BackgroundThe number of EDs visit is on the increase, and the pressure on EDs is of significant concern worldwide. The usage of EDs by parents of children with minor illness is an important and still unresolved problem causing a burden to healthcare services. The aim of this study was to review the literature to summarise parental reasons for visiting ED for children with minor illness.MethodSeven electronic databases (Medline, Embase, PsycINFO, CINAHL, PubMed, Web of Science and Scopus) were comprehensively searched during a 2-week period in August 2016 and updated between 11 and 20 June 2018. The study selection process was undertaken independently by two authors. Qualitative and quantitative studies that focused on the reasons for parents of children with minor illness to attend an ED were included. Studies were assessed for quality and data were analysed by means of narrative synthesis.ResultsTwenty-four studies were included. Eleven studies employed quantitative methods, eleven studies used qualitative methods and two studies used mixed methods. Parental reasons for using ED included perceived urgency, ED advantages (eg, faster service, superior ED resources and efficiency), difficulties with getting a general practitioner appointment, lack of facilities in primary healthcare services, lack of health insurance, reassurance, convenience and access.ConclusionThis review identified some of the reasons why parents bring their children to the ED for minor illnesses highlighting the multifaceted nature of this problem. Understanding parental reasons behind their choice to use the ED may help us better design targeted interventions to reduce unnecessary ED visits and alleviate the burden on overstretched healthcare services. This review may help inform emergency care policy makers, researchers and healthcare staff to understand parents’ reasons for visiting the ED, to better meet their healthcare needs.

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Background: Overcrowding in Emergency Departments (EDs) is a significant global concern with negative consequences for patients, healthcare staff, and healthcare systems. The use of EDs by parents of children with non-urgent conditions is associated with overcrowding, higher healthcare costs, lower quality of care, and longer waiting times. Research in this area has largely been conducted in high-income countries, with a dearth of work originating in middle and low-income regions. The aim of this study was to explore the reasons for parents attending EDs with their child for non-urgent conditions in Turkey.Method: Semi-structured interviews were conducted with 13 parents, 15 ED staff, and 10 General Practitioners (GPs) in 2 regions of Turkey between March and May 2017. Data were analyzed using the principles of grounded theory.Results: The findings were classified into 5 core categories: (1) parents' feelings, knowledge, and perceived inability to provide self-care; (2) perceived limitations of healthcare services, system, and staff; (3) parents' preferences for hospital and ED services; (4) adverse impact on ED services; and (5) perceived needs for care.Conclusion: This is the first study conducted in a middle-income country regarding parental reasons for using the ED for nonurgent conditions. Greater efforts must be made to reduce unnecessary visits to the ED to better meet service user needs and to increase the satisfaction of both parents and healthcare staff. The findings of this study may inform healthcare providers, policymakers, healthcare staff, and researchers to design interventions in order to mitigate overcrowding in the ED.

Background: Emergency department (ED) overcrowding is among the biggest and most important problems experienced by ED staff. The number of ED visits is on the increase and remains an unresolved problem. Emergency department overcrowding has become an important problem for emergency care services worldwide. There is a relationship between overcrowding and patients' negative experiences of using ED and therefore reporting reduced patients' satisfaction. This study aimed to identify the causes of ED overcrowding, determine the reasons for people's use of EDs, and develop solutions for reducing ED overcrowding.Methods: This study used quantitative methods using a descriptive approach. The participants were patients who visited the ED. A questionnaire was administered to 296 participants between December 2021 and February 2022. The study included 5 different hospitals in Turkey. The data were analyzed using descriptive statistics.Results: This study identified the most common presenting medical problems in the ED and why patients used the ED. Reasons for using the ED included patients perceiving their condition as really urgent (62.8%), the ED being open for 24 hours (36.1%), and receiving faster care in the ED (31.4%). This study also developed recommendations for alleviating ED overcrowding. Conclusion:This study identified causes of ED overcrowding and some solutions for alleviating the issue. Emergency department overcrowding should be perceived as an international problem, and initiatives for solutions should be implemented quickly.

ABS TRACT During the coronavirus disease-2019 (COVID-19) pandemic, clinical training, which is essential to nursing practice, has been largely delayed. The aim of this study is to identify the predictors of nursing students' experienced ethical problems in clinical practicum and self-regulated learning levels during the COVID-19 pandemic. The sample of this cross-sectional study consisted of 306 nursing students studying in the third and fourth grades of 2 universities located in the east of Türkiye. The data were collected by using a Student Introduction Form, the Scale of Ethical Problems in Clinical Teaching in Nursing, and the Self-Regulated Learning Scale for Clinical Nursing Practices form. The independent sample t-test, one-way ANOVA F test, Pearson correlation test, and multiple regression were used in the analysis of the data. It was determined that there was a positive and moderately significant relationship between the total mean score of the Scale of Ethical Problems in Clinical Teaching in Nursing and the Self-Regulated Learning Scale for Clinical Nursing Practices, total mean score (r=509, p<0.001). A regression model indicated that 4 predictors (clinical educator, health professionals, learning strategies, and self-regulated learning levels) explained 28% of the variance (R=0.516, Adjusted R2=0.284, F=13.255, p<0.001) in their ability to identify ethical problems in clinical practicum. In this study, it was determined that health professionals and self-regulated learning levels positively affected students' ability to identify ethical problems in the clinical practice setting. The level of clinical educator was found to negatively affected students' ability to identify ethical problems in the clinical practice setting.