Perceived Causes and Impact of Emergency Department Overcrowding on Nursing Performance and Patient Safety at Al-Iman General Hospital

Abstract

Background: Emergency Department (ED) overcrowding represents another issue that pervades hospitals across the world, and it affects the performance of nurses. The overcrowding of EDs increases the workload, and the stress involved heightens the possibility of missing nursing care.
Aim: This study aimed to identify the main causes of overcrowding and assess the impact of overcrowding on nursing performance (workload and missed care) and patient safety outcomes at Al-Iman General Hospital.
Design: A descriptive cross-sectional study design was utilized.
Setting: The current study was conducted at Al-Iman General Hospital, southern Riyadh, Saudi Arabia.
Sample: All the registered nurses (N = 103) who work in clinical roles in the Emergency Department at Al-Iman General Hospital. Tool: A systematic self-administered questionnaire which is divided into 4 parts.
Results: The majority of participants experienced elevated levels of mental (35.9%), physical (39.8%), and temporal (39.8%) demands due to overcrowding, along with considerable levels of effort (54.4%) and moderate levels of frustration (22.3%). MISSCARE was also evident in terms of specific tasks, such as documentation (35.9%) and patient education/discharge explanation (27.2%). In terms of patient safety, 46.6% agreed that overcrowding led to patients leaving without being seen, 38.8% noticed a decrease in the quality of care provided, and 41.7% noticed an increase in the number of medical errors.
Conclusion: Significant overcrowding in the ED of Al-Iman General Hospital increases the nursing workload and missed care, which negatively impacts patient safety. It is recommended that specific interventions aimed at staffing and workflow management should be implemented to reduce the impact of overcrowding on patient care and safety.