Paper
Friday, July 13, 2007
This presentation is part of : Primary Care Issues
Negative Labeling of Primary Care Patients in an Irish A&E Department
Yvonne Conway, MsC, BNS, RN, Nursing Studies, National University of Ireland, Galway, Galway, Ireland
Learning Objective #1: gain insight into the complexities involved in identifying Emergency Nurses' Attitudes towards Primary Care Patients
Learning Objective #2: discuss how a medically biased culture within a department can result in negative attitude formation and patient labelling

The overall purpose of this quantitative study was to explore Irish Emergency Nurses attitudes towards patients who present to Accident &Emergency (A&E) Departments with primary care type needs. One of the key research questions to stem from this aim was whether A&E nurses label these patients as being “inappropriate attenders” as much of the international literature suggests.

 Limited empirical research has been conducted which examines A&E nurses perceptions of this population of patients.  A descriptive survey approach was used and data collected using a self-developed structured questionnaire. A non-probability convenience sample of 52 qualified A&E nurses was obtained from a 600 bed large urban Regional teaching hospital in the Republic of Ireland. A pilot study was conducted in the A&E department of a second regional teaching hospital. Permission was obtained from the directors of nursing of both hospitals.

 The data within the questionnaires were analysed using descriptive and inferential statistical measures.  Spearman’s rho was utilized to investigate the relationships between the responses to the Likert Scale statements and a high number of correlations were found.  Some of these are statistically significant at the smaller p values of <.01 and even <.001 which suggests that the items are highly reliable and have low-error components.

 The findings of the study suggest that A&E nurses appear to label patients based on the “suitability” of the presenting condition from a medical perspective. Analysis revealed 77% of the respondents felt that many patients presenting to A&E were “inappropriate” with 66% agreeing that they should be referred back to their primary care physician and not offered treatment in A&E.  It is clear that negative attitudes amongst A&E staff towards this category of patients must be challenged with education and training and clarity sought on the primary care role of Emergency Departments within the Irish health service..