A qualitative descriptive study of the contextual factors influencing the practice of emergency nurses in managing emerging infectious diseases

Stanley K K Lam,Enid W Y Kwong,Maria S Y Hung,Samantha M C Pang,Wai T Chien

doi:10.1080/17482631.2019.1626179

Abstract

ABSTRACT Purpose: Emergency nurses are engaged in the management of epidemic events that unfold along with the evolution of diseases. The goal of this study was to explore the contextual factors that inhibited the ability of emergency nurses to perform their duties in response to an outbreak. Methods: A qualitative descriptive design was used to explore the experiences and perceptions of emergency nurses. Participants were purposively recruited from 12 emergency departments in Hong Kong. Semi-structured face-to-face individual interviews were conducted with 26 emergency nurses. The audio-recorded interviews were transcribed verbatim and interpreted with a thematic analysis approach. Results: Four intertwined themes emerged from the analysis: resource constraints, threats of infection, ubiquitous changes and lingering uncertainties. These themes portrayed the constraints and challenges surrounding the work environment of emergency nurses. Conclusion: This study described the instabilities and vulnerabilities of the circumstances in which the emergency nurses were situated in during epidemic events. The findings shed light on the importance of hospitals and emergency departments in addressing both the technical problems and adaptive challenges that face emergency nurses during epidemic events.

Highlights

Despite efforts to promote disease surveillance and infection control, the outbreak of emerging infectious diseases (EIDs) has remained a major threat to global public health and presents enormous challenges for healthcare systems worldwide (Weber, Rutala, Fischer, Kanamori, & Sickbert-Bennett, 2016)
All of the participants reported that EID management created an additional workload on top of their already heavy workload
The major barriers facing nurses under such circumstances were mainly infection risk, resource shortages, workplace changes and uncertainties surrounding the situation. These impediments in the everyday practices of emergency care delivery were the fundamental sources making up the tasks and issues facing emergency nurses and that compelled them to engage in EID management

Summary

Introduction

Despite efforts to promote disease surveillance and infection control, the outbreak of emerging infectious diseases (EIDs) has remained a major threat to global public health and presents enormous challenges for healthcare systems worldwide (Weber, Rutala, Fischer, Kanamori, & Sickbert-Bennett, 2016). The extended nature of emergency services in an EID event requires emergency nurses to demonstrate the capability to offer emergency care services to the public and the capacity to participate in public health responses and combat a large-scale public health emergency In addition to their important role in the public health response to an epidemic event, emergency nurses face barriers to fulfilling their duties in the course of EID management. It has been reported that the issue of emergency nurses’ non-compliance with guidelines could still occur, regardless of the availability of sufficient resources (Lam & Hung, 2013) This suggests the existence of other contextual factors that affect the decision about whether to conform to a protocol. What is less clear is which factors in the emergency care setting adversely affect

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Discussion

Conclusion