What are the information needs of patients receiving procedural sedation in the Emergency Department? A descriptive exploratory study

This research addressed the question ‘what information, and in what format, do patients, nurses and medical staff believe should be provided for patients undergoing procedural sedation in the Emergency Department setting?’ Providing sedation to perform painful procedures on patients in the hospital Emergency Department (ED) setting has become commonplace in recent years. Best practice guidelines address minimal staffing levels, staff expertise and minimal monitoring and resuscitative equipment but do not cover how patients should receive information about their sedation or what information should be included. Whilst providing patients with additional written information prior to planned procedures is well reported in the literature, no prior studies looked at the effect of giving supplemental written information specifically for procedural sedation in the ED setting. METHOD This was a qualitative, descriptive study involving face-to-face semi-structured interviews with patient participants and two focus groups; one with ED nursing staff and the other with medical staff. Eight patients with recent experience of receiving procedural sedation in a New Zealand regional ED were convenience sampled. Purposive sampling was utilized to recruit five ED nurses and four ED medical staff with experience of monitoring and providing procedural sedation in the same ED. RESULTS Inductive thematic analysis was applied to the interview and focus group transcripts and several themes were identified. The overarching need of patient participants was to feel safe and to trust the staff. The information requirements that contributed to meeting this need, recognized by all participant groups, were: competence and efficiency of staff; explanations of progress, delays, procedures and the environment; repetition and clarification of information using a whole team approach; support person presence; and medico-legal discussions including risk versus benefit information. Pharmacology was important to only the doctor participants. Additional written information was not considered to be of value by any of the patient participants. CONCLUSION This research found that adherence to national and international clinical practice guidelines appears to contribute positively to meeting patients’ information needs. Incorporation of these guidelines into a clear local policy that is followed consistently by the whole team effectively provides consistent high quality ED sedation that is deliverable within the local resources. Consistent and repeated information given verbally by multiple members of a cohesive team appears to meet patients’ need to feel safe and to trust the staff without the requirement for additional written information. However, whilst patients in this study rejected the need for additional written information, further research into whether support persons value written information may be beneficial.

Name thesis:degree_name

Master of Nursing

Level thesis:degree_level

Masters

Grantor

Eastern Institute of Technology

Year dc:date.issued

2013

Author dc:creator

• Revell, Suzanne

• New Zealand
• patients
• emergency departments (EDs)
• procedural sedation
• patient information
• patient needs
• interviews

Statement dc:rights

• All rights reserved

Language dc:language.iso

en

Handle dc:identifier.uri

https://hdl.handle.net/10652/6497

OAI identifier oai:identifier

oai:null:10652/6497