Workload tools used in emergency departments: A scoping review

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Authors
Cowley, Jennifer
Author ORCID Profiles (clickable)
Degree
Master of Health Science
Grantor
Eastern Institute of Technology (EIT)
Date
2018
Supervisors
Lander, Patrick
Type
Masters Dissertation
Ngā Upoko Tukutuku (Māori subject headings)
Keyword
emergency nursing
workload tools
patient ratios
safe staffing
ANZSRC Field of Research Code (2020)
Citation
Cowley, J. (2018). Workload tools used in emergency departments: A scoping review. (Unpublished document submitted in partial fulfilment of the requirements for the degree of Master of Health Science). Eastern Institute of Technology (EIT), New Zealand. https://hdl.handle.net/10652/6053
Abstract
OBJECTIVE The objective of this research was to conduct a scoping review of existing research on emergency nurses’ use of workload tools in emergency departments. INTRODUCTION Recording the workload encountered by nurses working in emergency departments has been an area of concern for nurses, nursing unions and healthcare institutions, both nationally and internationally. The modelling of patient needs to nursing requirements in the dynamic healthcare setting of emergency departments has been a source of worldwide debate. To date no research has been conducted in New Zealand regarding workload tool utilisation in emergency departments. INCLUSION CRITERIA Essential elements for the literature review identified the population as emergency nurses, the concept under examination was workload tools, and the context where research was undertaken was emergency departments. The Joanna Briggs Institute format for scoping reviews was utilised. The literature search initially considered all resources that focused on emergency nurses’ workplace environments and workload tools, including published and unpublished primary sources. Studies published in English were inclusive. METHOD A literature search of articles published between 2000-2017 focusing on the emergency department nursing work environment was undertaken over a four-month period using the search engine Primo. Anonymous material was restricted. Keywords were “emergency departments”, and/or “workload assessments”, “emergency nurses’ workloads” and/or “assessment” and “safe staffing”. Active filters were “emergency department”, “patient”, “nurses” and “nursing". RESULTS 144 articles were identified. 54 additional articles were obtained through reference lists of the identified studies being hand searched for inclusion. 165 articles remained after duplicate articles were removed. The remaining material titles/abstracts were screened for the identification of the subject inclusion criteria – nursing workload tools used in emergency departments. 30 full text articles were reviewed using the Joanna Briggs Institute critical appraisal check lists for inclusion/exclusion analysis. 11 articles that identified 9 workload tools were included in the final analysis. These studies were summarised focusing on the tools validity, reliability and transferability, and then discussed in relation to the current New Zealand emergency department healthcare environment. CONCLUSION No one workload tool was identified as being effectively utilised in international emergency department healthcare settings. Research summarised in the review indicates poor emergency department transferability due to the generalisation of workload tools. Thus, workload tools require adaptation to offer clinical value within the unique cultural context of the New Zealand Emergency Department workplace. This scoping review concludes that further research is needed into the development and utilisation of workload tools used in the emergency department healthcare setting to provide clinical validity, reliability and transferability.
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