Abstract
Background
Acute abdominal pain is a common reason for presentation to the emergency department.
Understanding the role of nurses involved in management of acute abdominal pain is
important for improving patient care and outcomes. The aim of this study was to understand
the perceptions of emergency nurses in the management of acute abdominal pain.
Methods
Using a qualitative design, a purposeful sample (n = 9) of experienced registered nurses was recruited from the emergency department of
a large tertiary public hospital in South Australia. Semi-structured interviews, informed
by literature describing the management of acute abdominal pain, were used to identify
the perceptions of emergency nurses when caring for patients with acute abdominal
pain.
Results
Thematic analysis of interviews identified four themes: Centrality of Diagnosis; Busyness
and Patient Management; Systems Issues; and Communication Challenges. Of the four
themes, the Centrality of Diagnosis was especially important to the nurses’ sense
of contribution to patient care. Care was also affected by the busyness of the environment,
the systems and processes in place to manage patients and communication in the emergency
department.
Conclusions
The management of patients with acute abdominal pain is influenced by how nurses participate
in the diagnostic process. Nurses identified their role in this process and described
how this role impacted their delivery of fundamental care. Further studies of the
nursing contribution to diagnosis, communication, and the systems that affect care
delivery in the emergency department are required.
Keywords
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References
- Evaluation and management of acute abdominal pain in the emergency department.Int J Gen Med. 2012; 5: 789-797
- Emergency department care 2016–17: Australian hospital statistics. Health services series no. 80. Cat. no. HSE 194.AIHW, Canberra2017
- National Hospital Ambulatory Medical Care Survey: 2010 Emergency Department Summary Table.Centers for Disease Control and Prevention, 2010 (http://www.cdc.gov/nchs/data/ahcd/nhamcs_emergency/2010_ed_web_tables.pdf (accessed 15 May 2015).)
- Reclaiming and redefining the Fundamentals of Care: nursing's response to meeting patients’ basic human needs.School of Nursing, The University of Adelaide, Adelaide, South Australia2013: 1-39
- Defining the fundamentals of care.Int J Nurs Pract. 2010; 16: 423-434
- Report of the Mid Staffordshire NHS Foundation trust public inquiry.The Stationery Office, London2013: 1-121
- Transforming care in the emergency department.Top Emerg Med. 2004; (October–December): 331-336
- The effect of emergency department crowding on patient outcomes: a literature review.Adv Emer Nurs J. 2011; 33: 39-54
- Patient safety in the emergency department.Emerg Med. 2016; 48: 396-404
- Patients with acute abdominal pain describe their experiences of fundamental care across the acute care episode: a multi-stage qualitative case study.J Adv Nurs. 2016; 72: 791-801
- Following patients with acute abdominal pain in emergency departments.Scand J Trauma Resusc Emerg Med. 2013; 19: 23
- Outcomes of a nurse-initiated intravenous analgesic protocol for abdominal pain in an emergency department: a quasi-experimental study.Int J Nurs Stud. 2011; 48: 13-23
- Nurse-initiated intravenous morphine in the emergency department: efficacy, rate of adverse events and impact on time to analgesia.Emerg Med. 2002; 14: 249-254
- A systematic review of the impact of nurse-initiated medications in the emergency department.Austral Emerg Nurs J. 2017; 20: 53-62
- Using thematic analysis in psychology.Qual Res Psychol. 2006; 3: 77-101
- Fundamentals of nursing: Australia & NZ edition – revised, Cengage.2016
- Differences in test ordering between nurse practitioners and attending emergency physicians when acting as Provider in Triage.Am J Emerg Med. 2017; 35: 1426-1429
- Differential diagnosis of abdominal pain.Primary Health Care. 2009; 19: 20-22
- Analyzing qualitative data: systematic approaches.Sage Publications, Thousand Oaks, CA2010
- Nurses perceptions of diagnosis and prognosis-related communication: an integrative review.Cancer Nurs. 2016; 39: 48-60
Committee on Diagnostic Error in Health Care 2015; Board on Health Care Services; Institute of Medicine; The National Academies of Sciences, Engineering, and Medicine; Balogh EP, Miller BT, Ball JR, editors. Washington (DC), 29 Dec, p. 1–472.
- Factors affecting communication in emergency departments: doctors and nurses’ perceptions of communication in a trilingual ED in Hong Kong.Int J Emerg Med. 2015; 8: 1-12
- Interprofessional communication supporting clinical handover in emergency departments: an observation study.Austral Emerg Nurs J. 2017; 20: 122-130
- Person-centred pain management for the patient with acute abdominal pain: an ethnography informed by the Fundamentals of Care framework.J Adv Nurs. 2018; 74: 2596-2609
- Factors influencing the delivery of the fundamentals of care: perceptions of nurses, nursing leaders and healthcare consumers.J Clin Nurs. 2017; 27: 2373-2386
Article info
Publication history
Published online: May 02, 2019
Accepted:
April 18,
2019
Received in revised form:
April 18,
2019
Received:
February 2,
2019
Identification
Copyright
Crown Copyright © 2019 Published by Elsevier Ltd on behalf of College of Emergency Nursing Australasia. All rights reserved.
