Advertisement
Literature review|Articles in Press

Meeting the wellness needs of emergency department clinicians: A scoping review of interventions

Published:October 31, 2022DOI:https://doi.org/10.1016/j.auec.2022.10.004

      Abstract

      Background

      Emergency Departments are stressful work environments that can adversely affect clinicians’ wellbeing. The purpose of this scoping review was to report wellness interventions evaluated in Emergency Departments and clinicians’ experience of these interventions.

      Methods

      Five data bases were searched using a modification of Arksey and O’Malley’s framework. PRISMA guidelines for scoping reviews were employed to report the findings. The review included only peer-reviewed articles and had no date or language restrictions applied.

      Results

      Nine studies met inclusion criteria. Interventions included tactile massage, hypnosis, mindfulness, happiness practice, resiliency, meditation, and video-based debriefing. Three key themes emerged following data extraction and analysis: The value of mindfulness; One size doesn’t fit all; and Enablers and Barriers.

      Conclusions

      Successful wellness programs must be relevant to Emergency Departments and staff need to be involved in the development and application of these programs to achieve maximum benefit. For long term benefits and sustainability, the strategies must be supported by senior hospital management.

      Keywords

      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'

      Subscribe:

      Subscribe to Australasian Emergency Care
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect

      References

        • Adriaenssens J.
        • De Gucht V.
        • Van Der Doef M.
        • Maes S.
        Exploring the burden of emergency care: predictors of stress-health outcomes in emergency nurses.
        J Adv Nurs. 2011; 67: 1317-1328
        • Xu H.G.
        • Kynoch K.
        • Tuckett A.
        • Eley R.
        Effectiveness of interventions to reduce emergency department staff occupational stress and/or burnout: a systematic review.
        JBI Evid Synth. 2020; 18 (1156-88)
        • Anderson N.
        • Pio F.
        • Jones P.
        • Selak V.
        • Tan E.
        • Beck S.
        • et al.
        Facilitators, barriers and opportunities in workplace wellbeing: a national survey of emergency department staff.
        Int Emerg Nurs. 2021; 57
        • Airosa F.
        • Andersson S.K.
        • Falkenberg T.
        • Forsberg C.
        • Nordby-Hornell E.
        • Ohlen G.
        • et al.
        Tactile massage and hypnosis as a health promotion for nurses in emergency care – a qualitative study.
        BMC Alter Med. 2011; 11: 83
        • Muir K.J.
        • Keim-Malpass J.
        The emergency resiliency initiative: a pilot mindfulness intervention program.
        J Holist Nurs. 2020; 38: 205-220
        • Xu S.
        • Yang Q.
        • Xie M.
        • Wang J.
        • Shan A.
        • Shi F.
        Work experience of triage nurses in emergency departments during the prevalence of COVID-19.
        Int Emerg Nurs. 2021; 56
        • Zaidi S.R.
        • Sharma V.K.
        • Tsai S.
        • Flores F.
        • Lema P.C.
        • Castillo J.
        Emergency department well-being iniatives during the COVID-19 pandemic.
        AEM Edu Train. 2020; 4: 411-414
        • Verougstraete D.
        • Hachimi
        • Idrissi S.
        The impact of burn-out on emergency physicians and emergency medicine residents: a systematic review.
        Acta Clin Belg. 2020; 75: 57-79
        • Elder E.
        • Johnston A.
        • Wallis M.
        • Crilly J.
        The demoralisation of nurses and medical doctors working in the emergency department: a qualitative descriptive study.
        Int Emerg Nurs. 2020; : 52
        • Chung A.
        • Mott S.
        • Rebillot K.
        • Li-Sauerwine S.
        • Shah S.
        • Coates W.C.
        • et al.
        Wellness interventions in emergency medicine residency programs: review of the literature since 2017.
        West J Emerg Med. 2020; 22: 7-14
        • Johnston A.
        • Abraham L.
        • Greenslade J.
        • Thom O.
        • Carlstrom E.
        • Wallis M.
        • et al.
        Staff perception of the emergency deparment working environment: integrative review of the literature.
        Emerg Med Australas. 2016; : 7-26
        • d'Ettorre G.
        • Greco M.R.
        Assessment and management of work-related stress in hospital emergency departments in Italy.
        J Med Pract Manag. 2016; 31: 280-283
        • Xu H.G.
        • Johnston A.
        • Greenslade J.H.
        • Wallis M.
        • Elder E.
        • Abraham L.
        • et al.
        Stressors and coping strategies of emergency department nurses and doctors: a cross-sectional study.
        Austral Emerg Care. 2019; 22: 180-186
        • Copeland D.
        • Henry M.
        Workplace violence and perceptions of safety among emergency department staff members: experiences, expectations, tolerance, reporting, and recommendations.
        J Trauma Nurs. 2017; 24: 65-77
        • Howlett M.
        • Doody K.
        • Murray J.
        • LeBlanc-Duchin D.
        • Fraser J.
        • Atkinson P.R.
        Burnout in emergency department healthcare professionals is associated with coping style: a cross-sectional survey.
        Emerg Med J. 2015; 32: 722-727
        • Pollock A.
        • Campbell P.
        • Cheyne J.
        • Cowie J.
        • Davis B.
        • McCallum J.
        • et al.
        Interventions to support the resilience and mental health of frontline health and social care professionals during and after a disease outbreak, epidemic or pandemic: a mixed methods systematic review.
        Cochrane Database Syst Rev. 2020; 11: CD013779
      1. World Health Organization. WHO Director-General’s opening remarks at the media briefing on COVID-19. 〈https://www.who.int/director-general/speeches/detail/who-director-general-s-opening-remarks-at-the-media-briefing-on-covid-19---11-march-〉2020.

        • Monette D.L.
        • Macias-Konstantopoulos W.
        • Brown D.F.M.
        • Raja A.S.
        • Takayesu J.K.
        A video-based debriefing program to support emergency medicine clinician well-being during the COVID-19 pandemic.
        West J Emerg Med. 2020; 21: 88-92
        • Zhao Y.
        • Cui C.
        • Zhang K.
        • Liu J.
        • Xu J.
        • Nisenbaum E.
        • et al.
        COVID19: a systematic approach to early identification and healthcare worker protection.
        Front Public Health. 2020; 8
        • Verma S.
        • Deslypere J.
        • Mythily S.
        • Teo E.K.
        • Chong S.A.
        • Chan Y.H.
        Post-SARS psychological morbidity and stigma among general practitioners and traditional Chinese medicine practitioners in Singapore.
        Ann Acad Med Singap. 2004; : 743-748
        • Shanafelt T.
        • Ripp J.
        • Trockel M.
        Understanding and addressing sources of anxiety among health care professionals during the COVID-19 pandemic.
        JAMA: J Am Med Assoc. 2020; 323: 2133
        • Vizheh M.
        • Qorbani M.
        • Arzaghi S.M.
        • Muhidin S.
        • Javanmard Z.
        • Esmaeili M.
        The mental health of healthcare workers in the COVID-19 pandemic: a systematic review.
        J Diabetes Metab Disord. 2020; 19: 1967-1978
        • Hofmeyer A.
        • Taylor R.
        Strategies and resources for nurse leaders to use to lead with empathy and prudence so they understand and address sources of anxiety among nurses practising in the era of COVID-19.
        J Clin Nurs. 2020; 30: 298-305
        • Goetzel R.Z.
        • Henke R.M.
        • Tabrizi M.
        • Pelletier K.
        • Loeppke R.
        • Ballard D.W.
        • et al.
        Do workplace health promotion (Wellness) programs work?.
        J Occup Environ Med. 2014; 56: 927-934
        • Lynch J.
        • Prihodova L.
        • Dunne P.J.
        • O'Leary C.
        • Breen R.
        • Carroll Á.
        • et al.
        Mantra meditation programme for emergency department staff: a qualitative study.
        BMJ Open. 2018; 8 (e020685-e020685)
        • Reardon J.
        The history and impact of worksite wellness.
        Nurs Econ. 1998; 117
        • Parsons M.L.
        Capacity building for magnetism at multiple levels: a healthy workplace intervention, Part I.
        Top Emerg Med. 2004; 26: 287
        • Goetzel R.Z.
        Commentary on the study: "what do workplace wellness programs do? Evidence from the Illinois workplace wellness study.
        Am J Health Promot. 2020; 34: 440-444
        • Montano D.
        • Hoven H.
        • Siegrist J.
        Effects of organisational-level interventions at work on employees’ health: a systematic review.
        BMC Public Health. 2014; 14: 135
        • d'Ettorre G.
        • Greco M.
        Healthcare work and organizational interventions to prevent work-related stress in Brindisi, Italy.
        Saf Health Work. 2015; 6: 35-38
        • Simons G.
        • Baldwin D.
        A critical review of the definition of 'wellbeing’ for doctors and their patients in a post Covid-19 era.
        Int J Soc Psychiatry. 2021; 67: 984-991
        • Felce D.
        • Perry J.
        Quality of life: Its definition and measurement.
        Res Dev Disabil. 1995; 16: 51-74
        • Gable S.L.
        • Haidt J.
        What (and why) is positive psychology?.
        Rev Gen Psychol. 2005; 9: 103-110
        • Arksey H.
        • O’Malley L.
        Scoping studies: towards a methodological framework.
        Int J Soc Res Methodol. 2005; 8: 19-32
        • Levac D.
        • Colquhoun H.
        • O'Brien K.K.
        Scoping studies: advancing the methodology.
        Implement Sci. 2010; 5: 69
        • Pollock D.
        • Davies E.
        • Peters M.D.J.
        • Tricco A.C.
        • Alexander L.
        • McInerney P.
        • et al.
        Undertaking a scoping review: a practical guide for nursing and midwfery students, clinicians. reserachers, and academics.
        J Adv Nurs. 2021; : 2102-2113
        • Braun V.
        • Clarke V.
        Thematic Analysis: A Practical Guide.
        SAGE Publications Ltd, London2022
        • Team T.E.
        EndNote. EndNote 20.
        Clarivate, Philadelphia, PA2013
        • Page M.J.
        • McKenzie J.E.
        • Bossuyt P.M.
        • Boutron I.
        • Hoffmann T.C.
        • Mulrow C.D.
        • et al.
        The PRISMA 2020 statement: an updated guideline for reporting systematic reviews.
        Bmj. 2021; 372n71
        • Lenzen S.A.
        • Daniels R.
        • van Bokhoven M.A.
        • van der Weijden T.
        • Beurskens A.
        Disentangling self-management goal setting and action planning: a scoping review.
        PLOS One. 2017; 12 (e0188822-e0188822)
        • Elder E.
        • Johnston A.N.B.
        • Byrne J.H.
        • Wallis M.
        • Crilly J.
        Core components of a staff wellness strategy in emergency departments: a clinician-informed nominal group study.
        EMA - Emerg Med Australas. 2021; 33: 25-33
        • Parsons M.L.
        • Cornett P.
        • Sewell S.
        • Wilson R.W.
        Capacity building for magnetism at multiple levels: a healthy workplace intervention, part II - an emergency department's health workplace process and outcomes.
        Top Emerg Med. 2004; 26: 296-304
        • Hart D.
        • Paetow G.
        • Zarzar R.
        Does implementation of a corporate wellness initiative improve burnout?.
        West J Emerg Med. 2019; 20: 138-144
        • Xu H.
        • Tuckett A.
        • Kynoch K.
        • Eley R.
        A mobile mindfulness intervention for emergency department staff to improve stress and wellbeing: a qualitative study.
        Int Emerg Nurs. 2021; 58
        • Braganza S.
        • Young J.
        • Sweeny A.
        • Brazil V.
        oneED: embedding a mindfulness-based wellness programme into an emergency department.
        EMA - Emerg Med Australas. 2018; 30: 678-686
        • Ireland M.J.
        • Clough B.
        • Gill K.
        • Langan F.
        • O'Connor A.
        • Spencer L.
        A randomized controlled trial of mindfulness to reduce stress and burnout among intern medical practitioners.
        Med Teach. 2017; 39: 409-414
        • Beckman H.B.
        • Wendland M.
        • Mooney C.
        • Krasner M.S.
        • Quill T.E.
        • Suchman A.L.
        • et al.
        The impact of a program in mindful communication on primary care physicians.
        Acad Med. 2012; 87: 815-819
        • Elder E.
        • Johnston A.
        • Byrne J.H.
        • Wallis M.
        • Crilly J.
        Core components of a staff wellness strategy in emergency departments: a clinician-informed nominal group study.
        EMA - Emerg Med Australas. 2021; 33: 25-33
        • Reed C.
        • Gerhardt S.
        • Fonseca I.
        • Robertson K.
        Case study: creating a healthy workplace in a surgical trauma intensive care unit.
        Crit Care Nurs Q. 2009; 32: 232-241
        • Pfaff K.A.
        • Freeman-Gibb L.
        • Patrick L.J.
        • DiBiase R.
        • Moretti O.
        Reducing the “cost of caring” in cancer care: evaluation of a pilot interprofessional compassion fatigue resiliency programme.
        J Interprof Care. 2017; 31: 512-519
        • Basu S.
        • Yap C.
        • Mason S.
        Examining the sources of occupational stress in an emergency department.
        Occup Med. 2016; 66: 737-742
        • McCray L.W.
        • Cronholm D.
        • Bogner H.R.
        • Gallo J.J.
        • Neill R.A.
        Resident physician burnout: is there hope?.
        Fam Med. 2008; 40: 626-632
        • Dyrbye L.N.
        • Harper H.
        • Mutier C.
        • Durning S.J.
        • Power D.V.
        • Massie F.S.
        • et al.
        A multi-institutional study exploring the impact of positive mental health on medical students’ professionalism in an era of high burnout.
        Acad Med. 2012; 87: 1024-1031