Nurses Approach Issue of ER Overcrowding

Staff participation can help develop criteria for operational change
By Jane Parry
HealthDay Reporter

WEDNESDAY, July 30 (HealthDay News) -- Staff participation, such as deciding on the criteria for the closure of a hospital emergency department waiting room, is an effective way to conduct research into operational change, according to a study published in the August issue of the Journal of Emergency Nursing.

Paula Tanabe, Ph.D., of Northwestern University in Chicago and colleagues conducted a study with 100 nurses at an urban emergency department, of whom 73 participated in a four-hour workshop to tackle the issue of overcrowding in the emergency department waiting room. During the workshop, nurses were enlisted to decide on criteria for when to close the waiting room.

The nurses developed four questions with yes/no answers that could be used to make a decision on waiting room closure and addressed staff and space availability, patient acuity and capacity to cope with a surge in patients.

"Staff-based participation in the change process is not a new concept, but often it is neglected for several reasons. Historically, a hierarchical method of developing and implementing change is necessary to rapidly react to a problem. This may result in the development of a policy with or without associated education, and without staff input," the authors write. "Although occasionally such policy making is required, we believe the inclusion and empowerment of staff will facilitate successful practice change, when time is available for staff education."

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