748 SECUre -a multicenter survey of the safety of emergency care in UK emergency departments

Aims/Objectives/Background According to safety theory, frontline staff are often best informed identify problems that threaten in their workplace. Surveying emergency department (ED) is a straightforward method assess culture including investigating risks, identifying solutions and evaluating interventions. This study‘s aim was validate an ED questionnaire specifically for use the UK provide overview of risks. Differences between doctors nurses’ perception were also analysed. Methods/Design Safety has been focus succession high-profile reports, Francis Report. Using groupings similar US questionnaire, Cronbach’s Alpha calculated across five categories as estimate reliability. Simple descriptive statistics used risks or good practice. Chi Square test compared individual sites’ results with national highlight outlier questions (i.e. department’s strengths weaknesses). significant differences responses from nurses doctors. Abstract 748 Table 1 Category Item statement Overall respenses Questions (%) Respenses Sig. difference Doctors/Nurses (p<0.05) Never/Rarely Sometimes Usually/Always Teamwork (Cronbach’s alpha = 0.65) Interruptions disrupt ability care 5 40 55 8/3 45/37 47/60 * Doctors work well together 0 94 0/0 4/6 96/94 Nurses feel empowered question instructions when necessary 2 15 84 1/3 10/16 89/81 Important clinical information lost handovers at change shift 48 45 6 54/45 42/48 5/7 There communication patient management 13 86 1/1 6/18 93/81 44 50 45/43 50/50 Leadership 0.78) open, non-judgemental environment reporting concerns 22 71 4/8 14/28 82/64 In providing care, top priority 85 10/14 89/82 New mentored by more experience 9 24 67 2/14 17/28 81/58 leadership takes action improve patients 3 21 76 1/4 12/27 87/68 Protocols high risk complex medication administration (e.g. sedation, thrombolytic therapy, blood transfusion) 5/5 94/94 Junior adequately supervised 4 16 80 1/6 7/23 92/72 Incident 72 4/7 24/22 72/71 Physical Environment & Equipment 0.80) It easy find doctor/clinician caring 25 70 2/7 15/32 83/62 Mental health cared safe 33 42 14/33 33/33 53/34 Functioning routine physical examination equipment ophthalmoscopes, lights gynaecologic examination, manual pressure cuffs) available 11 65 7/14 23/25 70/61 Monitoring devices pulse oximeters, vital sign monitors, cardiac monitors) function 7 79 0/11 4/22 95/67 sufficient space delivery 36 32 29/41 32/32 38/28 personnel physically while working 19 74 1/10 9/36 90/64 nurse specific 31 63 8/5 35/28 57/67 Staff External Team 0.76) Appropriately experienced carry out triage/assessment 17 3/4 15/18 82/78 Clinician staffing handle load during busy periods 30 39 23/35 38/39 39/26 Nurse 43 36/47 35/33 29/20 Stat medications administered timely manner 6/6 36/29 58/65 CT (computed tomography) scans completed within hour clinically indicated 62 30/33 65/60 The number exceeds capacity 8 11/6 46/38 42/56 signs/Early Warning Scores effectively 14 13/14 86/83 Initial assessment/triage works my 20 77 2/4 19/21 79/75 critical team support 12 1/2 90/84 Patients receive access mental 28 20/35 37/41 44/25 Organisatisational Factors Informatics 0.73) unduly pressurised hospital managers prioritise targets over 10 17/6 47/38 35/56 transferred in-patient bed 34 30/29 35/36 34/34 Hospital escalation procedures effective improving flow 33/25 33/38 34/37 improvements 11/18 40/41 49/41 Procedures report errors near misses user-friendly 18/15 26/18 56/68 Effective systems place alerts allergies, dementia) 18 18/18 78/75 difficult obtain patient’s primary records needed 22/20 32/52 46/28 gain medical record 54 61/50 28/38 22/12 adequate functioning computers 58 21/20 23/21 56/59 Figure Results/Conclusions 1060 participants recruited sites (see attachments). Analysis highlighted posed interruptions, negative effects targets, deficient (especially care) crowding. Identifying provided opportunities learn excellence. Comparing highlights additional nursing staff. study provides first step towards assessing describing UK.