Effect of a Structured Emergency Nursing Framework on Quality of Emergency Nursing Care: A Quasiexperimental Study

AIMS: The aim of this study is to examine the effect of the HIRAID emergency nursing framework (History including Infection risk, Red flags, Assessment, Interventions, Diagnostics, reassessment and communication) on quality of emergency care indicators (patient experience, quantity and quality of nursing documentation, time to first dose analgesia, emergency department length of stay and unplanned representations within 72 h of discharge) in a Thai emergency department. METHODS: HIRAID was implemented in Chiangrai Prachanukroh Hospital, Thailand, in July 2025. In this quasiexperimental study, patient experience was measured using surveys; nursing documentation was evaluated using modified D-Catch tool; and time to analgesia was determined by record audit. Emergency department length of stay and unplanned representations were measured using electronic attendance records. Data were collected 14 April 2025 to 13 July 2025 (pretest) and 13 October 2025 to 11 January 2026 (posttest). RESULTS: HIRAID improved patient experience of emergency care and emergency nursing documentation at Chiangrai Prachanukroh Hospital, Thailand. There were no clinically significant changes in time to analgesia, ED length of stay or unplanned ED reattendance. CONCLUSION: HIRAID implementation improved patient experience and quality and quantity of emergency nursing documentation at Chiangrai Prachanukroh Hospital, Thailand. The results of this study also demonstrate that implementing and evaluating the HIRAID emergency nursing framework in a resource-limited setting are possible.