Aims The aim of this research study was to compare electrocardiogram (ECG) interpretation competency among emergency nurses and EMS personnel. Design A cross‐sectional comparative descriptive study design was used. Methods This study recruited 170 participants (105 emergency nurses and 65 EMS personnel) in northwest of Iran. Data were collected during 2018 using ECG, an interpretation competency questionnaire and analysed using SPSS V.24 through independent t test, linear regression, Pearson and Spearman correlation coefficient. A statistical significance of p < .05 was assumed. Results The study results showed a mean score of 6.65 ± 2.16 out of 10 for emergency nurses' and 4.87 ± 1.81 for EMS personnel ECG interpretation competency (p < .05). Conclusions Hospital emergency nurses were more qualified to interpret the ECG than the pre‐hospital emergency medical personnel (p = .792 and β (SE)) = 0.22 (0.84). Active involvement in ECG interpretation and standard continued education are needed to develop and improve the emergency nurses and EMS personnel ECG interpretation competency.

The public image (PI) of nursing, which incorporates beliefs, ideas and impressions that people have of nurses and nursing, has always been a socio-cultural issue for this profession (Emeghebo, 2012, Wallace, 2007. Recently, the environment in which nurses do practice has changed and this change foreshadows significant evolutions in the nursing profession (Maxwell, 2015). There is ample evidence that the PI of nursing has improved globally, especially in developed countries, which holds high value and reputation for the nursing profession. However, there still remains some negative view with regard to the PI of nurses (Meadus & Twomey, 2007;ten-Hoeve et al., 2014). For example, in a recent integrative review, Glerean et al., (2017) found that young people's perceptions of the nursing profession were outdated, partly unrealistic and did not reflect the tasks of a modern nurse. According to the results of this review, these perceptions were largely influenced by social factors such as family and relatives, friends, media and significant

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Globally, the nursing profession is experiencing a shortage; this is particularly evident in highly specialized hospital units, such as emergency departments (Gorman, 2019; Schriver, Talmadge, Chuong, & Hedges, 2003). Consequently, newly graduated nurses are employed to work in emergency departments (Salonen, Kaunonen, Meretoja, & Tarkka, 2007). In such wards, that dealing with patients facing imminent life-threatening situations is a common feature, the clinical competence of care providers is a concern. The competency of nursing staff in providing emergency care is a critical factor in patient safety. Further, the quality of services provided in the ED is considered a hospital performance indicator (Tourani et al., 2019). Therefore, nurses and other multidisciplinary team members must be competent and work collaboratively to improve patient and healthcare outcomes (Holanda, Marra, & Cunha, 2019). Considering the complexity and dynamic nature of the ED, ensuring the clinical competency of nursing staff, in particular new nurses, is prominent. Nursing competency has been defined by the International Council of Nurses (1997, p. 44) as: "a level of performance demonstrating

Background: Older people are vulnerable groups whose physical activity (PA) guarantees their health. Considering the low level of PA and the role of various factors, this study was designed to investigate the level of PA and its determinants using the socio-ecological approach.Material and methods: In 2016, a random sample of 340 older people in urban areas of the Maku county, West Azerbaijan province, Iran, were recruited to complete PASE (Physical Activity Scale for the Elderly) and a socioecological approach-based questionnaire. Structural equation modeling (SEM) was conducted by Stata. Results:The mean PA in our study was very low (94.02 ±3.41), and 50% of the participants had insufficient PA. The socio-ecological approach suggested that family support of the social level strongly affects PA (β = 2.79). Moreover, the psychological level had direct effects on PA (β = 2.79). The environmental level had effects on PA in a reverse direct as well as an indirect way (β = -2.09). Conclusions:The socio-ecological approach was found to be helpful in categorizing the determinant factors of PA among Iranian older people. Future research should focus on designing social support and self-efficacy interventional programs with a multilevel approach aiming at PA promotion among elder.