A Systematic Review of the Consumer Emergency Care Satisfaction Scale (CECSS).
Peter L T Hoonakker, Pascale Carayon, Roger L Brown and 1 others
PMID 35797636WHAT IT FOUND
The CECSS appears reliable and valid for asking ED patients and caregivers about nursing care satisfaction, but high scores are common and many studies used cross-sectional or convenience samples.
Key findings
01The CECSS shows high internal consistency, with Cronbach's alpha 0.81 to 0.97 for the full scale, 0.77 to 0.94 for Caring, and 0.86 to 0.93 for Teaching.
02High scores are common: 90% of respondents were satisfied, and 98% of patients in both groups were satisfied on Caring, leaving little room to show improvement.
03Overall study quality was low because the large majority of included studies were cross-sectional and 13 of 28 did not report a response rate.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
Most included studies were cross-sectional observational designs, so they cannot show that nursing care caused satisfaction. 13 of 28 studies did not report a response rate, and many used convenience samples, limiting generalizability. Two studies used aggregated data from earlier included studies, inflating respondent counts; without them, the total was 5,059 and average sample size was 202. The CECSS has ceiling effects, so high scores may not show improvement after changes. Studies used different CECSS versions, populations and settings, including patients, caregivers, hospital units, ambulance care and pediatric acute care wards, so results are not uniform. Only 2 randomized controlled trials were among the included studies.
Declared interests
The authors declared no conflicts of interest.
The easy way to misread this
Do not conclude that high CECSS scores prove emergency nursing care is excellent. The scale often produces ceiling scores, and most included studies were cross-sectional with convenience samples.