Interventions to improve nurse-family communication in the emergency department: A scoping review.

AIM: To determine and describe what interventions exist to improve nurse-family communication during the waiting period of an emergency department visit. BACKGROUND: Communication between nurses and families is an area needing improvement. Good communication can improve patient outcomes, satisfaction with care and decrease patient and family anxiety. DESIGN: Scoping Review. METHODS: A scoping review was conducted following the Joanna Briggs Institution methodology: (1) identify the research question, (2) define the inclusion criteria, (3) use a search strategy to identify relevant studies using a three-step approach, (4) select studies using a team approach, (5) data extraction, (6) data analysis, and (7) presentation of results. DATA SOURCES: Medline, CINAHL, EMBASE, PsychInfo and grey literature were searched on 3 August 2022. RESULTS: The search yielded 1771 articles from the databases, of which 20 were included. An additional seven articles were included from the grey literature. Paediatric and adult interventions were found targeting staff and family of which the general recommendations were summarised into communication models. CONCLUSION: Future research should focus on evaluating the effectiveness of interventions using a standardised scale, understanding the specific needs of families, and exploring the communication models developed in this review. IMPLICATIONS FOR CLINICAL PRACTICE: Communication models for triage nurses and all emergency department nurses were developed. These may guide nurses to improve their communication which will contribute to improving family satisfaction. REPORTING METHOD: PRISMA-ScR. TRIAL AND PROTOCOL REGISTRATION: Protocol has been registered with the Open Science Framework, registration number 10.17605/OSF.IO/ETSYB. PATIENT OR PUBLIC CONTRIBUTION: No patient or public contribution.

Mutuality in nurse-caregiver relationships in pediatric nursing: A concept analysis.

PROBLEM: Mutuality is often used in literature in the context of family-centered care and therapeutic relationship building. A therapeutic relationship is necessary to deliver family-centered care, strengthen family health and function, increase patient and family satisfaction, reduce anxiety, and empower decision-makers. Despite mutuality being such an important concept, it is not well defined in the literature. ELIGIBILITY CRITERIA: The Walker and Avant method for concept analysis was used. The databases Medline, PSYCHInfo, CINHAL and Nursing & Allied Health were searched for texts in English from 1997 to 2021 using specific search terms. SAMPLE: Of the 248 results, 191 articles were screened and 48 met inclusion criteria. RESULTS: Mutuality was found to be a process of dynamic reciprocity whereby the partners contribute uniquely to their shared goals, values, or purposes. CONCLUSION: Mutuality is an important aspect of family-centered care and is used throughout nursing and advanced nursing practice. IMPLICATIONS: The concept of mutuality should be incorporated into family-centered care policies, as without it, family-centered care cannot be established. Further research should be done to develop methods or educational techniques to establish and maintain mutuality in advanced nursing practice.

Why go to the emergency department? Perspectives from persons with borderline personality disorder.

Through this qualitative study, we explored frequent emergency department use by persons with borderline personality disorder from their perspective. Interpretive description guided the study design, and data were collected through interviews with six individuals diagnosed with borderline personality disorder who had at least 12 emergency department visits for reasons related to their mental illness within a 1-year timeframe. Using thematic data analysis, we articulate the participants' experiences through two broad themes: cyclic nature of emergency department use and coping skills and strategies. Unstable community management that leads to self- or crisis presentation to the emergency department often perpetuated emergency department use by our participants and the ensuing interventions aimed at acute stabilization. The participants identified a desire for human interaction and feelings of loneliness, failure of community resources (such as crisis lines or therapy), and safety concerns following suicidal ideation, self-harm, or substance use as the main drivers for their emergency department visits. Our participants identified several potential strategies to protect them against unnecessary emergency department use and improve their health care overall. More work is needed to explore the viability and effectiveness of these suggestions.