The reliability, validity and feasibility of tools used to screen for caregiver burden: a systematic review; The clinical effectiveness of nurse practitioners’ management of minor injuries in an adult emergency department: a systematic review; Oral liquid

BackgroundPatient experience is positively associated with both clinical effectiveness and patient safety and should be a priority for emergency care providers. While both quantitative and qualitative approaches can be used to evaluate patient experience in the emergency department (ED), the latter is well aligned to develop a detailed understanding of features influencing the lived experience of ED patients. This study aimed to systematically review the literature of qualitative studies to identify determinants of adult patient experience in the ED.MethodsA Preferred Reporting Items for Systematic review and Meta-Analysis compliant systematic review was conducted using PubMed, CINAHL, EMBASE, BNI and bibliography searches to identify qualitative studies exploring patient experiences in ED published in English between 1997 and 2018. Quality assessment was conducted using the Critical Appraisal Skills Programme checklist. Descriptive text and quotations relating to patient experience were extracted from included studies and a meta-synthesis conducted using thematic analysis.ResultsA total of 625 records were screened from which 40 studies underwent full review and 22 were included. Results were coded by two researchers (BG and JML). Meta-synthesis identified 198 discrete units of analysis which were clustered around five analytical themes. These were based on the perceived ‘needs’ of patients visiting the ED and were defined as communication, emotional, competent care, physical/environmental and waiting needs. Findings were translated into a conceptual model for optimising patient experience in the ED.ConclusionThis meta-synthesis provides a framework for understanding the determinants of patient experience in the ED. The resulting conceptual model and recommendations may have the potential to directly inform practice and improve the patient experience.

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Safety and Clinical Effectiveness of Midazolam versus Propofol for Procedural Sedation in the Emergency Department: A Systematic Review

Academic Emergency Medicine ◽

10.1111/j.1553-2712.2007.00022.x ◽

2008 ◽

Vol 15 (1) ◽

pp. 1-8 ◽

Cited By ~ 38

Author(s):

Corinne Michèle Hohl ◽

Mohsen Sadatsafavi ◽

Bohdan Nosyk ◽

Aslam Hayat Anis

Keyword(s):

Systematic Review ◽

Emergency Department ◽

Clinical Effectiveness ◽

Procedural Sedation

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A systematic review of the impact of nurse practitioners on cost, quality of care, satisfaction and wait times in the emergency department

CJEM ◽

10.1017/s1481803500015189 ◽

2007 ◽

Vol 9 (04) ◽

pp. 286-295 ◽

Cited By ~ 52

Author(s):

Alix J.E. Carter ◽

Alecs H. Chochinov

Keyword(s):

Systematic Review ◽

Emergency Department ◽

Patient Satisfaction ◽

Quality Of Care ◽

Nurse Practitioners ◽

Census Data ◽

Medical Community ◽

Wait Times ◽

The Impact

ABSTRACT Introduction: US emergency personnel cared for 106% more patients in 1990 than they did in 1980, and national emergency department census data show that 60%–80% of those patients presented with non-urgent or minor medical problems. The hiring of nurse practitioners (NPs) is one proposed solution to the ongoing overcrowding and physician shortage facing emergency departments (EDs). Methods: We conducted a systematic review of MEDLINE and Cinahl to find articles that discussed NPs in the ED setting, looking specifically at 4 key outcome measures: wait times, patient satisfaction, quality of care and cost effectiveness. Results: Although some questions remain, a review of the literature suggests that NPs can reduce wait times for the ED, lead to high patient satisfaction and provide a quality of care equal to that of a mid-grade resident. Cost, when compared with resident physicians, is higher; however, data comparing to the hiring additional medical professionals is lacking. Conclusion: The medical community should further explore the use of NPs, particularly in fast track areas for high volume departments. In rural areas, NPs could supplement overextended physicians and allow health centres to remain open when they might otherwise have to close. These strategies could improve access to care and patient satisfaction for selected urban and rural populations as well as make the best use of limited medical resources.

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