Emergency care nurses under pressure to meet four-hour target

Published: 29 April 2008

Nine out of ten emergency care nurses have felt unduly pressured to meet the four-hour waiting target, according to a new survey from the RCN.

The survey of over 500 frontline emergency care nursing staff across the UK shows that pressure to meet the four-hour waiting time has had negative consequences on the quality of patient care. Three quarters (75 per cent) of nurses say patients are regularly admitted to inappropriate wards just to meet the target.

RCN Scotland Director, Theresa Fyffe said that although more than half (52 per cent) of emergency care nurses felt the introduction of the target generally had a positive impact on patient care, many believed that lowering the percentage of patients to be treated within the time limit would improve quality of care.

“Therefore the RCN is calling for a more realistic target of 95 per cent of patients seen within four hours rather than the current 98 per cent. This would give A&E staff the flexibility and time to deliver the personalised, quality care patients deserve.

“More than anything, A&E nurses want to meet the needs of patients, but feel constrained by the needs of the four-hour target. Nurses’ concerns need to be heard and addressed. The survey makes it clear the target is too restrictive and unrealistic to provide the kind of care nurses want to deliver,” Theresa said.

The survey was conducted by the RCN Emergency Care Association (ECA). Lisa Falconer, Staff Nurse in the Royal Infirmary of Edinburgh Emergency Department and member of the ECA, said:

“The survey results highlight the concerns of many healthcare professionals striving to achieve the four-hour target. Whilst the 98 per cent target allows a margin for clinical exception, there is no flexibility for occasions when service and resources are under excess pressure. Whilst many would agree the target has streamlined and improved efficiency of the patient journey, nurses feel they are compromised in their professional ability to deliver quality nursing care.”