Aims and objectives To understand how parents experienced miscarriage in an emergency department setting. Objectives were to identify parents’ needs, isolate factors that influenced their experience, and provide recommendations to improve care from the perspective of women, their partners, nurses and nurse managers. Background Miscarriage is the most prevalent complication encountered during pregnancy. It subjects parents to a multitude of emotions and may have significant consequences on mental health. Emergency department visits are frequently the only opportunity for parents to receive formal support during a miscarriage; it is thus crucial to understand the experiences of parents in this setting. Design The study employed a descriptive, exploratory, qualitative approach with semi‐structured interviews. Methods The study was founded on the W.K. Kellogg Foundation's Logic Model Development Guide (2004) and Meleis’ Transitions Theory (2015). A total of 26 participants were interviewed (17 parents, 7 emergency department nurses and 2 emergency department nurse managers). Consolidated criteria for reporting qualitative research was used to report results. Results Three categories of needs were identified: physical health, cognitive and emotional. For instance, parents expressed a need to receive more information during their visit to the emergency department (i.e., a cognitive need), whether about the diagnostic test results or how to ensure a better recovery. Parents also reported a desire for professionals to address their emotional concerns. Nurses were aware of the emotional impact of miscarriage but felt that they were not adequately trained in providing optimal care to parents in this situation. Conclusions Parents who visited the emergency department for miscarriage reported several unfulfilled needs that generated dissatisfaction with care. Emergency department organisational constraints hindered optimal nursing care practices. Relevance to clinical practice Nurses have an important role to play in improving parents’ experience. They can do so by understanding the needs of parents and by being involved in developing new guidelines.

Cost-effective methods have been developed to help busy emergency department (ED) staff cope with the growing number of older patients, including quick screening and assessment tools to identify those at high risk and note their specific needs. This survey, from a sample of key informants from all EDs (n=111) in the province of Quebec (participation rate of 88.2%), investigated the implementation of these tools and barriers to implementation. Questionnaires (administered either by telephone or by self-completion) included characteristics of the ED, characteristics of the respondent, use of tools, and method of implementation. Barriers to the implementation of these tools included lack of resources for screening and follow-up, misunderstandings of the difference between screening and assessment tools, and need for adaptation of the tools to the local context. Education of staff and pre-implementation adaptation and testing are needed for successful implementation.

In many countries, parents experiencing miscarriage seek treatment in the emergency department (ED). Parents frequently report dissatisfaction with ED care, while nurses report not knowing how to provide optimal care. This article describes the development of a situationspecific theory, Compassionate care for parents experiencing miscarriage in the ED, based on 4 concepts (change trigger, transition properties, conditions of change, and interventions). This theory evolved from a comprehensive review of the literature, 2 empirical studies, Transitions Theory, and collaborative efforts of an experienced team. The detailed theory development process facilitates its integration in practice and supports new theory development.