Change search
CiteExportLink to record
Permanent link

Direct link
Cite
Citation style
  • apa
  • ieee
  • modern-language-association-8th-edition
  • vancouver
  • Other style
More styles
Language
  • de-DE
  • en-GB
  • en-US
  • fi-FI
  • nn-NO
  • nn-NB
  • sv-SE
  • Other locale
More languages
Output format
  • html
  • text
  • asciidoc
  • rtf
Referrals to emergency departments: the processes and factors that influence decision-making among community nurses
School of Health and Medical Sciences, Örebro University, Örebro, Sweden.
School of Health and Medical Sciences, Örebro University, Örebro, Sweden.
School of Social and Health Sciences, Halmstad University, Halmstad, Sweden.
University of Gävle, Faculty of Health and Occupational Studies, Department of Health and Caring Sciences, Nursing science. Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden.
2014 (English)In: Open Journal of Nursing, ISSN 2162-5336, E-ISSN 2162-5344, Vol. 4, no 5, p. 366-374Article in journal (Refereed) Published
Abstract [en]

The aim of the study was to describe the basis on which municipal care registered nurses (RN) make decisions and their experiences when referring older persons from nursing homes to emergency departments (EDs). RNS’ in the community are to ensure that older adults receive good care quality in nursing home. This study used a descriptive design with a qualitative content analysis. The analysis of the data from the 13 interviews revealed one theme “Shared responsibilities in the best interests of the older person reduce feelings of insufficiency”. The content was formulated, which revealed the RNs’ feelings, reasoning and factors influencing them and their actions in the decision-making situation, before the patients were referred to an emergency department. Complex illnesses, non-adapted organizations, considerations about what was good and right in order to meet the older person’s needs, taking account of her/his life-world, health, well-being and best interests were reported. Co-worker competencies and open dialogues in the “inner circle” were crucial for the nurses’ confidence in the decision. Hesitation to refer was associated with previous negative reactions from ED professionals. The RN sometimes express that they lacked medical knowledge and were uncertain how to judge the acute illness or changes. Access to the “outer circle”, i.e. physicians and hospital colleagues, was necessary to counteract feelings of insecurity about referrals. When difficult decisions have to be made, not only medical facts but also relationships are of importance. To strengthen the RNs’ and staff members’ competence by means of education seems to be important for avoiding unnecessary referrals. Guidelines and work routine need to be more transparent and referrals due to the lack of resources are not only wasteful but can worsen the older persons’ health.

Place, publisher, year, edition, pages
2014. Vol. 4, no 5, p. 366-374
Keyword [en]
Emergency Department, Older Persons, Municipal Care, Registered Nurse, Decision Making
National Category
Nursing
Identifiers
URN: urn:nbn:se:hig:diva-16602DOI: 10.4236/ojn.2014.45042OAI: oai:DiVA.org:hig-16602DiVA: diva2:715320
Available from: 2014-05-03 Created: 2014-05-03 Last updated: 2018-01-25Bibliographically approved

Open Access in DiVA

ED referrals(302 kB)86 downloads
File information
File name FULLTEXT01.pdfFile size 302 kBChecksum SHA-512
819fc6fdbf26b1a0221b3193df92475a900dc9db86461c6480fea8fba41d69e53a9c532b36f2c92b1c339ca926d941b98797564d759659003e0f64c6799f7337
Type fulltextMimetype application/pdf

Other links

Publisher's full text

Search in DiVA

By author/editor
Mamhidir, Anna-Greta
By organisation
Nursing science
In the same journal
Open Journal of Nursing
Nursing

Search outside of DiVA

GoogleGoogle Scholar
Total: 86 downloads
The number of downloads is the sum of all downloads of full texts. It may include eg previous versions that are now no longer available

doi
urn-nbn

Altmetric score

doi
urn-nbn
Total: 722 hits
CiteExportLink to record
Permanent link

Direct link
Cite
Citation style
  • apa
  • ieee
  • modern-language-association-8th-edition
  • vancouver
  • Other style
More styles
Language
  • de-DE
  • en-GB
  • en-US
  • fi-FI
  • nn-NO
  • nn-NB
  • sv-SE
  • Other locale
More languages
Output format
  • html
  • text
  • asciidoc
  • rtf