Perceived involvement in emergency department care

Abstract

Background
Involving patients in their care is an important aspect of quality emergency nursing, but remains difficult to achieve in busy and time-pressured settings. Bedside shift handover (BSH), where nurses exchange information in the patient’s presence, may support engagement, yet evidence from emergency departments (EDs) is limited.

Aim
To explore how patients perceived their involvement in communication and care during their ED stay, and whether exposure to nurse-led BSH, structured using the Situation-Background-Assessment-Recommendation (SBAR) format, was associated with higher perceived involvement.

Methods
A cross-sectional telephone survey was conducted among 104 recently discharged ED patients. Perceived involvement was assessed with the three-item CollaboRATE questionnaire. Additional data included patient and visit characteristics, crowding levels, and BSH exposure based on nursing documentation.

Results
Patients reported moderate-to-high perceived involvement (mean CollaboRATE 21.8 of 27), though only 11.5 % gave top scores across all items. BSH was documented in 36 % of eligible cases. No significant association was observed between documented BSH and perceived involvement (p = 0.81), nor between crowding and involvement (r = –.05, p = 0.59).

Conclusion
Most patients felt involved, yet optimal engagement was uncommon. No association was found between BSH and perceived involvement, likely reflecting variation in implementation. Consistent and inclusive handover practices may help support patient engagement, but this requires further study.