A Nurse-Led Study to Investigate Factors Influencing Patients' Perception of Diagnostic Quality in the Emergency...

Diagnostic errors in emergency departments significantly affect patient morbidity and mortality. Nurses play a crucial role in the diagnostic process. The Patient-Reported Instrument for Measuring Diagnostic Excellence in Emergency Departments assesses patient perceptions of diagnostic accuracy and communication. This study aimed to identify factors associated with patients' perceptions of diagnostic quality to support nursing efforts in improving patient safety.

A cross-sectional survey was administered to patients who visited an emergency department within the past 30 days using an electronic health record messaging platform. The 17-item Patient-Reported Instrument for Measuring Diagnostic Excellence in Emergency Departments survey measured perceptions of diagnostic experience, accuracy, and communication, with higher scores indicating more positive perceptions.

Among respondents (n = 454), most participants identified as white (78.7%), non-Hispanic (87%), and female (60.5%). Females reported significantly lower diagnostic experience scores than men (P = .003). Older adults, particularly those aged 70 to 79 years, reported significantly higher Patient-Reported Instrument for Measuring Diagnostic Excellence in Emergency Departments scores than younger participants (P<.03). In addition, longer ED stays correlated with lower perceived diagnostic excellence (P<.05).

Despite overall high ratings, disparities in diagnostic perception were evident, especially among females and younger patients, who reported lower satisfaction with diagnostic communication. Extended emergency department stays were linked to reduced perceptions of diagnostic quality. These findings highlight areas where nurses can positively influence patient understanding and safety through enhanced communication.