Patient Perspectives of Sickle Cell Management in the Emergency Department.
Nancy Crego, Rita Masese, Emily Bonnabeau and 4 others
PMID 33595963WHAT IT FOUND
Patients with sickle cell pain reported waiting long ED times, feeling disbelieved, and leaving without follow-up or transport.
Many managed severe pain at home. The study describes these barriers; it did not test ED nursing changes.
Key findings
01Five themes emerged from interviews and focus groups: ED is the last resort, treatment delays, inadequate discharge and follow-up, drug seeking stigma and disbelief, and ED provider knowledge gaps.
02In the 6 months before the survey, 80% reported having severe pain episodes that kept them from their usual daily activities but were not seen by a doctor or nurse.
03Fifty percent of participants waited 120 minutes or more in the ED for treatment of their sickle cell pain.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
Participants were recruited from one center, so results may not apply to all people with sickle cell disease. Only 14 participants completed interviews or focus groups, so qualitative themes come from a small group. Self-report was used for ambulatory and ED service use and was not validated with medical records. Most participants were affiliated with the study site, which already had sickle cell programs, so barriers may be under-reported and satisfaction over-reported.
Declared interests
The study was supported by the National Heart, Lung, and Blood Institute (NHLBI) (U01HL133964). The authors declare no conflicts of interest.
The easy way to misread this
Do not conclude that ED nurses are causing these delays or that a specific nursing change will improve pain control; the study reports patient perceptions at one center and did not test an intervention.