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Exploring Person- Centredness in the Emergency Department

Exploring Person- Centredness in the Emergency Department. Donna McConnell PhD Student Prof Tanya McCance Dr Vidar Melby Dr Paul Slater (adviser). Person-Centred Practice Framework (McCormack & McCance 2010) . Person-centred practice has shown to transform practices for patients.

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Exploring Person- Centredness in the Emergency Department

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  1. Exploring Person-Centredness in the Emergency Department Donna McConnell PhD Student Prof Tanya McCance Dr VidarMelby Dr Paul Slater (adviser)

  2. Person-Centred Practice Framework (McCormack & McCance 2010)

  3. Person-centred practice has shown to transform practices for patients... • increased choice and involvement in decision making • improved quality of nurse/patient engagements • staff taking time to get to ‘know’ the person in a more meaningful way • staff were more person-centred, in their language and team-work • a reduction in ritual and routine

  4. ....and staff • a shift in values to appreciate caring over the technical aspects of nursing care • increased effectiveness of teamwork and workload management • improved staff relationships with more effective collaborative working • increased personal and professional job satisfaction - less intention to leave posts • a more effective use of resources McCormack et al (2010)

  5. Themes from the literature • There is a distinct culture within EDs • The nature of ED work – saving lives, a medical-technical environment where technology, medical status and patient throughput is valued over caring • A culture of worthiness – appropriate pts for ED and the place of those who did not fit in with this • Staff experience of working in ED • A stressful environment • Violence and aggression • Managing the patient journey – high responsibility, low power

  6. Themes from the literature • Fragmented care • Lack of privacy • A feeling of not being considered as an individual and a lack of caring • Feeling abandoned, exposed, vulnerable, ashamed, ignored, insecure, frightened forgotten or unwelcome • Worse for vulnerable groups - older people, those with mental health issues and those at end of life

  7. Aim To explore person-centred practice within the ED environment.

  8. Methodology

  9. Data collection • Pilot study undertaken in August 2013 • Stage 1 - 714 questionnaires distributed to nursing and medical staff in 11 EDs in all 5 trusts in NI during March and April 2014 • Reminder letters sent • Questionnaires returned 317 (44%) • Effective responses 294 (41%)

  10. Missing data n=13

  11. Staff responded neutrally indicating that they neither agreed nor disagreed that they worked in a care environment conducive to person-centred practice Total mean score = 3.5 (1 = Strongly Disagree to 5 = Strongly Agree)

  12. Items comprising Supportive Organisational Systems scale1 = Strongly Disagree to 5 = Strongly Agree

  13. Staff agreed that they engaged in the necessary care processes to deliver person-centred practice Total mean score = 4 (1 = Strongly Disagree to 5 = Strongly Agree)

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