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{
    "pk": 7478,
    "title": "Comparison Between Emergency Department and Inpatient Nurses’ Perceptions of Boarding of Admitted Patients",
    "subtitle": null,
    "abstract": "Introduction: \nThe boarding of admitted patients in the emergency department (ED) is a major cause of crowding and access block. One solution is boarding admitted patients in inpatient ward (W) hallways. This study queried and compared ED and W nurses’ opinions toward ED and W boarding. It also assessed their preferred boarding location if they were patients.\n \nMethods: \nA survey administered to a convenience sample of ED and W nurses was performed in a 631-bed academic medical center (30,000 admissions/year) with a 68-bed ED (70,000 visits/ year). We identified nurses as ED or W, and if W, whether they had previously worked in the ED. The nurses were asked if there were any circumstances where admitted patients should be boarded in ED or W hallways. They were also asked their preferred location if they were admitted as a patient. Six clinical scenarios were then presented, and the nurses’ opinions on boarding based on each scenario were queried.\n \nResults: \nNinety nurses completed the survey, with a response rate of 60%; 35 (39%) were current ED nurses (cED), 40 (44%) had previously worked in the ED (pED). For all nurses surveyed 46 (52%) believed admitted patients should board in the ED. Overall, 52 (58%) were opposed to W boarding, with 20% of cED versus 83% of current W (cW) nurses (\nP \n< 0.0001), and 28% of pED versus 85% of nurses never having worked in the ED (nED) were opposed (\nP \n< 0.001). If admitted as patients themselves, 43 (54%) of all nurses preferred W boarding, with 82% of cED versus 33% of cW nurses (\nP \n< 0.0001) and 74% of pED versus 34% nED nurses (\nP \n= 0.0007). The most commonly cited reasons for opposition to hallway boarding were lack of monitoring and patient privacy. For the 6 clinical scenarios, significant differences in opinion regarding W boarding existed in all but 2 cases: a patient with stable chronic obstructive pulmonary disease but requiring oxygen, and an intubated, unstable sepsis patient.\n \nConclusion: \nInpatient nurses and those who have never worked in the ED are more opposed to inpatient boarding than ED nurses and nurses who have worked previously in the ED. Primary nursing concerns about boarding are lack of monitoring and privacy in hallway beds. Nurses admitted as patients seemed to prefer not being boarded where they work. ED and inpatient nurses seemed to agree that unstable or potentially unstable patients should remain in the ED but disagreed on where more stable patients should board. [West J Emerg Med 2013;14(2):90-95.]",
    "language": "en",
    "license": {
        "name": "Creative Commons Attribution-NonCommercial  4.0",
        "short_name": "CC BY-NC 4.0",
        "text": "Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\r\n\r\nNonCommercial — You may not use the material for commercial purposes.\r\n\r\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.",
        "url": "https://creativecommons.org/licenses/by-nc/4.0"
    },
    "keywords": [
        {
            "word": "crowding"
        },
        {
            "word": "overcrowding"
        },
        {
            "word": "hallway"
        },
        {
            "word": "emergency department"
        },
        {
            "word": "Emergency Medicine"
        }
    ],
    "section": "Emergency Department Access",
    "is_remote": true,
    "remote_url": "https://escholarship.org/uc/item/3bw4p9rb",
    "frozenauthors": [
        {
            "first_name": "Bryce",
            "middle_name": "C.",
            "last_name": "Pulliam",
            "name_suffix": "",
            "institution": "University of California Davis Medical Center, Department of Emergency Medicine,\nSacramento, California",
            "department": "None"
        },
        {
            "first_name": "Mark",
            "middle_name": "Y.",
            "last_name": "Liao",
            "name_suffix": "",
            "institution": "University of California Davis Medical Center, School of Medicine, Sacramento,\nCalifornia",
            "department": "None"
        },
        {
            "first_name": "Theodore",
            "middle_name": "M.",
            "last_name": "Geissler",
            "name_suffix": "",
            "institution": "University of California Davis Medical Center, School of Medicine, Sacramento,\nCalifornia",
            "department": "None"
        },
        {
            "first_name": "John",
            "middle_name": "R.",
            "last_name": "Richards",
            "name_suffix": "",
            "institution": "University of California Davis Medical Center, Department of Emergency Medicine,\nSacramento, California",
            "department": "None"
        }
    ],
    "date_submitted": "2012-06-20T09:02:27Z",
    "date_accepted": "2012-06-20T09:02:27Z",
    "date_published": "2013-01-24T21:21:15Z",
    "render_galley": null,
    "galleys": [
        {
            "label": "",
            "type": "pdf",
            "path": "https://journalpub.escholarship.org/westjem/article/7478/galley/4418/download/"
        }
    ]
}