The enigma: Decision-making to transfer residents to the emergency department; communication and care delivery between emergency department staff and residential aged care facilities' nurses.

Abstract

To investigate the experience of nurses involved in decision-making to transfer residents from a residential aged care facility (RACF) to their local hospital emergency department. This paper reports on the findings of the second phase of a two-phase study. Qualitative semi-structured interviews with 19 aged care nurses were conducted. Interviews were audio-taped and transcribed verbatim, and a thematic analysis was carried out. The analysis revealed five major themes that influenced decision-making in relation to the transfer of a resident from the residential aged care facility to the emergency department: conflict with key stakeholders; knowledge and experience; policy and process; stakeholder perception; and recognition and support. Robust outreach programs, support from other health-care professionals, and improving interdisciplinary understanding and communication between aged care nurses, paramedics and the emergency department would be advantageous to ensure effective care delivery and decision-making.