Investigation of the factors affecting the smooth and efficient operation of the emergency department (ED) at Cyprus Hospitals? (Original Research)
Efstathiou Andri MSc, PhD, RN- Cyprus health minister office, Symeou Mikaella MSc, PhD. RN- General Hospital of Nicosia, Dafni Kaitelidou Assistant professor National and Kapodistrian university of Athens. Dr George Charalambous Frederick University Cyprus.
Abstract
Background: The Emergency Department (ED) is the heart of every modern hospital and at all times must provide medical and nursing emergency care, accepting large numbers of victims. This Department is the section of the hospital that aims reception, health diagnosis and treatment of patients with a range and variety of problems. However, in recent years scientists have found that a combination of factors affect the ED operation and make the access for the patients very difficult.
Purpose: The aim of this study was to investigate the various factors which influence the operation of the A&E of the public Hospitals in Cyprus and to pinpoint the weaknesses of Primary Health Care in Cyprus.
Methods: This was a combination of a quantitative and qualitative research which was conducted in Cyprus between the months of March and May of the year 2016. The qualitative research included structured interviews with the Emergency Department’s managers, Primary Health Care doctors and patients’ representatives. The sampling of the quantitative research was carried out by an analogue random sampling and the research tool used was the Hospital Urgencies Appropriateness Protocol (HUAP). The sample of the study consisted of 910 patients who visited the Emergency Departments, five ED managers, eight Primary Health Care doctors and seven patients’ representatives.
Results: The qualitative research and structured interiews revealed that Emergency Department managers and patients’ representatives believe that ED need to upgrade their services to meet the needs of patients, wimilar responses were given by Primary Dare Physicians about their services as well. Through the quantitative research, it was found that 52.2% of the patients who visited the ED were in the age category of under 45 years old and 80.9% replied that they were beneficiaries of public insurance coverage.
According to their categorization on the patient Triage scale, 63.2% were included in the 4-5 category. According to the Triage nurses, 48.8% of the patients could have been seen by Primary Health Care. Inappropriate visits amounted to 39.1% and had positive correlation with the patient’s province of origin, age, education level, insurance cover and finally their means of arrival to the ED.
Discussion: This research suggests that ED in public hospitals in Cyprus are unable to respond fully to the needs of their patients and this is also the case for Primary Health Care services. It is essential to implement «Healthy» Health Systems with full population coverage, ease of access and establish strong Primary Health Care systems that will inspire confidence in citizens.
Keywords: «Emergency Departments», «Malfunction of ED», «Factors that affect ED operations», «Inappropriate visits in ED».
