Equitable Discharge Teaching During COVID-19: Paediatric Emergency Nurses' Perspectives From Qualitative Interviews.

Area of Science:

• Pediatric Emergency Medicine
• Healthcare Quality Improvement
• Pandemic Preparedness

Background:

• The COVID-19 pandemic presented unprecedented challenges to healthcare delivery.
• Discharge teaching is crucial for patient safety and outcomes, particularly in pediatric emergency settings.
• Equitable discharge teaching ensures all patients receive necessary information regardless of background or circumstances.

Purpose of the Study:

• To identify barriers and facilitators to quality, equitable discharge teaching by pediatric emergency department nurses during the COVID-19 pandemic.
• To describe the impacts of inequitable discharge teaching on patients and families.
• To identify potential solutions to mitigate identified barriers.

Main Methods:

• Qualitative study involving individual interviews with 22 nurses from a single urban pediatric hospital.
• Interviews were conducted via phone or videoconference between January and April 2022.
• Data were transcribed and analyzed using an inductive codebook approach.

Main Results:

• Six key barriers were identified: emergency department overcrowding, travel nurse training/knowledge gaps, nurse burnout and stress, increased role complexity, COVID-19 precautions, and resource bottlenecks.
• Engagement and effective communication were identified as facilitators.
• Nurses provided detailed accounts of the impacts of these barriers and proposed actionable solutions.

Conclusions:

• The COVID-19 pandemic exacerbated existing challenges and introduced new barriers to providing equitable discharge teaching in pediatric emergency departments.
• Addressing identified barriers through improved hospital policies and resource allocation is essential for enhancing discharge teaching quality.
• Findings offer guidance for improving emergency preparedness and ensuring equitable care during future public health crises.