A&E Nurses Under Pressure To Meet Four Hour Target, UK

Main Category: Nursing / Midwifery
Article Date: 30 Apr 2008 - 3:00 PDT

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Nine out of ten (1) accident & emergency (A&E) nurses have felt unduly pressured to meet the four-hour waiting target, according to a new survey from the Royal College of Nursing (RCN).

The survey of over 500 frontline A&E nursing staff shows that the pressure to meet the four-hour waiting time has had negative consequences for the quality of patient care. Three quarters (75%) of nurses say that patients were regularly admitted to inappropriate wards (2) just to meet the target.

Whilst more than half (52%) of A&E nurses said that the introduction of the target generally had a positive impact on patient care, many believed that lowering the percentage of patients who had to be treated within the time limit would improve the quality of care.

Chief Executive & General Secretary of the Royal College of Nursing, Dr. Peter Carter, said:

"More than anything, A&E nurses want to meet the needs of patients, but they work in a system which compels them to meet the needs of targets. Our members, who work in A&E departments up and down the country, say that this target is too restrictive and unrealistic for them to provide the kind of care they would like."

"The RCN is calling for a more realistic target of 95% of patients seen within four hours rather than the current 98%. This would give A&E staff the flexibility and the breathing space to deliver the personalised quality care that both patients and the government are demanding."

Other survey findings include:

- 55% have seen an expansion and development of nurse roles since the introduction of the target

- 78% felt that the introduction of the four-hour target has meant that certain groups of patients with multiple and complex needs have had their care rushed and compromised

- More than half of nurses (59%) felt that the responsibility to meet the target lay primarily with nursing staff as opposed to other clinical colleagues.

Notes

Royal College of Nursing (RCN) is the voice of nursing across the UK and is the largest professional union of nursing staff in the world. The RCN promotes the interest of nurses and patients on a wide range of issues and helps shape healthcare policy by working closely with the UK Government and other national and international institutions, trade unions, professional bodies and voluntary organisations.

1) 93% of respondents said that they felt unduly pressured to deliver the 4-hour target
2) This means anywhere outside the Accident & Emergency Department. Once a patient is across the threshold of the A&E department, they have officially been discharged and they are off the A&E waiting list.

Royal College of Nursing