Registered nurses’ perceptions of safe care in overcrowded emergency departments

Eriksson, Julia; Gellerstedt, Linda; Hillerås, Pernilla; Craftman, Åsa Gransjön

doi:10.1111/jocn.14143

Cited by 53 publications

(53 citation statements)

References 22 publications

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“…16 After the earthquakes, RSSAD conditions modified the baseline indicators and might have lead to some undesirable outcomes like an increase in waiting times, and a negative perception of safety and quality of attention in health care providers may be present. 17 Our results are in accordance with some previous studies that have reported significant enhancing in census activity of emergency departments of local general hospitals after a natural disaster had occurred. Aitken et al 18 found a significant increase in emergency consultations after Tropical Cyclone Yasi struck Australia on February 2011.…”

Section: Discussionsupporting

confidence: 93%

Reaction to Severe Stress and Adjustment Disorders After the September 2017 Earthquakes in a Psychiatric Emergency Department in Mexico City

Fresán

Robles-García

Becerra‐Palars

et al. 2019

Disaster med. public health prep.

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ObjectiveEarthquakes may lead to a reaction to severe stress and adjustment disorders (RSSAD). On September 7, 19, and 23, 2017, Mexico was struck by many severe earthquakes. The aim of this study was to examine whether there was an increase in the number of consultations and RSSAD in a psychiatric emergency department in Mexico City after these earthquakes.MethodsWe studied retrospectively the diagnosis and triage assessment from a Mexican psychiatric emergency department database from September 1 to November 30, 2017, and analyzed RSSAD and the number of consultations after the earthquakes.ResultsA total of 1,811 psychiatric emergency consultations were registered from the period of study. A total of 141 consultations represented RSSAD. There was a significant increase of RSSAD after the September 23, 2017, earthquake. The triage assessment revealed that the urgency of the consultations was higher immediately after the earthquakes.ConclusionNatural disasters, such as earthquakes, may trigger diverse RSSAD leading to increased emergency consultations, especially when those disasters are repetitive. Mental health professionals should be adequately trained and sensitized for possible acute disaster victims. (Disaster Med Public Health Preparedness. 2019;13:686–690).

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Section: Discussionsupporting

confidence: 93%

Reaction to Severe Stress and Adjustment Disorders After the September 2017 Earthquakes in a Psychiatric Emergency Department in Mexico City

Fresán

Robles-García

Becerra‐Palars

et al. 2019

Disaster med. public health prep.

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“…These situations creates moral distress, as staff willingness to create a good encounter often ends up with more discussions about the bed availability and the amount of time spent at the ED than on a patient–provider relationship level. It is well known that crowded EDs and high workflow make the environment stressful 12,21. As access to inpatient beds decreases, ED crowding increases 2,22, with even more pressure on the staff, who are given responsibility for patients for a longer time than the environment is built for.…”

Section: Discussionmentioning

confidence: 99%

“…High workloads and staff shortages have been identified as common stressors for staff working at ED. Stressful factors, together with extended lengths of stay for patients in overcrowded EDs are described as safety risks and are some of the most comprehensive challenges of modern emergency care (12). A consequence of high workload is staff feeling 'too busy to properly do their job' (13).…”

Section: Introductionmentioning

confidence: 99%

Staff strategies for dealing with care situations at an emergency department

Frank

Elmqvist

2019

Scandinavian Caring Sciences

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Staff strategies for dealing with care situations at an emergency department Introduction: Overcrowding is a common international problem at Emergency Departments often due to those patients get recommendations or referrals from other health professionals to seek care at the emergency department. Crowding brings with it an amount of adverse consequences for both patients and staff, and knowledge about staff's strategies of dealing with this caring situation is limited. Aim: The aim of the present study was thus to describe staffs' strategies to deal with the caring situations at an emergency department. Method: Secondary analysis has been made of 18 qualitative interviews grounded in a lifeworld perspective. The interviews were analysed by qualitative content analysis. Findings: The results showed that the staff at the ED worked in twofold directions using both proactive and reactive strategies in order to deal with the care situation when caring for patients at ED. The proactive strategy is optimising conditions, controlling patient flow and being boundary. The reactive strategy is about customising the conversation and holding an open approach. Conclusion: In conclusion, the proactive strategy is to make what you decided for unseen circumstances. The reactive strategy is then about less anticipation of the encounter, waiting for the patient to act and react to it. Implication: The result can have implications with respect to developing and improving care at crowded Emergency departments. Knowledge about strategies creates a fundament for developing visible sustainable structure for patient flow in making work patient safety for patients, staff and organisation.

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“…Furthermore, it is difficult to continually practice and reinforce certain skills, because emergency care staff encounter a wide variety of patient presentations in their daily work (Garside et al, ). Emergency departments require faster and more accurate decision‐making than other hospital departments, due to their complex and dynamic environments and uncontrollable and unpredictable workloads (Eriksson, Gellerstedt, Hillerås, & Craftman, ). Specific programs are needed to train nurses to accurately and promptly assess patients' neurological status in the emergency department.…”

Section: Discussionmentioning

confidence: 99%

“…Emergency departments require faster and more accurate decisionmaking than other hospital departments, due to their complex and dynamic environments and uncontrollable and unpredictable workloads (Eriksson, Gellerstedt, Hillerås, & Craftman, 2018). Specific programs are needed to train nurses to accurately and promptly assess patients' neurological status in the emergency department.…”

Section: Discussionmentioning

confidence: 99%

Training needs analysis of Korean nurses' neurological assessment competency

Bae

Roh

2019

Nursing & Health Sciences

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Despite the importance of neurological assessment, there is a lack of research directed at nurses' competency in performing these assessments. We aimed to identify nurses' competency levels in performing neurological assessments and prioritize their related training needs using importance–performance analysis. This survey research was conducted and reported based on the enhancing the quality and transparency of health research (EQUATOR) guidelines. A total of 213 nurses participated in a descriptive, cross‐sectional survey study. Exploratory factor analysis identified seven factors that together accounted for 70.34% of the variance: cerebral function, signs and symptoms, pathologic reflexes, motor strength, assessment of an unconscious patient, reporting and documentation, and neurological assessment scales. [Correction added on 10 February 2020, after first online publication: the value of the variance has been corrected from ‘7.34%’ to ‘70.34%’ in the preceding sentence.] There were significant gaps between importance and performance for all seven factors. The importance–performance matrix identified the neurological assessment scales factor as a high priority for continuing education. Emergency department nurses reported lower neurological assessment competency when compared with ward and intensive care unit nurses. The analysis of training needs is beneficial for developing programs to enhance neurological assessment competency. Training in neurological assessment scales is a priority for nurses, and they prefer simulation‐ and practicum‐based methods.

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Registered nurses’ perceptions of safe care in overcrowded emergency departments

Cited by 53 publications

References 22 publications

Reaction to Severe Stress and Adjustment Disorders After the September 2017 Earthquakes in a Psychiatric Emergency Department in Mexico City

Reaction to Severe Stress and Adjustment Disorders After the September 2017 Earthquakes in a Psychiatric Emergency Department in Mexico City

Staff strategies for dealing with care situations at an emergency department

Training needs analysis of Korean nurses' neurological assessment competency

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