Patient experience in the emergency department: inconsistencies in the ethic and duty of care

Moss, Cheryle; Nelson, Kathy; Connor, Margaret; Wensley, Cynthia; McKinlay, Eileen; Boulton, Amohia

doi:10.1111/jocn.12612

Cited by 14 publications

(28 citation statements)

References 28 publications

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“…Bernard requested assistance as he could not get to the toilet himself and was told to soil himself where he was. 33 For others, healthcare workers' prejudices contributed to their negative experiences:…”

Section: Open Accessmentioning

confidence: 99%

Experience of being a frequent user of primary care and emergency department services: a qualitative systematic review and thematic synthesis

et al. 2020

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BackgroundFrequent users of healthcare services are often categorised as ‘heavy-cost patients’. In the recent years, many jurisdictions have attempted to implement different public policies to optimise the use of health services by frequent users. However, throughout this process, little attention has been paid to their experience as patients.ObjectiveTo thematically synthesise qualitative studies that explore the experience of frequent users of primary care and emergency department services.DesignQualitative systematic review and thematic synthesis.SettingPrimary care and emergency department.ParticipantsFrequent users of primary care and emergency department services.MethodsA qualitative systematic review was conducted using three online databases (MEDLINE with full text, CINAHL with full text and PsycINFO). This search was combined to an extensive manual search of reference lists and related citations. A thematic synthesis was performed to develop descriptive themes and analytical constructs.Study selectionTwelve studies were included. All included studies met the following inclusion criteria: qualitative design; published in English; discussed frequent users’ experiences from their own perspectives and users’ experiences occurred in primary care and/or emergency departments.ResultsThe predominant aspects of frequent users’ experiences were: (1) the experience of being ill and (2) the healthcare experience. The experience of being ill encompassed four central themes: physical limitations, mental suffering, impact on relationships and the role of self-management. The healthcare experience embraced the experience of accessing healthcare and the global experience of receiving care.ConclusionThis synthesis sheds light on potential changes to healthcare delivery in order to improve frequent users’ experiences: individualised care plans or case management interventions to support self-management of symptoms and reduce psychological distress; and giving greater importance on the patient–providers relationship as a central facet of healthcare delivery. This synthesis also highlights future research directions that would benefit frequent users.

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Section: Open Accessmentioning

confidence: 99%

Experience of being a frequent user of primary care and emergency department services: a qualitative systematic review and thematic synthesis

et al. 2020

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“…Limitations for generalizability include the following: 1. This was a retrospective study using a dataset collected for administrative claims purposes according to the conceptualization of appropriate ED visits, which may be de ned at the patient level, disease level, hospital level, and social context level [46,[86][87][88][89][90][91]. In this study, we did not have enough information to address these holistic concerns.…”

Section: Strengths and Limitationsmentioning

confidence: 99%

Effectiveness of Hospital Emergency Department Regionalization and Categorization Policy on Appropriate Patient Emergency Care Use - A nationwide long-term observational study in Taiwan

Lin

Lee²

2020

Preprint

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Background: The goal of this study was to examine the effect of hospital emergency department (ED) regionalization policy and the categorization of hospital emergency care policy (categorization policy) on patient appropriate ED use.Methods: We conducted an observational study of the effect of emergency care policy intervention on patients' visits. Seven years of data from the Taiwan National Health Insurance Research Database (NHIRD) were examined. Taiwan implemented a nationwide three-tiered hospital ED regionalization and categorization policies in 2007 and 2009, respectively. There were 1,835,860 ED visits found among one million random samples from the NHIRD between 2005 and 2011. ED visits were categorized by the modified New York University ED algorithm. A time series analysis was performed to examine the change in the rate of appropriate ED use after the policy took effect.Results: Total ED visits increased by 10.7% from 2005 to 2011. Average appropriate ED visit rate was 66.9% during the policy intervention. The trend in the appropriate ED visit rate showed no significant policy effect.Conclusions: Provider side of regionalization and categorization policies did increase emergency care accessibility. However, regionalization and categorization policies no significant effect on patient appropriate ED use.

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“…(23) Acil servise birçok kronik hastalık nedeniyle başvuran hastalar kendi düşüncelerine göre acildirler ve burada sağlık personelinin de aynı şekilde hassas bir tutum sergileyeceği ilgili profesyoneller tarafından ayrıntılı bakım alacağı beklentisindedirler. (42) Çoğu zaman gergin, agresif olabilmekte ve kendilerine öncelik tanınması konusunda triyaj yapan kişiye baskı yapmaktadırlar. Yapılan bir çalışmada, böyle durumlarda hemşirelerin etik karar vermede güvenlik sorunları yaşadığı bildirilmiştir.…”

Section: Triyaj Ve Etikunclassified

Nursing Ethics at Emergency Department

Bayraktar¹,

Sivrikaya²

2018

HEAD

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Patient experience in the emergency department: inconsistencies in the ethic and duty of care

Abstract: Findings carry implications for emergency department care of people who present on multiple occasions and for emergency department health professionals to increase awareness of their moral comportment in care.

Cited by 14 publications

References 28 publications

Experience of being a frequent user of primary care and emergency department services: a qualitative systematic review and thematic synthesis

Experience of being a frequent user of primary care and emergency department services: a qualitative systematic review and thematic synthesis

Effectiveness of Hospital Emergency Department Regionalization and Categorization Policy on Appropriate Patient Emergency Care Use - A nationwide long-term observational study in Taiwan

Nursing Ethics at Emergency Department

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