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Direct Bedding in the Emergency Department: A Concept Analysis
Journal of Emergency Nursing
|June 8, 2026
Summary
Direct bedding in emergency departments (EDs) places patients directly into treatment spaces, improving operational efficiency and patient satisfaction. This study provides the first conceptual definition of this widely used ED overcrowding mitigation strategy.
Area of Science:
- Healthcare Management
- Emergency Medicine
- Nursing Administration
Background:
- Direct bedding is a common strategy in US emergency departments (EDs) to manage overcrowding.
- A lack of a formal conceptual definition hinders consistent interpretation and evaluation of direct bedding.
- This study addresses the need for a clear definition by synthesizing existing literature.
Purpose of the Study:
- To synthesize and evaluate literature on direct bedding in ED settings.
- To describe the attributes, antecedents, and consequences of direct bedding.
- To generate the first formal conceptual definition of direct bedding.
Main Methods:
- Comprehensive literature search of PubMed, CINAHL, Embase, and Scopus (N=1622).
- Rodgers' evolutionary method used for concept analysis, extracting attributes, antecedents, and consequences.
- Thematic synthesis and nursing services delivery theory applied for analysis and conceptualization.
Main Results:
- Analysis of 22 publications revealed no prior formal concept analysis.
- Direct bedding defined as a dynamic operational strategy for simultaneous multidisciplinary assessment and care.
- Key antecedents include patient volume, space availability, policy, and team buy-in.
Conclusions:
- Direct bedding improves time-based ED operational performance (e.g., reduced door-to-provider time, LOS).
- Consequences include increased patient satisfaction, altered resource utilization, and potential for mistriage.
- The conceptual definition provides a foundation for consistent evaluation and implementation.
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