- Five intervention categories identified, with organisational support and system level reforms most frequently reported for enhancing resilience among ED nurses and AHPs.
- Controlled studies consistently reported positive effects on resilience and stress, including RCTs and a meta-analysis showing moderate pooled effects.
- Significant gaps: limited leadership-focused strategies and scarce AHP-specific research; future studies need longitudinal designs, standardised outcomes, and cultural adaptation.
J Multidiscip Healthc. 2026 Jul 17;19:609206. doi: 10.2147/JMDH.S609206. eCollection 2026.
ABSTRACT
BACKGROUND: Emergency department (ED) nurses and allied health professionals (AHPs) face persistent occupational stressors that threaten workforce sustainability. Burnout prevalence exceeds 50% among ED nurses, and post-traumatic stress disorder (PTSD) prevalence among paramedics ranges from 11% to 37%. Despite growing research interest, the team-based and organisational resilience-enhancement strategies targeting both ED nurses and AHPs have not been comprehensively reviewed.
OBJECTIVE: This narrative review synthesises current evidence on team-based and organisational resilience-enhancement strategies targeting ED nurses and AHPs in emergency and acute care settings globally.
METHODS: A systematic search informed by JBI scoping methodology and reported in line with PRISMA 2020 was conducted across three databases (Scopus, PubMed, Web of Science) for studies published between January 2016 and March 2026. Search terms combined three concept blocks-emergency care personnel (eg, “emergency nurs*”, “paramedic*”, “allied health professional*”), resilience constructs (eg, “resilien*”, “coping”, “hardiness”, “post-traumatic growth”), and emergency/acute care context (eg, “emergency department*”, “prehospital”, “ambulance service*”)-using Boolean operators. The Population-Concept-Context (PCC) framework guided eligibility. Studies scoring ≥70% on JBI critical appraisal checklists were included; a sensitivity analysis examined the effect of relaxing this threshold to ≥50%. Data were charted using a standardised JBI extraction form and synthesised narratively.
RESULTS: From 766 identified records, 160 duplicates were removed, 606 titles/abstracts were screened, and 196 full texts were assessed. Forty-nine empirical studies met the inclusion criteria; one record initially retrieved was a registered trial protocol with no outcome data and was excluded from synthesis. Of the 49 studies, 32 (65.3%) focused on ED nurses, 12 (24.5%) on AHPs/paramedics, and 5 (10.2%) on mixed teams. Five intervention categories were identified: organisational support (n=17, 34.7%), system-level reforms (n=12, 24.5%), structured training programmes (n=11, 22.4%), peer/team-based support (n=7, 14.3%), and leadership development (n=2, 4.1%). Controlled intervention studies reported positive effects: a three-arm randomised controlled trial (RCT) demonstrated significant improvement in psychological resilience (p<0.05), and a violence-coping programme produced a large effect on resilience (F=59.41, p<0.001). The Cochrane meta-analysis included reported a moderate pooled effect on resilience (standardised mean difference [SMD]=0.45) and stress (SMD=-0.61). Cross-sectional studies reported moderate-to-strong associations between perceived organisational support and resilience (eg, r=0.549).
CONCLUSION: This narrative review identified five intervention categories addressing resilience in emergency care teams, with organisational support and system-level reforms most frequently reported. Controlled studies, although few, consistently reported positive effects. Critical gaps exist in leadership-focused strategies (4.1%) and AHP-specific research (24.5%). Future studies should prioritise longitudinal designs, standardised resilience outcome measures, and culturally adapted interventions.
PMID:42488140 | PMC:PMC13388374 | DOI:10.2147/JMDH.S609206
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