The lived experiences of patients and ambulance ramping in a regional Australian emergency department: An interpretive phenomenology study

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• 作者：Chris Kingswell ; RN ; BN^a ; Ramon Z. Shaban ; RN ; CICP ; PhD^b ; ^c ; ^{r.shaban@griffith.edu.au" class="auth_mail" title="E-mail the corresponding author} ; Julia Crilly ; RN ; PhD^b ; ^d
• 关键词：Ambulances ; Emergency departments ; Paramedics ; Patients ; Qualitative research
• 刊名：Australasian Emergency Nursing Journal
• 出版年：2015
• 出版时间：November 2015
• 年：2015
• 卷：18
• 期：4
• 页码：182-189
• 全文大小：542 K

文摘

Internationally, the workload of emergency departments (ED) has increased, resulting in overcrowding and frequent delays in the offloading of patients arriving via ambulance – referred to in Australia as ‘ambulance ramping’.

Methods

Using interpretive phenomenology, this study sought to understand the experience of ambulance ramping from the perspective of patients. Semi-structured interviews were undertaken with seven patients who presented to a regional Queensland ED via ambulance, and experienced an ambulance offload delay of >30 min.

Results

Ambulance ramping in the ED was described as ‘Being a patient, patient’, and three major themes emerged: Understanding the emergency healthcare system; Making do within the emergency healthcare system; and Being ‘in the dark’ during ambulance ramping. Most participants did not understand the antecedents to ambulance ramping, but understood some of the consequences. Most were happy to wait with paramedics for a bed and, although without privacy, felt safe. However, most participants felt ‘in the dark’ during ambulance ramping, due to communication difficulties regarding bed availability, and this led to frustration.

Conclusions

In light of the Australian Charter of Healthcare Rights, service improvement opportunities exist for patients arriving to the ED by ambulance to ensure delays are minimised and quality care is delivered.