Measuring organizational context in Australian emergency departments and its impact on stroke care and patient outcomes.
Adult
Aged
Australia
/ epidemiology
Cross-Sectional Studies
Emergency Service, Hospital
/ organization & administration
Female
Humans
Male
Middle Aged
Organizational Culture
Outcome Assessment, Health Care
/ standards
Perception
Quality of Health Care
/ standards
Retrospective Studies
Stroke
/ complications
Surveys and Questionnaires
Alberta Context Tool
Emergency care
Guideline implementation
Knowledge transfer
Organizational context
Research utilization
Journal
Nursing outlook
ISSN: 1528-3968
Titre abrégé: Nurs Outlook
Pays: United States
ID NLM: 0401075
Informations de publication
Date de publication:
Historique:
received:
21
04
2020
revised:
22
07
2020
accepted:
15
08
2020
pubmed:
29
9
2020
medline:
2
2
2021
entrez:
28
9
2020
Statut:
ppublish
Résumé
Emergency departments (ED) are challenging environments but critical for early management of patients with stroke. To identify how context affects the provision of stroke care in 26 Australian EDs. Nurses perceptions of ED context was assessed with the Alberta Context Tool. Medical records were audited for quality of stroke care and patient outcomes. Collectively, emergency nurses (n = 558) rated context positively with several nurse and hospital characteristics impacting these ratings. Despite these positive ratings, regression analysis showed no significant differences in the quality of stroke care (n = 1591 patients) and death or dependency (n = 1165 patients) for patients in EDs with high or low rated context. Future assessments of ED context may need to examine contextual factors beyond the scope of the Alberta Context Tool which may play an important role for the understanding of stroke care and patient outcomes in EDs.
Sections du résumé
BACKGROUND
Emergency departments (ED) are challenging environments but critical for early management of patients with stroke.
PURPOSE
To identify how context affects the provision of stroke care in 26 Australian EDs.
METHOD
Nurses perceptions of ED context was assessed with the Alberta Context Tool. Medical records were audited for quality of stroke care and patient outcomes.
FINDINGS
Collectively, emergency nurses (n = 558) rated context positively with several nurse and hospital characteristics impacting these ratings. Despite these positive ratings, regression analysis showed no significant differences in the quality of stroke care (n = 1591 patients) and death or dependency (n = 1165 patients) for patients in EDs with high or low rated context.
DISCUSSION
Future assessments of ED context may need to examine contextual factors beyond the scope of the Alberta Context Tool which may play an important role for the understanding of stroke care and patient outcomes in EDs.
Identifiants
pubmed: 32981669
pii: S0029-6554(20)30623-0
doi: 10.1016/j.outlook.2020.08.009
pii:
doi:
Types de publication
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
103-115Informations de copyright
Copyright © 2020 Elsevier Inc. All rights reserved.