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Different patient groups request different emergency care: A survey in a Swedish emergency department
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Caring Sciences.
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Caring Sciences.
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences.
2008 (English)In: International Emergency Nursing, ISSN 1755-599X, Vol. 16, 223-232 p.Article in journal (Refereed) Published
Abstract [en]

AIM: This study investigates possible differences in the perception of quality of care at an emergency department, as related to patient background and visit characteristics. METHODS: The study uses a prospective, descriptive survey design with data collected in May 2002 from the emergency department of a Swedish university hospital. It included 200 patients with an average age of 51 yr (range 18-91 yr). The research-based Quality from the Patient's Perspective (QPP) questionnaire, emergency department version, was used for data collection. RESULTS: Several factors, for example, information after procedures, respect and empathy, nutrition, general atmosphere and routines, were rated significantly lower by patients with gastrointestinal symptoms, general surgery patients and patients admitted to a hospital ward, than by patients with other background or visit characteristics. CONCLUSIONS: There are differences in the perception of quality of care related to patient background and visit characteristics at the emergency department. Clinical guidelines for different patient groups could facilitate the quality improvement work. However, to improve the quality of care at the emergency department there should be a balance between standardized care and individualized patient care. In addition, there has to be a changed attitude and behaviour towards the ED patients to improve their perception of the emergency care.

Place, publisher, year, edition, pages
2008. Vol. 16, 223-232 p.
Keyword [en]
Patients’perceptions; Quality of care; Emergency department; Quality improvement
National Category
Nursing
Research subject
Caring Sciences
Identifiers
URN: urn:nbn:se:uu:diva-110252DOI: 10.1016/j.ienj.2008.07.006PubMedID: 18929340OAI: oai:DiVA.org:uu-110252DiVA: diva2:275582
Available from: 2009-11-06 Created: 2009-11-06 Last updated: 2010-11-09Bibliographically approved
In thesis
1. Identifying and Improving Quality of Care at an Emergency Department: Patient and healthcare professional perspectives
Open this publication in new window or tab >>Identifying and Improving Quality of Care at an Emergency Department: Patient and healthcare professional perspectives
2009 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

Background: Patients in the emergency department are not always satisfied with the care received and the nursing care in the emergency department is sometimes described as instrumental and non-holistic. Structured quality improvement work and evidence-based practice are needed. Aim: The overall aim was to emphasize general patients in the emergency department to enhance the knowledge on how they perceive the quality of care and how the care could be improved through collaboration with the healthcare professionals. Methods: Four studies, with quantitative and qualitative designs, were conducted in a Swedish emergency department. Two hundred patients answered a questionnaire, after which 22 healthcare professionals comprising five focus groups were interviewed, and finally 200 patients were included in an intervention study. Results: The following five areas for improvement were identified: “information, respect and empathy”, “pain relief”, “nutrition”, “waiting time” and “general atmosphere”. Of these areas, the healthcare professionals prioritized “information, respect and empathy”, “waiting time” and “pain relief” to be highlighted in the quality improvement work. Although goals and suggestions for changes were stated, barriers to quality improvement at different levels in the health care were detected. The results of the intervention study showed that structured nursing assessment of the patients’ abdominal status and nurse-initiated intravenous opioid analgesic could increase frequency of analgesic and reduce time to analgesic in the emergency department. Patients perceived lower pain intensity and improved quality of care in pain management. Conclusions: An uncomplicated nursing intervention, related to pain management, based on the results from a patient questionnaire and interviews with healthcare professionals, can improve the care process and pain management in the emergency department, as well as patients’ perceptions of the quality of care in pain management. To succeed with continuous quality improvement work, barriers to change should be addressed.

Place, publisher, year, edition, pages
Uppsala: Acta Universitatis Upsaliensis, 2009. 76 p.
Series
Digital Comprehensive Summaries of Uppsala Dissertations from the Faculty of Medicine, ISSN 1651-6206 ; 499
Keyword
nursing, emergency department, quality improvement, evidence-based care, patient perspectives, healthcare professional perspectives, pain management, intervention, implementation
National Category
Nursing
Research subject
Caring Sciences in Medical Sciences
Identifiers
urn:nbn:se:uu:diva-110260 (URN)978-91-554-7657-1 (ISBN)
Public defence
2009-12-18, Grönwallsalen, Akademiska sjukhuset, Ing 70, Akademiska sjukhuset, Uppsala, 09:15 (Swedish)
Opponent
Supervisors
Available from: 2009-11-27 Created: 2009-11-06 Last updated: 2010-11-09Bibliographically approved

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