Nurses' perception about the quality of care provided to patients in a situation of hospitalization in the emergency rooms
DOI:
https://doi.org/10.33448/rsd-v11i5.28461Keywords:
Perception; Nursing; Nursing Care; Emergency Medical Services; Quality of Health Care; Outcome Assessment Health Care; Teaching.Abstract
Aim: To analyze the nurses’ perception about the quality of nursing care provided to patients in a situation of hospitalization in the Emergency Room. Method: This is a descriptive and cross-sectional study carried out with the application of a structured questionnaire, via online, with Brazilian nurses who have been working in urgent and emergency services, public or private, for at least six months. The questionnaire, developed by the researchers, contains 13 questions aimed at evaluating the Urgency and Emergency Service and evaluating the nursing care offered to patients in a situation of hospitalization in the Emergency Room. Responses were rated on a seven-point Likert scale: Never, Very Rarely, Rarely, Occasionally, Often, Very Often, Always. Results: 146 nurses participated in the survey. Most evaluated overcrowding as a frequent experience, reported delays and/or difficulties in adjusting patients to a regular hospital bed, showed flaws in the nursing dimensioning for the surplus of patients and that at times of high volume of admissions, the nursing care is compromised. Conclusion: In the nurses' perception, the quality of nursing care provided to patients admitted to the emergency room is impaired when compared to care received in a regular hospital bed.
References
Ackroyd-Stolarz, S., Guernsey, J. R., MacKinnon, N. J., & Kovacs, G. (2011). The association between a prolonged stay in the emergency department and adverse events in older patients admitted to hospital: a retrospective cohort study. BMJ Quality & Safety, 20, 564–569. doi: https://doi.org/10.1136/bmjqs.2009.034926
Afaya, A., Bam, V., Azongo, T.B., Afaya, R.A., Yakong, V.N., Kpodo, G.K., Kaba, R.A., Zinle, D.A.N., Tayuu, D.K., Asantewaa, S. & Adatara, P. (2021). "We are left with nothing to work with"; challenges of nurses working in the emergency unit at a secondary referral hospital: A descriptive qualitative study. PLoS One.16(2) doi: 10.1371/journal.pone.0247062
American College of Emergency Physicians – ACEP (2013). Policy statements. Ann Emerg Med, 61:6. doi: https://doi.org/10.1016/j.annemergmed.2013.02.012
Ausserhofer, D., Schubert, M., Desmedt, M., Blegen, M.A., De Geest, S. & Schwendimann, R. (2013). The association of patient safety climate and nurse-related organizational factors with selected patient outcomes: a cross-sectional survey. Int J Nurs Stud, 50(2):240-52. http://www.journalofnursingstudies.com/article/S0020-7489(12)00145-9/fulltext
Ball, J.E., Bruyneel, L., Aiken, L.H., Sermeus, W., Sloane, D.M., Rafferty, A.M., Lindqvist, R., Tishelman, C. & Griffiths, P. (2018). RN4Cast Consortium. Post-operative mortality missed care and nurse staffing in nine countries: A cross-sectional study. Int J Nurs Stud. Feb;78:10-15. doi: 10.1016/j.ijnurstu.2017.08.004
Ball, J.E., Murrells, T., Rafferty, A.M., Morrow, E. & Griffiths, P. (2014). 'Care left undone' during nursing shifts: associations with workload and perceived quality of care. BMJ Qual Saf, 23(2):116-125. doi:10.1136/bmjqs-2012-001767
Bittencourt, R. J., Stevanato, A. M., Bragança, C. T. N. M., Gottems, L. B. D. & O’Dwyer, G. (2020) Interventions in overcrowding of emergency departments: an overview of systematic reviews. Rev. saúde pública, 540:66. doi: https://doi.org/10.11606/s1518-8787.2020054002342
Boudi, Z., Lauque, D., Alsabri, M., Östlundh, L., Oneyji, C., Khalemsky, A., … & Bellou, A. (2020). Association between boarding in the emergency
department and in-hospital mortality: A systematic review. PLoS One, 15(4), e0231253. https://doi.org/10.1371/journal.pone.0231253
Brasil (2014). Tribunal de Contas da União. Saúde / Tribunal de Contas da União – Brasília : TCU, https://portal.tcu.gov.br/data/files/B1/20/29/03/75A1F6107AD96FE6F18818A8/Fisc_Saude_2013.PDF
Brasil (2020). Ministério da Saúde. Secretaria de Ciência, Tecnologia, Inovação e Insumos Estratégicos em Saúde. Departamento de Ciência e Tecnologia. Síntese de evidências para políticas de saúde: congestão e superlotação dos serviços hospitalares de urgências. Brasília: Ministério da Saúde; EVIPNet Brasil, 81 p. https://docs.bvsalud.org/biblioref/2020/04/1087521/13-sintesecongestaosuperlotacaofinal31mar2020.pdf
Carter, E. J., Pouch, S. M., & Larson, E. L. (2014). The relationship between emergency department crowding and patient outcomes: A systematic review. Journal of Nursing Scholarship, 46(2), 106–115. https://doi.org/10.1111/jnu.12055
Chen, L.C., Lin, C.C., Han, C.Y., Hsieh, C.L., Wu, C.J. & Liang, H. F (2018). An Interpretative Study on Nurses' Perspectives of Working in an Overcrowded Emergency Department in Taiwan. Asian Nurs Res (Korean Soc Nurs Sci), 12(1):62-68. doi: 10.1016/j.anr.2018.02.003
Coil, J., Flood, D., Belyeu, M., Young, P., Kaji, P, A., & Lewis, R. J. (2016). The effect of emergency department boarding on order completion. Annals of Emergency Medicine 67(6), 730–736.E2. doi: https://doi.org/10.1016/j.annemergmed.2015.09.018
Hernández-Cruz, R., Moreno-Monsiváis, M.G., Cheverría-Rivera, S. & Díaz-Oviedo, Ar. (2017).Fatores que influenciam o cuidado de enfermagem omitido em pacientes de um hospital particular. Rev. Latino-Am. Enfermagem. doi https://doi.org/10.1590/1518-8345.1227.2877
Hooper, C., Craig, J., Janvrin, D.R., Wetsel, M.A., Reimels, E., Greenville, A. & Clemson, S.C. (2010). Compassion satisfaction, burnout, and compassion fatigue among emergency nurses compared with nurses in other selected inpatients specialties. J Emerg Nurs,36(5):40–427. http://dx.doi.org/10.1016/j.jen.2009.11.027
Hwaly, S. & Tyrrell, M. (2011). Stress in emergency departments: experiences of nurses and doctors. Emerg Nurse;19(4):31–7. http://dx.doi.org/10.7748/en2011.07.19.4.31.c8611
Kalisch, B.J., Landstrom, G. & Williams, R.A. (2009). Missed nursing care: errors of omission. Nurs Outlook. 57(1):3-9. doi: 10.1016/j.outlook.2008.05.007.
Konder, M. & O’dwyer, G. (2019). As Unidades de Pronto Atendimento como unidades de internação: fenômenos do fluxo assistencial na rede de urgências. Physis;29(2) https://doi.org/10.1590/s0103-73312019290203
Lin, C.C., Liang, H.F., Han, C.Y., Chen, L.C. & Hsieh, C.L. (2019). Professional resilience among nurses working in an overcrowded emergency department in Taiwan. Int Emerg Nurs. 42:44-50. doi: 10.1016/j.ienj.2018.05.005
Lindner, G. & Woitok, B.K. (2020). Emergency department overcrowding: Analysis and strategies to manage an international phenomenon. Wien Klin Wochenschr. 13. doi: 10.1007/s00508-019-01596-7
Morley, C. M., Peterson, G.M., Stankovich, J., & Kinsman, L. (2018). Emergency department crowding: A systematic review of causes, consequences and solutions. PLoS ONE, 13(8), e0203316. doi: https://doi.org/10.1371/journal.pone.0203316
Rouquayrol, M. Z & Silva, M.G.C da. (2018). Epidemiologia & saúde. 8. ed. - Rio de Janeiro : Medbook,
Silva, L.C., Oliveira, D.A.L., Santos, A.B.R., et al (2019). Personel dimensioning and its interference in the quality of care. Rev. enferm. UFPE on line; 13(2): 491-498. doi:10.5205/1981-8963-v13i02a236551
Singer, A. J., Thode, H. C., Jr, Viccellio, P., & Pines, J. M. (2011). The association between length of emergency department boarding and mortality. Academic Emergency Medicine, 18(12), 1324–1329. https://doi.org/10.1111/j.1553-2712.2011.01236.x
Sri-On, J., Chang, Y., Curley, D. P., Camargo, C. A., Jr, Weissman, J. S., Singer, S. J., & Liu, S. W. (2014). Boarding is associated with higher rates of medication delays and adverse events but fewer laboratory-related delays. The American Journal of Emergency Medicine, 32(9), 1033–1036. https://doi.org/10.1016/j.ajem.2014.06.001
Van der Linden, N., Van der Linden, M.C, Richards, J.R., et al (2016). Effects of emergency department crowding on the delivery of timely care in an inner-city hospital in the Netherlands. European Journal of Emergency Medicine: Official Journal of the European Society for Emergency Medicine. 23(5):337-343. doi: 10.1097/mej.0000000000000268
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Copyright (c) 2022 Hertaline Menezes do Nascimento Rocha; Ammanda Hermes de Oliveira; Akitila Maila dos Santos Azevedo; Iasmin Santos Andrade; Marcos Antônio Gois Santana; José Marcos de Jesus Santos; Anny Giselly Milhome da Costa Farre; Valter Joviniano de Santana-Filho
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