Date of this Version

12-13-2023

Document Type

DNP Project

Abstract

Background: Emergency department (ED) bounce-back visits pose a significant challenge, contributing to the issue of ED overcrowding. Exploring the perspectives of ED staff on patient-centered care (PCC) is crucial in informing the implementation of targeted PCC interventions aimed at mitigating ED bounce-back visits.

Purpose: The purpose of this project was to explore the perspectives of ED staff regarding the provision of PCC within the ED.

Methodology: A cross-sectional survey was conducted, employing a convenience sample of the ED staff at a general acute care hospital. There were 47 participants. Inclusion criteria comprised ED nurses and ED technicians who provided direct patient care. The 30-item survey encompassed three sections: socio-demographics, the Provider-Patient-Relationship Questionnaire (PPRQ), and queries related to PCC barriers and enablers. The PPRQ assessed staff confidence in their ability to provide PCC across four domains (effective communication, interest in the patient’s agenda, empathy, and patient involvement in care).

Results: Most participants were female (n = 37, 79%), bachelor-prepared registered nurses (n = 26, 56%), ages 24 to 35 years (n = 25, 52%), with less than 2 years of ED clinical experience (n = 21, 45%). Self-ratings using the PPRQ indicated that most participants perceived themselves as highly competent across all four PCC domains, with effective communication (EC) receiving the highest self-rating mean score. There were statistically significant differences in the reported EC domain by age. A significant difference in reported EC between the age group 25 to 34 years and age group 55 years and older (p = 0.015) was observed, with younger ED staff reporting higher levels of EC.

Conclusion: It is promising that ED staff generally rated themselves as highly competent across all PCC domains; however, substantial barriers to effective PCC persist. A plausible explanation for the higher levels of EC reported by younger ED staff could be attributed to younger ED staff receiving PCC education and targeted onboarding PCC training, in contrast to older ED staff who may not have been exposed to or trained on PCC concepts. Higher burnout rates among older, more experienced ED staff may also contribute to lower self-ratings in the EC and empathy (E) domains among this group. Addressing the identified barriers for delivery of PCC intervention, alongside other initiatives, is essential to promote PCC and mitigate ED bounce-back visits.

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