Article
Details
Citation
Hoyle L & Grant A (2015) Treatment targets in emergency departments: nurses' views of how they affect clinical practice. Journal of Clinical Nursing, 24 (15-16), pp. 2211-2218. https://doi.org/10.1111/jocn.12835
Abstract
Aims and objectives
To understand nurses' views and experiences of four‐hour treatment targets in the emergency department and how this impacts clinical decision‐making throughout acute secondary care hospitals.
Background
In many countries, national treatment targets in the emergency department have been introduced. However, research and a recent enquiry into poor clinical care in one hospital in the UK have highlighted that patient care may be compromised by the need to meet these targets.
Design
Qualitative descriptive study as part of a case study approach.
Methods
Semi‐structured interviews were conducted with 31 nurses working in UK secondary care hospitals which had an emergency department. Nurses were purposively sampled from three specialities: emergency arenas (emergency department, n = 5; medical assessment n = 4 surgical receiving n = 2) (n = 11), surgical wards (n = 11) and medical wards (n = 9).
Results
Nurses in emergency arenas reported considerable burden, in terms of a very high workload and pressure from senior staff to meet the target. Respondents reported that negative impact on patient care for the majority of patients, excluding the most sick, for whom emergency arena nurses reported that they ensured received appropriate treatment, regardless of breaching treatment targets. Around half of the nurses working outside emergency arenas felt pressure and amended their work practices to enable colleagues in emergency arenas to meet treatment targets.
Conclusions
Four‐hour targets were not viewed as clinically helpful by the majority of nurses, some of whom questioned their appropriateness for patient care.
Keywords
discretion; emergency care; emergency department; health care; health care administration; nurses; nursing care; qualitative; targets; work environment;
Journal
Journal of Clinical Nursing: Volume 24, Issue 15-16
Status | Published |
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Funders | ESRC PhD studentship |
Publication date | 31/08/2015 |
Publication date online | 07/04/2015 |
Date accepted by journal | 01/02/2015 |
URL | http://hdl.handle.net/1893/28790 |
Publisher | Wiley |
ISSN | 0962-1067 |
People (1)
Senior Lecturer in Nursing, Health Sciences Stirling