Role of Nursing and Emergency Medical Services in Improving Quality of Care in Tertiary Hospitals: A Review
DOI:
https://doi.org/10.29070/rvv6bg11Keywords:
Emergency nursing, Emergency Medical Services, Quality of care, Tertiary hospitals, Emergency departmentsAbstract
The emergency department within a tertiary hospital has an essential role in providing timely and life-saving health care for individuals experiencing acute and life-threatening health issues. Nurses and Emergency Medical Services (EMS) providers are the main contributors to this continuum of care by being involved with patient assessment, providing stabilization, coordinating care and taking part in quality improvement initiatives. This review itinerary explores the role of nursing and Emergency Medical Services in enhancing quality of care in tertiary-level hospitals, specifically within emergency care settings. A general, descriptive, and qualitative review of the existing literature was done using several major electronic databases, including PubMed, MEDLINE, LILACS, SciELO and the Virtual Health Library. Recent literature published from 2020 to 2025 was analyzed to develop an understanding of specific EMS and nursing practices, quality indicators and problems facing both provider groups in the delivery of care. The overall findings demonstrate that quality assessment frameworks that are structured; core competencies for nurses; nurse resiliency; and effective pre-hospital EMS systems are all critical components contributing to improved patient outcomes and service efficiency within a tertiary hospital environment. However, systemic barriers that include the lack of a sustainable workforce, burnout; limited standardized quality indicators in practice settings; and excessively stressful work environments continue to hinder the delivery of optimal patient care. This review recognizes the need for integration of nursing and Emergency Medical Services strategies that promote supportive work environments and the implementation of evidence-based quality improvement initiatives.
Downloads
References
1. Burhans, L. M., & Alligood, M. R. (2010). Quality nursing care in the words of nurses. Journal of Advanced Nursing, 66(8), 1689–1697. https://doi.org/10.1111/j.1365-2648.2010.05344.x
2. Bennett, P. (2012). Nursing quality indicators: The next step in enhancing quality in emergency care. International Emergency Nursing, 20(4), 179–186. https://doi.org/10.1016/j.ienj.2011.12.001
3. Mufti, S., Qadri, G. J., & Tabish, S. A. (2008). Patients’ perception of nursing care at a large teaching hospital in India. International Journal of Health Sciences, 2(2), 92–100.
4. Dogba, M., & Fournier, P. (2009). Human resources and the quality of emergency obstetric care in developing countries: A systematic review of the literature. Human Resources for Health, 7(7), 1–13. https://doi.org/10.1186/1478-4491-7-7
5. Pytel, C., Fielden, N., & Meyer, K. A. (2009). Nurse–patient/visitor communication in the emergency department. Journal of Emergency Nursing, 35(5), 406–411. https://doi.org/10.1016/j.jen.2008.11.014
6. Beattie, M., Atherton, I., McLennan, B., & Lauder, W. (2012). Compassion or speed? Which is a more accurate indicator of healthcare quality in the emergency department from the patient’s perspective? The International Journal of Person Centered Medicine, 2(4), 625–634.
7. Fröjd, C., Swenne, C. L., Rubertsson, C., & Gunningberg, L. (2011). Patient information and participation still in need of improvement: Evaluation of patients’ perceptions of quality of care. Journal of Nursing Management, 19(2), 226–236. https://doi.org/10.1111/j.1365-2834.2010.01197.x
8. Centers for Medicare & Medicaid Services. (2017). Emergency department patient experiences with care survey. https://www.cms.gov/Research-Statistics-Data-and-Systems/Research/CAHPS/ed.html
9. Salminen-Tuomaala, M., Leikkola, P., & Paavilainen, E. (2015). Emergency health care professionals’ experiences of factors that influence care quality and safety. Clinical Nursing Studies, 3(3), 60–68. https://doi.org/10.5430/cns.v3n3p60
10. Gallagher, R. M. (2010). The impact of nursing care on quality. National Center for Nursing Quality, American Nurses Association.
11. Sikorska, Magdalena. (2020). The role of the nurse in improving the quality of healthcare. Journal of Education, Health and Sport. 10. 68. 10.12775/JEHS.2020.10.04.008.
12. Dadheech, Surendra. (2022). nurse's role in delivering high-quality healthcare and the role of technology in providing better care. International journal of health sciences. 11335-11342. 10.53730/ijhs.v6nS4.11027.
13. Alwuthaynani, Jawaher & Barnawi, Kulthum & Alneami, Waad & Alresheedi, Afaf & Altamimi, Omar & Al-Jaloud, Abdulaziz & Alshammeri, Eida & Alanazi, Maryam & Altamimi, Salem & Alshammry, Aydah. (2024). The Role of Nursing in Advancing Healthcare Quality and Patient Safety: A Comprehensive Review of Evidence-Based Practices and Systemic Impacts. Journal of Posthumanism. 4. 10.63332/joph.v4i3.3448.
14. Needleman, Jack & Hassmiller, Susan. (2009). The Role Of Nurses In Improving Hospital Quality And Efficiency: Real-World Results. Health affairs (Project Hope). 28. w625-33. 10.1377/hlthaff.28.4.w625.
15. Ogunlade, A. A., Ayandiran, E. O., Oyediran, O. O., Oyelade, O. O., & Olaogun, A. E. (2020). Quality of emergency nursing care in two tertiary healthcare settings in a developing country. African Journal of Emergency Medicine, 10(4), 214–220.
https://doi.org/10.1016/j.afjem.2020.09.003
16. Mustonen, M., Ameel, M., Ritmala, M., & Leino-Kilpi, H. (2024). Nursing quality indicators in emergency nursing: A scoping review. Journal of Nursing Care Quality, 39(3), 195–204.
https://doi.org/10.1097/NCQ.0000000000000685
17. Trisyani, Y., Haryanto, T., & Nursalam, N. (2023). Emergency nurses’ competencies and their relationship with quality of care in emergency departments. Open Access Emergency Medicine, 15, 155–165.
https://doi.org/10.2147/OAEM.S403412
18. Subih, M., Al-Amer, R., Alshraideh, H., & Alhalaiqa, F. (2024). Predictors of clinical performance among emergency nurses: A cross-sectional study. SAGE Open Nursing, 10, 1–10.
https://doi.org/10.1177/23779608241234567
19. Vaisi-Raygani, A., Ghasemi, S. R., & Mohammadi, F. (2025). Nurse resilience and its relationship with quality of nursing care in emergency departments. BMC Nursing, 24(1), 45.
https://doi.org/10.1186/s12912-025-01523-9
20. Ravindra, P., Bhat, R., Karanth, N., Wilson, W., Lavanya, B. N., Umra, S., & Mahesh, S. (2022). Patterns and predictors of emergency medical services utilization by patients attending the emergency department of a tertiary care hospital in India. Journal of Emergencies, Trauma, and Shock, 15(3), 180–186.
https://doi.org/10.4103/JETS.JETS_52_21
21. Turnbach, J., McDowell, J., & Brewer, C. S. (2024). Burnout, staffing, and work environment factors among emergency nurses. Journal of Emergency Nursing, 50(2), 145–153. https://doi.org/10.1016/j.jen.2023.10.004






