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2047 The impact of patient-to-staff incivility in the emergency department: a qualitative study
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  1. Ewan AM Pow1,
  2. Janet Skinner2
  1. 1The University of Aberdeen
  2. 2NHS Lothian/The University of Edinburgh

Abstract

Aims and Objectives This qualitative study aims to establish the existence and impact of patient-to-staff incivility on staff wellbeing and patient care in the Emergency Department (ED).

Background Research has indicated that incivility between staff in clinical environments negatively impacts their wellbeing, clinical performance and the care patients receive (Riskin et al., 2015). However, incivility can occur between any group of persons, including between staff and patients. There is currently no UK-based research investigating patient-to-staff incivility in EDs; thus investigating this literature gap is important as there may be negative implications similar to staff-to-staff incivility. This aligns with Royal College of Emergency Medicine Research Priority-10.

Method and Design Ethical approval was received prior to commencement of this study and 3 EDs were identified as recruiting centres. A purposive sampling strategy was employed, and participants recruited via mixed methods. Informed written consent was received by all participants.

Semi-Structured interviews were used to collect data as the study was exploratory in nature and required flexibility for the interviewer to explore arising themes. Interviews were ~30 minutes long and were recorded and transcribed. Thematic analysis was used to analyse the transcripts and identify themes from the data.

Results and Conclusion 15 participants were recruited. Four main themes emerged in analysis of transcripts: ‘Training and Coping Strategies’, ‘Environmental Accentuation and the related Impact’, ‘Power Dynamics and Latent Factors’, and ‘Implications on Staff Resilience and Wellbeing’.

Conclusions This study confirms that patient-to-staff incivility exists in EDs and has negative implications on patient care and staff wellbeing. Findings included: Staff reduced the impact of patient-to-staff incivility on patient safety by relating incivil incidents to patients clinical conditions; Staff wellbeing can be better protected after incidents of incivility by providing peer-peer support as opposed to a traditional hierarchal structure; and that patient-to-staff incivility is a main cause of avoidance behaviours in ED staff.

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