A descriptive analysis of emergency department overcrowding in a selected hospital in Kigali, Rwanda

ABSTRACT

Introduction:Emergency Centre (EC) overcrowding is a global concern. It limits timeous access to emergency care; prolongs patient suffering; compromises quality of clinical care; increases staff frustration and chances of exposing staff to patient violence and is linked to unnecessary preventable fatalities. The literature shows that a better understanding of this phenomenon may contribute significantly in coming up with solutions; hence the need to conduct this study in Rwanda.Methods:A quantitative descriptive design; guided by the positivist paradigm; was adopted in this study. Self-administered questionnaires were distributed to 40 nurses working in the EC. Only 38 returned questionnaires; thus making the response rate 95.Results:The findings revealed that EC overcrowding in Rwanda is characterised by what is considered as reasonable waiting time for a patient to be seen by a physician; full occupancy of beds in the EC; time spent by patients placed in the hallways waiting; and time spent by patients in waiting room before they are attended. Triggers of EC overcrowding were classified into three areas (a) those associated with community level services; (b) those associated with the emergency centre; (c) those associated with inpatient and emergency centre support services. Discussion:A number of recommendations were made; including the Ministry of Health in Rwanda adopting a collaborative approach in addressing EC overcrowding with emergency trained nurses and doctors playing an active role in coming up with resolutions to this phenomenon; conducting research that will lead to an African region definition of EC overcrowding and solutions best suited for the African context; and increasing the pool of nurses with emergency care training