University of Southern Denmark, Denmark
Helen Schultz performs a Ph.D. research study at the University of Southern Denmark of Emergency Departments, Emergency Department Observation Units and Surgical Assessment Units and has published papers on the topic. She is a specialist in critical care nursing and supervision, has 18 years experiences within critical care nursing, 3 years experiences within general surgical nursing and 12 years experiences as supervisor and has published a book on that subject.
Background: A nationwide reorganization of emergency departments (ED) takes place in Denmark. Th e ED becomes gatekeeper to the hospital for acute somatic patients and emergency department observation units (EDOU) replace acute specialized wards. Consequently, the journey of acute patients changes from admission to specialized wards staff ed by specialist nurses to stay in EDs and EDOUs staff ed by emergency nurses. Aims: To compare the journey of patients with acute abdominal pain when hospitalized in an ED and an EDOU with hospitalization in a surgical assessment unit (SAU). Methods: An ethnographic fi eld study with qualitative interviews included 24 patients and an observational study included 109 patients. Results: At arrival in the ED patients experienced rapid action, extensive patient-nurse interaction and need for repetition. In the SAU, patients experienced a long and uncomfortable waiting time with limited patient-nurse interaction. In the EDOU and the SAU, patients experienced lack of information about routines in the unit and care, making it diffi cult for patients to make informed decisions. In the ED, patients had more interaction with nurses (p≤0.0001) than in the SAU. Waiting time to a treatment plan was 50 minutes longer (p=0.02) in the ED than in the SAU. Conclusion: Emergency nurses had signifi cant more interaction with patients than surgical nurses which aff ected patient experience positively. Lack of information during short-term observation and care in the EDOU and the SAU made patients' ability to make decisions diffi cult.