency settings, examining training models for emergency nurses, implementation strategies across clinical contexts (triage, trauma care, mass casualty events, bad news disclosure), and impact on patient distress and satisfaction.
Methods: A narrative review methodology was employed, searching PubMed, CINAHL, PsycINFO, Scopus, and Web of Science for literature published between 2010 and 2024.
Results: PFA training for emergency nurses enhances knowledge, performance competence, and self-efficacy, with effects lasting three months post-training. The predominant models are WHO PFA, NCTSN PFA, and Johns Hopkins RAPID-PFA. Challenges in implementation include time limitations, poor documentation, and insufficient organizational support. Evidence indicates improvements in reducing acute anxiety and aiding adaptive functioning, while the evidence for alleviating PTSD and depressive symptoms is weaker. Improved patient outcomes are noted in psychological state, satisfaction, and number of complaints.
Conclusions: Nurse-led PFA represents a promising approach to integrating mental health support into emergency care. Realizing its potential requires standardized training, organizational investment, and integration with broader trauma-informed care frameworks.
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References
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Authors
Copyright (c) 2024 Manahil Abdurahman Noradin Yar, Abdullah Ali Al Johani, Abrar Abdullah Aljohani, Nahala Swalem Al Marwany, Abdulhadi Hamad Abdulellah Alahmadi, Sultan Saad Marzwq Alharbi, Fouad Zaid Aloufi, Azzam Fahad Alsarani, Heba Abdullah Bakerman, Zainab Ibrahim Saigh
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