Health care staff experiences of delayed transfer of critically ill patients from an emergency centre in the Western Cape, South Africa

Thesis (MCur)--Stellenbosch University, 2018.ENGLISH SUMMARY: Background Globally, critically ill patients are accommodated in emergency centres for different reasons. One of these reasons is delay in transfer for admission purposes. The purpose of this study was to explore the experiences of health care staff with regard to delayed transfer of critically ill patients from an emergency centre in the Western Cape, South Africa. Methods A descriptive design with a qualitative approach was used. A total of ten (N=10) participants took part in the study. A self-developed semi-structured interview guide with open-ended questions and probes were used during data collection. The Health Research Ethics Committee at Stellenbosch University, South Africa gave approval for the study. Approval was also received from the Western Cape Government Health Department and the senior medical manager of the regional hospital to conduct the study at the emergency centre. Informed written consent was obtained from all the participants as well as consent to use a digital recorder. Themes were identified during data analysis and verified with the academic supervisor. Themes are described in the researcher’s analogy of an engine as follows: resource engine, staff engine, critical care patient engine and emergency centre engine. Results The findings of the study showed that delayed transfer of critically ill patients from the emergency centre leads to pressure on the health care workers in the emergency centre and ultimately compromises the patient in need of quality care. The recommendations for strategic management are thus to recruit critical care staff, to support further education of staff, and to utilise the high care unit appropriately.AFRIKAANSE OPSOMMING: Agtergrond Kritieke siek pasiënte word gesien in noodeenhede met verskillende siektestoestande. Wêreldwyd word kritiese siek pasiënte geakkomodeer in noodgevalle eenhede. Een van die redes is vertraging in saal opname. Die doel van die studie is om personeel se ervarings ten opsigte van vertraging in oorplasing van kritieke pasiënte in ’n noodeenheid in die Wes-Kaap, Suid-Afrika te ondersoek. Metode ’n Beskrywende model met ‘n kwalitatiewe benadering was gebruik. ’n Totaal van tien (N=10) persone het deelgeneem aan die studie. ʼn Self-ontwikkelde semi-gestruktureerde onderhoudgids met oop vrae en peilvrae was gebruik in die data kolleksie. Die Etiese Navorsingskommitee van die Universiteit van Stellenbosch, Suid-Afrika het die studie goedgekeur. Goedkeuring was ook ontvang van die Westelike Provinsiale Regerings department van Gesondheid en die senior mediese bestuurder van die hospitaal om die studie te onderneem in die noodsentrum. Skriftelike en ingeligte toestemming was by al die deelnemers gekry wat die digitale opname van die onderhoude insluit. Temas was geïdentifiseer gedurende data analise en was geverifieer met die akademiese toesighouer. Temas is beskryf volgens die navorser se analogie van ‘n engin as volg: hulpbronne engin, personeel engin, kritiekesorg pasiënt engin en noodsentrum engin. Resultate Die resultate van die studie het bewys dat ’n vertraging in die oorplasing van die kritieke siek pasiënt lei tot ’n verhoogde werkslading op die gesondheidswerkers in die noodsentrum en is uiteindelik tot nadeel van die pasiënt wat nie goeie kwaliteit versorging ontvang nie. Die aanbevelings is dat personeel opgelei en gewerf moet word en dat ʼn meer doelgerigte verbruik van die hoësorgeenheid tot verbeterde pasiënt uitkomste sal lei