Nurse-initiated care in the emergency department: A scientometric review of the research

BACKGROUND: To address increasing wait times and length of stay, many emergency departments (EDs) have implemented protocols focused on nurse-initiated care, enabling nurses to commence treatments, investigations or medications under standing orders or protocols. This study provides scientometric analysis and data visualisation of nurse-initiated care research. METHODS: A systematic search of the Web of Sciences Core Collection was conducted from inception to November 2025. Bibliometric and scientometric techniques examined publication trends, journals, authorship, co-citation patterns and keyword co-occurrence. Clinical coding was applied to classify problems, interventions and populations. RESULTS: A total 126 papers were identified, published between 1971 and 2025 across 64 journals and 23 countries. Publication activity was limited until 2000, until an increase and more marked growth from 2012. Nurse-initiated analgesia and x-rays were most frequently studied. Other studies examined nurse-initiated care for time-sensitive conditions such as pain, musculoskeletal injuries and trauma. Most protocols were for adult populations, though paediatric and older adult cohorts also featured. Keywords consistently included triage, analgesia and emergency care. CONCLUSIONS: Nurse-initiated care in EDs is a growing field, with increasing evidence supporting its relevance to time-critical presentations.