Improving care for patients who experience miscarriage in emergency departments: a practice innovation

Vaginal bleeding during pregnancy is a common patient presentation in emergency departments (EDs), and in some cases this will occur due to miscarriage. However, there are several barriers to effective and sensitive communication with patients experiencing a miscarriage. Women presenting to EDs who are experiencing a miscarriage are more likely to be psychosocially vulnerable and less satisfied with their care compared with those seeking care in the outpatient setting. There is a gap in nursing and advanced practice provider preparation regarding techniques for breaking bad news to patients in the ED setting. At one high-volume, urban ED in the US, an education programme for staff regarding best practice in breaking bad news to patients experiencing a miscarriage was developed based on an established protocol. The intention was to increase the confidence levels of nurses and other healthcare professionals in breaking bad news to these patients. After the education programme, many participants self-reported increased confidence in breaking bad news and comfort in managing patients' emotions. The results can be used to inform education for healthcare professionals who deliver bad news in the ED and other departments.