Emergency and Critical Care Management Experiences of Nurses in Selected Hospitals in MIMAROPA Region
DOI:
https://doi.org/10.67903/ijroms0329Keywords:
Emergency and Critical Care, Emergency Response Framework, MIMAROPA Region, Nurse Experiences, Patient TransportAbstract
Emergency and critical care nurses play an important role in providing immediate care to patients, especially in hospitals with limited resources. However, few studies have explored the experiences of nurses working in geographically isolated and resource-limited areas. Most studies focus on patient outcomes rather than the challenges nurses face in managing emergencies, stabilizing patients, and arranging patient transport. This study explored the experiences of nurses in managing emergency and critical care cases in selected hospitals in the MIMAROPA Region. It focused on their experiences, challenges, and strategies in providing care from initial treatment to patient stabilization and referral. A qualitative research design using narrative inquiry was employed. Fifteen (15) nurses from three government hospitals were selected through purposive sampling. Data were collected through semi-structured interviews and analyzed using thematic analysis with the help of NVivo software. The findings showed that nurses often handled emergency cases that required quick decisions and immediate action. However, they faced challenges such as limited medicines, problems with patient monitoring, financial difficulties among patients, and transportation barriers. Despite these difficulties, nurses showed resourcefulness, teamwork, and adaptability in providing care and stabilizing patients. The study concluded that limited resources and healthcare support affect the quality and timeliness of emergency care. Therefore, the implementation of the S.A.F.E. Emergency Response Framework is recommended to improve resource availability, clinical decision-making, teamwork, patient transport, and continuity of care. This framework aims to promote patient safety and improve healthcare services and patient outcomes.
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Aitken, L., Chaboyer, W., & Elliott, D. (2020). Scope of critical care practice. Australian College of Critical Care Nurses.
Alberto, N. R. I., Alberto, I. R. I., Eala, M. A. B., Dee, E. C., & Canal, J. P. A. (2022). Availability of essential diagnostics in the Philippines. The Lancet Regional Health – Western Pacific. https://doi.org/10.1016/j.lanwpc.2021.100375
Alfuhiqi, M. F. H., Al Dhefeeri, D. K., Ali Alruwaili, S. J., Alfurayji, N. M. N., Alhazmi, S. S. D., & Alqarni, L. Y. M. (2024). The importance of effective communication among healthcare providers. Gland Surgery.
Alanazi, M. A., & Shaban, M. (2025). Exploring the decision-making dynamics of emergency nurses in high- stakes older adults care scenarios. Nursing in Critical Care. https://doi.org/10.1111/nicc.70233
Alsabri, M., Oboli, V. N., Rath, S., Tsoi, V., Del Castillo Miranda, J. C., Alagarswamy, K., & Shehada, W. (2025). Bridging the gap: Lessons from low-resource pediatric emergency medicine for high-resource settings. Current Emergency and Hospital Medicine Reports. https://doi.org/10.1007/s40138-025-00315-z
Atento, R. G., Quinto, L., & Espelita, C. A. M. (2025). Bridging global health workforce gaps 2050: A multilevel analysis of global demand, Philippine supply fragilities, and competency alignment. International Journal of Health & Business Analytics. https://journal.ijhba.com/index.php/ijhba/article/view/37
Bagaria, D., Ratnayake, A. S., Madrid, A., & Worlton, T. J. (2024). Trauma systems in Asian countries: Challenges and recommendations. Critical Care. https://doi.org/10.1186/s13054-024-04838-x
Bam, V., Diji, A. K., Asante, E., Lomotey, A. Y., Adade, P., & Akyeampong, B. A. (2020). Self-assessed competencies of nurses at an emergency department in Ghana. African Journal of Emergency Medicine. https://doi.org/10.1016/j.afjem.2019.09.002
Bissonette, S., Chartrand, J., Bailey, L., Lalonde, M., & Tyerman, J. (2024). Interventions to improve nurse– family communication in the emergency department: A scoping review. Journal of Clinical Nursing. https://doi.org/10.1111/jocn.17068
Braun, V., & Clarke, V. (2019). Reflecting on reflexive thematic analysis. Qualitative Research in Sport, Exercise and Health. https://doi.org/10.1080/2159676X.2019.1628806
Burrows, G. L., Calleja, P., & Cooke, M. (2019). What are the support needs of nurses providing emergency care in rural settings as reported in the literature? A scoping review. Rural and Remote Health. https://doi.org/10.22605/RRH4805
Campbell, A., Ascenzi, J., & Busch, D. W. (2022). An integrative review regarding knowledge and self- competency of pediatric and neonatal critical care transport nurses. Air Medical Journal. https://doi.org/10.1016/j.amj.2022.06.006
Capuno, J. J., Kraft, A. D., Poco, L. C., Quimbo, S. A., & Tan, C. A. R. (2017). Factors associated with the delay in seeking inpatient and outpatient care services in the Philippine. UPSE Discussion Paper.
Cochran, C. B. (2019). Infusing the principles of trauma-informed care into emergency nursing: A comprehensive approach to change practice. Journal of Forensic Nursing. https://doi.org/10.1097/JFN.0000000000000267
Collado, Z. C. (2024). The right to healthcare must include the right to ease of physical access: Exploring geography-health nexus in GIDA communities in the Philippines. International Journal of Social Determinants of Health and Health Services. https://doi.org/10.1177/27551938241265673
Côté, M. J., & Shrestha, A. (2023). Hospital and emergency services in rural areas. In A. O. Ferdinand, J. N. Bolin, T. Callaghan, H. I. Rochford, A. Lockman, & N. Y. Johnson (Eds.), Rural healthy people 2030 (Chapter 19). Texas A&M University School of Public Health, Southwest Rural Health Research Center. http://hdl.handle.net/1969.1/1581911
Crawford, A. M., Shiferaw, A. A., Ntambwe, P., Milan, A. O., Khalid, K., Rubio, R., & Madzimbamuto, F. (2023). Global critical care: A call to action. Critical Care. https://doi.org/10.1186/s13054-022-04296-3
Cunningham, C., Brysiewicz, P., Sepeku, A., White, L., Murray, B., Lobue, N., & Sawe, H. (2017). Developing an emergency nursing short course in Tanzania. African Journal of Emergency Medicine. https://doi.org/10.1016/j.afjem.2017.08.002
Davis, W. D., Evans, D. D., Fiebig, W., & Lewis, C. L. (2020). Emergency care: Operationalizing the practice through a concept analysis. Journal of the American Association of Nurse Practitioners. https://doi.org/10.1097/JXX.0000000000000229
Dayapera, L. Z. A., Sy, J. C. Y., Valenzuela, S., Eala, S. J. L., Del Rosario, C. M. I. P., Buensuceso, K. N. C., Dy, A. S., Morales, D. A., Gibson, A. G., & Apostol, G. L. C. (2024). One health in the Philippines: A review and situational analysis. One Health. https://doi.org/10.1016/j.onehlt.2024.100758
De Mesa, R. Y. H., Marfori, J. R. A., Fabian, N. M. C., Villaverde, J. E. T., Villanueva, H. M. S., Alegado, R., Dela Cruz, M., Malou, J. E. L., Jr., Mirano, J., & Alfonso, C. R. (2023). Experiences from the Philippine grassroots: Impact of strengthening primary care systems on health worker satisfaction and intention to stay. BMC Health Services Research. https://doi.org/10.1186/s12913-022-08799-1
Dekeseredy, P., Landy, C. M. K., & Sedney, C. L. (2019). An exploration of work-related stressors experienced by rural emergency nurses. Online Journal of Rural Nursing and Health Care. https://doi.org/10.14574/ojrnhc.v19i2.550
Del Mundo, M. C., & Reyes, T. (2023). Decision-making competence and critical thinking ability among triage nurses in a selected hospital in Batangas, Philippines. International Journal of Multidisciplinary: Applied Business and Education Research, 4(3). https://babmrjournal.org/index.php/ijmaber/article/view/1253
Department of Health. (2024). Health Facility Enhancement Program (HFEP). https://doh.gov.ph
Department of Health. (2025). Implementation of patient transport vehicle services under Universal Health Care. https://doh.gov.ph
Diaz, J. V., Riviello, E. D., Papali, A., Adhikari, N. K., & Ferreira, J. C. (2019). Global critical care: Moving forward in resource-limited settings. Annals of Global Health. https://doi.org/10.5334/aogh.2413
Du, J., Huang, S., Lu, Q., Ma, L., Lai, K., & Li, K. (2022). Influence of empathy and professional values on ethical decision-making of emergency nurses: A cross-sectional study. International Emergency Nursing. https://doi.org/10.1016/j.ienj.2022.101186
EpiGuard. (n.d.). Patient transport 101: Understanding intrahospital and interhospital transport. Retrieved March 27, 2025, from https://epiguard.com/patient-transport-101-intrahospital-interhospital-transport/
Erickson, S. (2021). Communication in a crisis and the importance of authenticity and transparency. Journal of Library Administration. https://doi.org/10.1080/01930826.2021.1906556
Garces-Cabanas, C. T., & Dano, J. C. (2022). The experiences of nurses’ frustrations in clinical settings. The Malaysian Journal of Nursing. https://doi.org/10.31674/mjn.2022.v13i03.012
Geleto, A., Chojenta, C., Musa, A., & Loxton, D. (2018). Barriers to access and utilization of emergency obstetric care at health facilities in sub-Saharan Africa: A systematic review of literature. Systematic Reviews. https://doi.org/10.1186/s13643-018-0842-2
Glasser, A. (2023). The role of emergency nursing in critical care. Journal of Perioperative Medicine. https://doi.org/10.35248/2684-1290.23.6.186
Greene, A., Dion, P.-M., Nolan, B., Trachter, R., Vu, E., & Trojanowski, J. (2023). Overcoming distance: An exploration of current practices of government- and charity-funded critical care transport and retrieval organizations. Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine. https://doi.org/10.1186/s13049-023-01158-5
Greenwood-Lee, J., Wild, G., & Marshall, D. (2017). Improving accessibility through referral management: Setting targets for specialist care. Health Systems. https://doi.org/10.1057/hs.2015.20
Guégan, J. F., Suzán, G., Kati-Coulibaly, S., Bonpamgue, D. N., & Moatti, J. P. (2018). Sustainable Development Goal #3, “Health and well-being,” and the need for more integrative thinking. Veterinaria México OA, 5.
Hansen, G., Beer, D. L., & Vallance, J. K. (2017). The impact of interfacility transport of critically ill pediatric patients on staffing in rural emergency departments. Canadian Journal of Rural Medicine. https://www.srpc.ca/page-17229/4863907
Heaton, J., & Kohn, M. D. (2025). EMS inter-facility transport. In StatPearls. StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK441879/
Hendrickx, L., & Winters, C. (2017). Access to continuing education for critical care nurses in rural or remote settings. Critical Care Nurse. https://doi.org/10.4037/ccn2017999
Hodge, M. B., et al. (2017). The impact of advanced practice nursing in emergency and critical care settings: A systematic review. Journal of Advanced Nursing. https://doi.org/10.1111/jan.13249
Horn, D., Lindström, M., & Rosengren, K. (2018). Managing a stressful work environment through improved teamwork: A qualitative content analysis of nurses’ working environment within emergency care. International Archives of Nursing and Health Care. https://doi.org/10.23937/2469-5823/15100109
Horn, R., Mertenskoetter, T., Grunewald, F., & Boell, J. E. (2018). Emergency nursing practice in the Philippines: A cross-sectional study of stress and challenges. Asian Nursing Research. https://doi.org/10.1016/j.anr.2018.07.003
Hospital Management and Health Services. (2020). Hospital management and health services report. Provincial Government of Marinduque. https://marinduque.gov.ph/health-and-nutrition/
Hsia, R. Y., & Zagorov, S. (2022). Structural discrimination in emergency care: How a sick system affects us all. https://www.cell.com/med/fulltext/S2666-6340(22)00041-1
Ifrim, R. A., Klugarová, J., Măguriță, D., Zazu, M., Mazilu, D. C., & Klugar, M. (2022). Communication, an important link between healthcare providers: A best practice implementation project. JBI Evidence Implementation. https://doi.org/10.1097/XEB.0000000000000319
Iyi, O. (2015). Stress management and coping strategies among nurses: A literature review. Theseus. https://www.theseus.fi/bitstream/handle/10024/103386/Iyi_Obiora.pdf
Kilpatrick, M. (2024, October 14). Novice to expert: The value of nursing expertise – Dr. Patricia Benner’s five stages of clinical competence. Washington State Nurses Association. https://www.wsna.org/news/2024/novice-to-expert-the-value-of-nursing-expertise
Kironji, A. G., Hodkinson, P., De Ramirez, S. S., Anest, T., Wallis, L., Razzak, J., & Hansoti, B. (2018). Identifying barriers for out-of-hospital emergency care in low- and low-middle-income countries: A systematic review. BMC Health Services Research. https://doi.org/10.1186/s12913-018-3091-0
Kiwanuka, F., Kopra, J., & Kvist, T. (2025). Family support in acute care settings: Perspectives of family members on cognitive and emotional support. BMC Nursing. https://doi.org/10.1186/s12912-025-00752-x
Kornelsen, J., Hobbs, B., Buhler, H., Kaus, R., Grant, K., Lamont, S. C., & Grzybowski, S. (2018). High-acuity rural transport: Findings from a qualitative investigation. Rural and Remote Health. https://www.rrh.org.au/journal/article/4366
Kulshrestha, A., & Singh, J. (2016). Inter-hospital and intra-hospital patient transfer: Recent concepts. Indian Journal of Anaesthesia. https://doi.org/10.4103/0019-5049.186012
Labrague, L. J. (2024). Relationship between transition shock in novice emergency room nurses, quality of nursing care, and adverse patient events: The mediating role of emotional exhaustion. Australasian Emergency Care. https://doi.org/10.1016/j.auec.2023.07.001
Labrague, L. J., McEnroe-Pettite, D., & Leocadio, M. C. (2019). Transition experiences of newly graduated Filipino nurses in a resource-scarce rural health care setting: A qualitative study. Nursing Forum. https://doi.org/10.1111/nuf.12330
Laranang, J. M. (2024). Challenges faced by nurses towards emergency and disaster cases. Asian Journal of Research in Nursing and Health. https://journalajrnh.com/index.php/AJRNH/article/view/17
Lawal, O., & Anyiam, F. E. (2019). Modelling geographic accessibility to primary healthcare facilities: Combining open data and geospatial analysis. Geo-Spatial Information Science. https://doi.org/10.1080/10095020.2019.1621543
Lin, Y. P., Chan, L. Y. C., & Chan, E. Y. (2020). Interprofessional collaboration during medical emergencies among doctors, nurses, and respiratory therapists in the intensive care unit: A phenomenological study protocol. Journal of Advanced Nursing. https://doi.org/10.1111/jan.14244
Liu, R., Dong, X., Wang, X. C., Zhang, P., Liu, M., & Zhang, Y. (2021). Study on the relationship among the urbanization process, ecosystem services, and human well-being in an arid region in the context of carbon flow: Taking the Manas River Basin as an example. Ecological Indicators. https://doi.org/10.1016/j.ecolind.2021.108248
Maake, G., Harmse, C. P. J., & Schultz, C. M. (2023). A performance management system, employment relationships and work engagement framework for the public sector in South Africa. Southern African Business Review, 27. https://doi.org/10.25159/1998-8125/13795
Macey, A., O’Reilly, G., Williams, G., & Cameron, P. (2021). Critical care nursing role in low- and lower-middle- income settings: A scoping review. BMJ Open. https://doi.org/10.1136/bmjopen-2022-055585
Mamalelala, T. T., Holzemer, W., Seloilwe, E. S., Iwu, E., & Kamienski, M. (2023). Experiences of rural nurses with emergency patient transport in a resource-limited setting. International Emergency Nursing. https://doi.org/10.1016/j.ienj.2023.101379
Mancheva, L., & Dugdale, J. (2016). Understanding communications in medical emergency situations. In Proceedings of the 49th Hawaii International Conference on System Sciences (HICSS). IEEE. https://doi.org/10.1109/HICSS.2016.32
Marshall, J. C., Bosco, L., Adhikari, N. K. J., Connolly, B., Diaz, J. V., Dorman, T., & Zimmerman, J. (2022). What is an intensive care unit? A report of the task force of the World Federation of Societies of Intensive and Critical Care Medicine. Journal of Critical Care. https://doi.org/10.1016/j.jcrc.2021.10.015
Marsden, E., Taylor, A., Wallis, M., et al. (2018). A structure, process and outcome evaluation of the Geriatric Emergency Department Intervention model of care: A study protocol. BMC Geriatrics. https://doi.org/10.1186/s12877-017-0462-z
Masbi, M., Tavakoli, N., & Dowlati, M. (2024). Challenges of providing special care services in hospitals during emergencies and disasters: A scoping review. BMC Emergency Medicine. https://doi.org/10.1186/s12873-024-01160-1
McCaul, M., Clarke, M., Bruijns, S. R., Hodkinson, P. W., de Waal, B., Pigoga, J., Wallis, L. A., & Young, T. (2018). Global emergency care clinical practice guidelines: A landscape analysis. African Journal of Emergency Medicine. https://doi.org/10.1016/j.afjem.2018.09.002
McCullough, K., Andrew, L., Genoni, A., Dunham, M., Whitehead, L., & Porock, D. (2023). An examination of primary health care nursing service evaluation using the Donabedian model: A systematic review. Research in Nursing & Health. https://doi.org/10.1002/nur.22291
McDermid, F., Mannix, J., & Peters, K. (2020). Factors contributing to high turnover rates of emergency nurses: A review of the literature. Australian Critical Care. https://doi.org/10.1016/j.aucc.2019.09.002
McFarland, M. R., & Wehbe-Alamah, H. B. (2019). Leininger’s Theory of Culture Care Diversity and Universality: An overview with a historical retrospective and a view toward the future. Journal of Transcultural Nursing. https://doi.org/10.1177/1043659619867134
McKinney, E. L., McKinney, V., & Swartz, L. (2021). Access to healthcare for people with disabilities in South Africa: Bad at any time, worse during COVID-19? South African Family Practice. https://doi.org/10.4102/safp.v63i1.5226
Milton, J., Andersson, A. E., & Oxelmark, L. (2022). Healthcare professionals’ perceptions of interprofessional teamwork in the emergency department: A critical incident study. Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine. https://doi.org/10.1186/s13049-022-01029-0
Moore, L., Lavoie, A., Bourgeois, G., & Lapointe, J. (2015). Donabedian’s structure-process-outcome quality of care model: Validation in an integrated trauma system. Journal of Trauma and Acute Care Surgery. https://doi.org/10.1097/TA.0000000000000663
Mueller, S. K., Zheng, J., Orav, E. J., Schnipper, J. L., & Burke, L. G. (2019). Interhospital transfer and hospital mortality: A retrospective cohort study. BMJ Quality & Safety. https://doi.org/10.1136/bmjqs-2018-008325
Munroe, B., Curtis, K., Fry, M., Shaban, R. Z., Moules, P., Elphick, T. L., & Considine, J. (2022). Increasing accuracy in documentation through the application of a structured emergency nursing framework: A multisite quasi-experimental study. Journal of Clinical Nursing. https://doi.org/10.1111/jocn.16115
Nascimento, L., Correia, M. F., & Califf, C. B. (2024). Towards a bright side of technostress in higher education teachers: Identifying several antecedents and outcomes of techno-eustress. Technology in Society, 76, Article 102428. https://doi.org/10.1016/j.techsoc.2023.102428
Ngo, T. T., Nguyen, H. V., Pham, T. H., Nguyen, T. V., Vu, K. D., Pham, M. D., Phung, D., & Tran, A. N. T. (2022). The relationship between team dynamics with healthcare coordination and clinical work satisfaction among commune health workers: A Bayesian model averaging study. The International Journal of Health Planning and Management. https://doi.org/10.1002/hpm.3494
Norouzinia, R., Yarmohammadian, M. H., Ferdosi, M., Masoumi, G., & Ebadi, A. (2020). Professional resilience among trauma emergency department nurses in Iran: A qualitative study. Frontiers in Emergency Medicine. https://fem.tums.ac.ir/index.php/fem/article/view/363
Nkoana, M. E., & Matjie, M. A. (2024). Employee’s psychological experiences with bank’s pay for performance system in South Africa. SA Journal of Industrial Psychology, 50, Article a2166. https://doi.org/10.4102/sajip.v50i0.2166
Obbarius, N., Fischer, F., Liegl, G., Obbarius, A., & Rose, M. (2021). A modified version of the transactional stress concept according to Lazarus and Folkman was confirmed in a psychosomatic inpatient sample. Frontiers in Psychology. https://doi.org/10.3389/fpsyg.2021.584333
Oschman, B., & Matjie, M. A. (2025). Exploring employees’ experiences with the performance appraisals at the South African Air Force. SA Journal of Human Resource Management, 23, Article a2925. https://doi.org/10.4102/sajhrm.v23i0.2925
Ortiz, M. R. (2018). Patient-centered care: Nursing knowledge and policy. Nursing Science Quarterly.
Owen, C., Brooks, B., Curnin, S., & Bearman, C. (2018). Enhancing learning in emergency services organisational work. Australian Journal of Public Administration. https://doi.org/10.1111/1467-8500.12309
Paguio, J. T., & Banayat, A. C. (2018). Commentary on challenges to critical care nursing practice in the Philippines. Connect: The World of Critical Care Nursing. https://doi.org/10.1891/1748-6254.12.1.8
Palozzi, G., Schettini, I., & Chirico, A. (2020). Enhancing the sustainable goal of access to healthcare: Findings from a literature review on telemedicine employment in rural areas. Sustainability. https://doi.org/10.3390/su12083318
Park, H.-Y., & Kim, J.-S. (2017). Factors influencing disaster nursing core competencies of emergency nurses. Applied Nursing Research. https://doi.org/10.1016/j.apnr.2017.06.004
Philippine Statistics Authority. (2024, September 26). Highlights of the 2021 city and municipality level poverty estimates in the MIMAROPA Region (Ref. No. 2024-SR-81). https://psa.gov.ph
Presidential Communications Office. (2024a, July 12). Local execs thank PBBM for patient transport vehicle, “a lifesaving gift”. Philippine Information Agency. https://pia.gov.ph/local-execs-thank-pbbm-for-patient-transport-vehicle-a-lifesaving-gift/
Presidential Communications Office. (2024b, July 18). PBBM commits to further develop Romblon’s healthcare system. https://pco.gov.ph/news_releases/pbbm-commits-to-further-develop-romblons-healthcare-system/
Provincial Government of Marinduque. (2020). Hospital management and health services report. Provincial Planning and Development Office. https://marinduque.gov.ph/health-and-nutrition/
Rai, N. (2025). Empathy-driven care in the intensive care unit: Exploring nurses’ experiences and perceptions. International Journal of Community Medicine and Public Health. https://doi.org/10.18203/2394-6040.ijcmph20253723
Ramos, V. B. (2024). Access to universal health care in the Philippines: The challenges of ethnicity, barriers, and inequities. Cultural and Pedagogical Inquiry. https://journals.library.ualberta.ca/cpi/index.php/cpi/article/view/29782
Revels, A., Goldberg, L., & Watson, J. (2016). Caring science: A theoretical framework for palliative care in the emergency department. International Journal for Human Caring. https://doi.org/10.20467/1091-5710.20.4.206
Rigaud, J. P., Ecarnot, F., & Quenot, J. P. (2023). Patient information and consent for care in the intensive care unit. Healthcare, 11(5), Article 707. https://doi.org/10.3390/healthcare11050707
Rodrigo, C. G. G. (2025). Lived experiences of Filipino nurses in the global healthcare arena: A qualitative inquiry. https://www.ijams-bbp.net/wp-content/uploads/2025/07/6-IJAMS-JUNE-2025-501-537.pdf
Salvacion, A. R. (2022). Measuring spatial accessibility of healthcare facilities in Marinduque, Philippines. ISPRS International Journal of Geo-Information. https://doi.org/10.3390/ijgi11100516
Santana, T. D. S., Servo, M. L. S., Sousa, A. R. D., Fontoura, E. G., Góis, R. M. O. D., & Merces, M. C. D. (2021). Coping strategies used by hospital emergency nurses. Texto & Contexto-Enfermagem, 30, Article e20200435. https://doi.org/10.1590/1980-265X-TCE-2020-0435
Schell, C. O., Gerdin Wärnberg, M., Hvarfner, A., Höög, A., Baker, U., Castegren, M., & Baker, T. (2018). The global need for essential emergency and critical care. Critical Care. https://doi.org/10.1186/s13054-018-2219-2
Schamisso, B. (2024, December 9). Trapped in transit: Delays in hospital transfers put Illinois lives at risk. Northwestern Medicine. https://www.northwestern.edu/newscenter/stories/2024/12/delays-in-hospital-transfers.html
Secheresse, T., Pansu, P., & Lima, L. (2020). The impact of full-scale simulation training based on Kolb’s learning cycle on medical prehospital emergency teams: A multilevel assessment study. Simulation in Healthcare. https://doi.org/10.1097/SIH.0000000000000461
Senesac, P. A., & Roy, S. C. (2015). Sister Callista Roy’s adaptation model. In M. R. Alligood (Ed.), Nursing theories and nursing practice. Elsevier.
Sharif, A., & Rubio, R. R. (2022). Filipino nurses’ experiences in conducting health education in the emergency room. International Journal of Nursing and Health Services. https://doi.org/10.35654/ijnhs.v5i3.597
Sharkiya, S. H. (2023). Quality communication can improve patient-centred health outcomes among older patients: A rapid review. BMC Health Services Research. https://doi.org/10.1186/s12913-023-09869-8
Shoham, D. A., Harris, J. K., Mundt, M., & McGaghie, W. (2016). A network model of communication in an interprofessional team of healthcare professionals: A cross-sectional study of a burn unit. Journal of Interprofessional Care. https://doi.org/10.1080/13561820.2016.1203296
Silva, L. M. da, Monteiro, C. E. A., Santos, L. C. R., & Medeiros, S. M. (2018). Contributions of Jean Watson’s theory to holistic critical thinking of nurses. Revista Brasileira de Enfermagem. https://doi.org/10.1590/0034-7167-2017-0065
Slusher, T. M., Kiragu, A. W., Day, L. T., Bjorklund, A. R., Shirk, A., Johannsen, C., & Hagen, S. A. (2018). Pediatric critical care in resource-limited settings—Overview and lessons learned. Frontiers in Pediatrics. https://doi.org/10.3389/fped.2018.00049
Smith, S., Lapkin, S., Halcomb, E., & Sim, J. (2023). Job satisfaction among small rural hospital nurses: A cross-sectional study. Journal of Nursing Scholarship. https://doi.org/10.1111/jnu.12800
Smith, S., Sim, J., & Halcomb, E. (2019). Nurses’ experiences of working in rural hospitals: An integrative review. Journal of Nursing Management. https://doi.org/10.1111/jonm.12716
Solheim, J. (2018). Emergency nursing: A global perspective. Journal of Emergency Nursing. https://www.jenonline.org/article/S0099-1767(17)30603-7
Spencer, S. A., Adipa, F. E., Baker, T., Crawford, A. M., Dark, P., Dula, D., & Morton, B. (2023). A health systems approach to critical care delivery in low-resource settings: A narrative review. Intensive Care Medicine, 49(7), 772–784.
Subedi, K. R. (2021). Determining the sample in qualitative research. ERIC. (ERIC No. ED618228). https://eric.ed.gov/?id=ED618228
Sy, P. A., & Cabanes, R. V. D. (2022). Research conversations: Ethics and privacy in research. University of the Philippines Open University. https://networks.upou.edu.ph
Tariverdi, M., Nunez-del-Prado, M., Leonova, N., & Rentschler, J. (2023). Measuring accessibility to public services and infrastructure criticality for disaster risk management. Scientific Reports. https://doi.org/10.1038/s41598-023-28778-4
Tasneem, S., & Baig, A. M. (2025). Ethical dilemmas and clinical decision-making processes faced by nurses working in high-stakes critical and emergency care environments. Mader-e-Milat International Journal of Nursing and Allied Sciences. https://doi.org/10.5281/zenodo.16400093
Tan, C. (2020). Character and citizenship education in Singapore: Policy and practice. Journal of Moral Education, 49(4), 451–465. https://doi.org/10.1080/03057240.2020.1713688
Teske, K., Hallas, P., & Ellensen, V. S. (2024). Nurses’ experiences in mobile emergency care: A qualitative study. BMC Health Services Research. https://doi.org/10.1186/s12913-024-11517-8
Tofil, N. M., Lin, Y., Zhong, J., Peterson, D. T., White, M. L., Grant, V., & Cheng, A. (2017). Workload of team leaders and team members during a simulated sepsis scenario. Pediatric Critical Care Medicine. https://doi.org/10.1097/PCC.0000000000001258
Urden, L. D., Stacy, K. M., & Lough, M. E. (2019). Priorities in critical care nursing: Caring for critically ill patients (8th ed.). Elsevier Health Sciences.
Urden, L. D., Stacy, K. M., & Lough, M. E. (Eds.). (2021). Critical care nursing. Elsevier Health Sciences. https://www.asia.elsevierhealth.com/critical-care-nursing-e-book-9780323694001.html
Uwimana, A., Mukeshimana, M., & Mukagatare, A. (2021). Clinical learning in nursing: The use of Kolb’s Experiential Learning Theory by medical-surgical nursing students at CHUK. Rwanda Journal of Medical and Health Sciences. https://doi.org/10.4314/rjmhs.v4i3.13
Vasli, P., & Dehghan-Nayeri, N. (2016). Emergency nurses’ experience of crisis: A qualitative study. Japan Journal of Nursing Science. https://doi.org/10.1111/jjns.12086
Veenema, T. G., Griffin, A., Gable, A. R., et al. (2019). Nurses as leaders in disaster preparedness and response. Journal of Nursing Scholarship. https://doi.org/10.1111/jnu.12478
Walt, G., & Gilson, L. (1994). Reforming the health sector in developing countries: The central role of policy analysis. Health Policy and Planning, 9(4), 353–370. https://doi.org/10.1093/heapol/9.4.353
Watkins, D. A., Jamison, D. T., Mills, A., Atun, R., Danforth, K., Glassman, A., Horton, S., Jha, P., Kruk, M. E., Norheim, O. F., Qi, J., Soucat, A., Verguet, S., Wilson, D., & Alwan, A. (2017). Universal health coverage and essential packages of care. In D. T. Jamison et al. (Eds.), Disease control priorities: Improving health and reducing poverty. World Bank. https://doi.org/10.1596/978-1-4648-0527-1_ch3
Widiyawati, K., & Lestari, R. (2025). Emergency response in resource-constrained settings: A scoping review of prehospital trauma care in LMICs. The American Journal of Emergency Medicine. https://doi.org/10.1016/j.ajem.2025.08.005
Wood, C., Chaboyer, W., & Carr, P. (2019). How do nurses use early warning scoring systems to detect and act on patient deterioration to ensure patient safety? A scoping review. International Journal of Nursing Studies. https://doi.org/10.1016/j.ijnurstu.2019.03.012
Whyte, H. E., & Narvey, M. (2017). Team models in interfacility transport—Building and maintaining competencies. Current Treatment Options in Pediatrics. https://doi.org/10.1007/s40746-017-0107-7
World Health Organization. (n.d.). Emergency care. Retrieved March 6, 2025, from https://www.who.int/health-topics/emergency-care#tab=tab_1
Yumul, R. L., Navarro, K. A., & Santos, A. J. (2023). The state of emergency medicine research in the Philippines: A scoping review. Philippine Journal of Emergency Medicine.
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