The potential for missed care and impact on staff wellbeing – Emergency Nursing Views

Activity: Talk or presentation typesOral presentation

Description

Introduction
In the context of providing quality safe care, the Irish Health Information and Quality Authority (HIQA) (2009) recommended a reconfiguration of smaller hospitals which resulted in some emergency departments being downsized to minor injury units.

Aims & Objectives
The aim of this study was to explore the transition experiences of frontline staff in an Irish Emergency department which was reconfigured to a minor injury unit.

Methods
A qualitative descriptive design with purposeful sampling was employed for this study. Semi-structured interviews were conducted with 8 nurses and 2 doctors who were present throughout the transition period. Braun and Clarke’s (2006) thematic analysis framework was used for data analysis.

Outcomes
The findings of this study gave rise to the view that frontline staff experience a mixture of positive and negative feelings when a change occurs in their role and place of work. Staff experienced considerable levels of moral distress and expressed concerns regarding patient care and safety. The concept and process of change management was raised by all participants and suggestions for key interventions required at both group level and an individual level were identified. Negative impacts can be negated where there is good communication from senior and middle management and provision of information to both staff and public. This is borne out also in the literature where it appears to be key through all stages of transition and restructuring (Burke et al, 2016; Nelson & Pilon, 2015).

This study found that after a period of time staff adjusted to their new roles and saw the benefits the reconfiguration gave to staff and patients. They expressed greater confidence in their knowledge and skills, enhanced levels of job satisfaction and less occupational stress. There was an appreciation that ultimately the streamlining resulted in a safer more efficient service being offered to the public.

Conclusion
This study reinforces the recommendations among the research literature for involving frontline staff in all stages of the change process when a healthcare organisation is undergoing reconfiguration. This study suggests various measures and initiatives which may assist hospitals going through a similar reconfiguration of their services in the future.

References
Braun, V. & Clarke, V. (2006) Using thematic analysis in psychology, Qualitative Research in Psychology, 3(2), 77-101.
Burke, R.J., Ng, E.S. & Wolpin, J. (2016) Effects of Hospital Restructuring and Downsizing on Nursing Staff: The Role of Union Support. Journal of Health Management 18(3), 473-488
Health Information and Quality Authority (2009) Report of the investigation into the quality and safety of services and supporting arrangements provided by the Health Service Executive at Mid-Western Regional Hospital Ennis. Available: http://www.lenus.ie/hse/handle/10147/71314 (Accessed 12th of July 2017).
Nelson, K.E. & Pilon, B. (2015) Managing Organizational Transitions: The Chief Nurse Perspective. Nurse Leader 13(3), 71-76.
Period23 Aug 201825 Aug 2018
Event title22nd International Philosophy of Nursing (IPONS): Missed care, care left undone: Organisation ethics and the appropriate use of the nursing resource.
Event typeConference
LocationGalway, IrelandShow on map
Degree of RecognitionNational