The "4-hour target": emergency nurses' views
- PMID: 17513535
- PMCID: PMC2658273
- DOI: 10.1136/emj.2006.044933
The "4-hour target": emergency nurses' views
Abstract
Objective: To explore nurses' views and to identify the perceived advantages and disadvantages of the "4-hour target."
Methods: The study was based in one emergency department (ED) in the UK and took a generic qualitative approach. A stratified sample of nine experienced ED nurses were recruited for semi-structured interviews. Data was analysed using the framework analysis approach.
Results: The 4-hour target was considered an overall success in reducing waiting times and increasing patient satisfaction. However, staff expressed concerns over the imposed nature of the target, workload pressures, quality of care, and the level of support from secondary and primary care.
Conclusion: Although deemed an overall success, there were reservations as to the target's sustainability. Recommendations are made for improved communication between primary and secondary care and establishing the target as a shared goal within the hospital environment.
Conflict of interest statement
Competing interests: None
Similar articles
-
Triaging the Emergency Department, Not the Patient: United States Emergency Nurses' Experience of the Triage Process.J Emerg Nurs. 2018 May;44(3):258-266. doi: 10.1016/j.jen.2017.06.010. Epub 2017 Jul 25. J Emerg Nurs. 2018. PMID: 28750891
-
Effects of the four-hour operational standard.Emerg Nurse. 2010 Feb;17(9):10-5. doi: 10.7748/en2010.02.17.9.10.c7534. Emerg Nurse. 2010. PMID: 20209749
-
The Acute Care Nurse Practitioner: challenging existing boundaries of emergency nurses in the United Kingdom.J Clin Nurs. 2006 Mar;15(3):253-63. doi: 10.1111/j.1365-2702.2006.01306.x. J Clin Nurs. 2006. PMID: 16466474
-
Nurse-initiated x-ray of isolated limb fractures in the emergency department: research outcomes and future directions.Aust Crit Care. 2002 Aug;15(3):119-22. doi: 10.1016/s1036-7314(02)80052-2. Aust Crit Care. 2002. PMID: 12371379 Review.
-
ED Greeter Nurse: Transforming Triage and Improving Patient Care Outcomes.J Emerg Nurs. 2015 May;41(3):265-7; quiz 269-70. doi: 10.1016/j.jen.2015.01.009. Epub 2015 Mar 17. J Emerg Nurs. 2015. PMID: 25794979 Review. No abstract available.
Cited by
-
Overcrowding in emergency department: an international issue.Intern Emerg Med. 2015 Mar;10(2):171-5. doi: 10.1007/s11739-014-1154-8. Epub 2014 Dec 2. Intern Emerg Med. 2015. PMID: 25446540
-
National targets, process transformation and local consequences in an NHS emergency department (ED): a qualitative study.BMC Emerg Med. 2014 Jun 13;14:12. doi: 10.1186/1471-227X-14-12. BMC Emerg Med. 2014. PMID: 24927819 Free PMC article.
-
A qualitative study exploring the factors influencing admission to hospital from the emergency department.BMJ Open. 2017 Aug 29;7(8):e011543. doi: 10.1136/bmjopen-2016-011543. BMJ Open. 2017. PMID: 28851767 Free PMC article.
-
US emergency department performance on wait time and length of visit.Ann Emerg Med. 2010 Feb;55(2):133-41. doi: 10.1016/j.annemergmed.2009.07.023. Epub 2009 Oct 1. Ann Emerg Med. 2010. PMID: 19796844 Free PMC article.
-
Effects of multidisciplinary teamwork on lead times and patient flow in the emergency department: a longitudinal interventional cohort study.Scand J Trauma Resusc Emerg Med. 2013 Nov 1;21:76. doi: 10.1186/1757-7241-21-76. Scand J Trauma Resusc Emerg Med. 2013. PMID: 24180367 Free PMC article. Clinical Trial.
References
-
- Green T, Thorogood N.Qualitative methods for health research. London: Sage Publications, 2004
-
- Department of Health The NHS plan. London: HMSO, 2000
-
- Department of Health Reforming emergency care. London: HMSO, 2001
-
- Department of Health Clinical exceptions to the 4 hour emergency care target. 2003. http://www.dh.gov.uk/en/Publicationsandstatistics/Publications/Publicati... (accessed 23 March 2007)
MeSH terms
LinkOut - more resources
Full Text Sources