Nursing duties and accreditation standards and their impacts: The nursing perspective

Medical advances and increasingly complex patients presenting to the Emergency Department (ED) make nursing challenging. Gaining new knowledge and skills is a perpetual requirement. New quality initiatives to improve patient safety and care are being constantly introduced and create significant work and time pressures for healthcare providers involved.

Do ED nurses support the introduction of new quality standards, in addition to their current heavy workload?

A cross-sectional survey.

All ED nurses in the Edmonton zone were invited to complete a survey on nursing beliefs regarding various accreditation standards and their impacts. The survey was developed iteratively, involving study investigators, the Health Authority Management Team, and Nursing Managers. Response options included a 7-point Likert scale of agreement. Median ratings and interquartile ranges were determined for each survey statement.

A total of 433/1241 (34.9%) surveys were completed. Respondents were RNs (91.4%), female (88.9%), with 0-5years ED experience (43.7%). Overall, respondents 'agreed' or 'strongly agreed' with the statements, indicating favourable attitudes towards Accreditation Canada standards and other quality initiatives. They were neutral towards universal domestic violence screening, and the differentiation between a Best Possible Medication History and medication reconciliation.

Despite their heavy workload, nurses strongly agreed on the importance of medication reconciliation, falls risk, and skin care, but felt that improved documentation forms could support efficiency. This nursing perspective is valuable in informing attempts to standardize and simplify documentation, including the design and implementation of a provincial clinical information system.