ABSTRACT
Emergency department (ED) overcrowding is a global health issue that is associated with poor quality of care and affects the timeliness of treatment initiation. The purpose of this systematic review is to assess the association between overcrowding and delay in treatment. A systematic review was conducted using four databases (CINAHL, PubMed, Scopus, Cochrane Library), following the preferred reporting items for systematic reviews and meta-analysis (PRISMA). A structured search was conducted to identify peer-reviewed articles aimed at assessing the relationship between overcrowding and delay in treatment, published between January 2000 and January 2021. Only studies that were conducted in the ED settings were included, and that includes both triage and observation rooms. The studies were appraised using two quality appraisal tools including the critical appraisal skills programme (CASP) for cohort studies and the Joanna Briggs Institute (JBI) checklist tool for cross-sectional studies. A total of 567 studies screened, and 10 met the inclusion criteria. Of these studies, 8 were cohorts and 2 were cross-sectionals. The majority reported that overcrowding is associated with a delay in the initiation of antibiotics for patients with sepsis and pneumonia. The review identified that overcrowding might impact time-to-treatment and, thus, the quality of care delivered to the patient. However, further research aimed at finding feasible solutions to overcrowding is encouraged.
ABSTRACT
AIM: Hospitals operate on a 24-hr basis, with shiftwork being unavoidable for most nurses. This study aims to explore the impact of night shiftwork rotations on nurses' physiological status, work performance and patient safety concerns among nurses in public hospitals. DESIGN: A descriptive predictive correlational design using a self-administered questionnaire. METHODS: Electronic and printable survey questionnaires were distrusted among nurses working in public hospitals in multiple regions of Saudi Arabia. The study recruited 1,256 nurses from different nationalities, hospital work units and work experience. RESULTS: A large proportion of nurses on night shiftwork encountered patient safety issues (85.7%) and physiological consequences (93.6%). Counselling sessions and programmes to support at-risk nurses are recommended.
