{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,28]],"date-time":"2026-07-28T11:59:03Z","timestamp":1785239943094,"version":"3.55.0"},"reference-count":23,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2026,7,15]],"date-time":"2026-07-15T00:00:00Z","timestamp":1784073600000},"content-version":"vor","delay-in-days":14,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2026,7,1]],"date-time":"2026-07-01T00:00:00Z","timestamp":1782864000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Nursing Open"],"published-print":{"date-parts":[[2026,7]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Aim<\/jats:title>\n                    <jats:p>To explore emergency staff perspectives on the Hospital Safety Index (HSI), focusing on its utility, implementation challenges and implications for hospital preparedness in Thailand.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>Qualitative descriptive study.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>In\u2010depth interviews were conducted with 19 emergency physicians, nurses and administrative personnel from tertiary, general and community hospitals across Thailand. Data were analysed thematically using an inductive approach.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Participants valued the HSI for promoting interdisciplinary collaboration and raising disaster risk awareness. However, significant barriers were identified, including technical complexity and ambiguous scoring criteria, which created equity gaps and disproportionately affected resource\u2010limited community hospitals. These challenges undermined trust in the HSI's reliability and raised concerns regarding its epistemic validity and comparability across hospital settings.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>The HSI is a valuable framework for hospital disaster preparedness. Clearer guidance, structured assessor training and context\u2010sensitive implementation may strengthen confidence in preparedness assessment and improve health system resilience.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Implications for Nursing Practice<\/jats:title>\n                    <jats:p>Nurses should strengthen HSI implementation through multidisciplinary assessment, preparedness planning, training and advocacy for resource\u2010limited hospitals.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>No Patient or Public Contribution<\/jats:title>\n                    <jats:p>This study did not involve patients or the general public.<\/jats:p>\n                  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