Better communication in the emergency department

Area of Science:

• Nursing
• Emergency Medicine
• Healthcare Management

Background:

• The role of the Emergency Nurse Practitioner (ENP) in UK emergency departments (EDs) has expanded significantly since the 1980s.
• ENPs now autonomously manage patients, requiring effective history taking and communication skills, particularly with complex cases.
• Increasing ED attendances and workforce pressures impact the time ENPs can dedicate to patient interactions, potentially affecting outcomes.

Purpose of the Study:

• To conduct a literature review identifying limitations to effective history taking and communication for ENPs.
• To highlight best practices for managing emergency and urgent-care patients with complex needs.
• To propose strategies for overcoming identified challenges in the ENP role.

Main Methods:

• A systematic literature search was conducted across key nursing and medical databases (British Nursing Index, CINAHL, Medline).
• Eight research articles specifically addressing history taking and communication in emergency care were identified and analyzed.
• The review focused on identifying themes related to pressures and barriers faced by ENPs.

Main Results:

• Three primary themes emerged: interruptions, information overload, and communication barriers.
• Interruptions are more frequent in EDs, particularly affecting senior staff, and contribute to information overload and potential medical errors.
• A significant barrier identified was the inability to understand patients with limited English proficiency.

Conclusions:

• Recommendations include increasing staffing levels and providing targeted training for ENPs.
• Training should focus on pressure management and effective communication strategies for diverse patient populations.
• Environmental adjustments, such as closing doors and curtains, can help minimize interruptions.