Give some privacy to hallway hold patients
October 1, 2009
Give some privacy to hallway hold patients
ED nurses use scripting
Is your patient better off in the ED waiting room, or in the hallway?
"It's six of one, half a dozen of the other," says Deborah M. Dixon, RN, MSN, APN, ED educator at Summa Health System in Akron, OH. "Are they better off in the hallway without privacy, or in the waiting room, where there is even less privacy and a sentinel event can happen?"
When the ED surveyed its hallway patients, they learned their two main concerns were privacy and having space for their visitors. However, 75% said they'd rather be in the hallway than the waiting room. This scripted response was developed for ED nurses to tell patients assigned to hallway beds: "I am sorry you are being assigned to a hallway bed during your visit. I understand that your concern for privacy is important, and we will make you as comfortable as possible. Unfortunately, our private rooms are occupied at the moment, but we want to make sure you are seen and treated as quickly as possible, which is why you are being placed in the hallway. We will bring your visitors back as soon as we can. Please let us know if you need anything."
With this script, "we are addressing their two big concerns right off the bat," says Dixon.
At University of Pittsburgh Medical Center — Presbyterian, eight "hallways bays" have been created.
"As in most EDs across the country, we have had issues with hallway usage related to flow," says David Bertoty, RN, MSN, clinical director of emergency and trauma services. "To maintain privacy, we have identified specific hallway locations for placement. We have numbered these for ease of identification by staff."
ED nurses speak in a lower tone and offer to close curtains. "However, our experience has shown that most times patients prefer to have the curtains open," he says.
The ED uses specific criteria to determine if a patient is appropriate for placement in a hallway bay. "It is not necessarily appropriate for all patients waiting for an inpatient bed assignment to be placed in the hallway just because their ED work-up is completed," says Bertoty.
If a hallway patient requires a specific intervention, patients are moved in and out of rooms to facilitate appropriate care and ensure privacy, says Bertoty. "We also have two X-ray rooms that, in certain instances, will be utilized for a procedure or patient care such as toileting or dressing," says Bertoty.
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