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Left behind: Exploring the concerns of emergency department staff when personnel are utilised for inter-hospital
Clare Walters1, Vicki Cope1, Martin P R Hopkins1
1School of Nursing, College of Health and Education, Murdoch University, 90, South Street, Murdoch, WA 6150, Australia.
Background:
Inter-Hospital Transfer (IHT) may require an escort from the referring hospital, either a Registered Nurse (RN), physician or both, leading to a sudden drop in staffing levels within the referring department potentially increasing risk to patients and staff.
Aims:
To explore the perspectives of RNs and physicians of differing experience levels when left behind due to an escorted IHT, and the decision-making protocols for IHT.
Method:
A qualitative exploratory approach of 5 RNs and 4 physicians selected using purposeful sampling. Data were collected through semi-structured interviews and thematically analysed.
Findings:
Five themes were identified: the impact of being left behind; the burden of transfer; missed care; a triangulation of competing needs upon the decision-making process; and the effect of inter-hospital transfers on staff with different experience levels.
Conclusion:
IHT is described differently by less experienced RNs compared to their more experienced counterparts especially concerning safety and risk. Physicians described the department as vulnerable with ad-hoc decision-making protocols surrounding IHT the norm.
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