DOI: 10.1097/ec9.0000000000000189 ISSN: 2693-860X

The effects of emergency department overcrowding on safety attitudes of healthcare staff: a cross-sectional observational study

Hasan Bicen, Ahmet Butun

Introduction:

Overcrowding in the emergency departments (EDs) has many negative effects on patients, healthcare staff, and the healthcare system. Overcrowding in ED can negatively affect the safety attitudes of healthcare staff. This study aimed to examine the relationship between ED overcrowding and the safety attitudes of healthcare staff.

Methods:

This cross-sectional descriptive study included 336 healthcare staff working in the EDs of 4 hospitals located in the southeast of Türkiye. Data were collected between February 16, 2024, and March 30, 2024. Statistical analyses were performed using IBM SPSS Statistics for Windows, Version 26.0 (IBM Corp., Armonk, NY), and the significance level was determined as P < 0.05.

Results:

As a result of 43 days of data collection, the National Emergency Department Overcrowding Scale score was determined as “extremely busy but not overcrowded” for 21 days, “overcrowded” for 17 days, and “severely overcrowded” for 5 days. As the National Emergency Department Overcrowding Scale score increased, the scores of teamwork climate (r: −0.236), safety climate (r: −0.248), job satisfaction (r: −0.254), perceptions of management (r: −0.302), and working conditions (r: −0.348) decreased significantly ( P < 0.001). Doctors and experienced staff had higher safety attitude scores. All subdimension scores decreased on days when crowding increased. ED overcrowding negatively affects the safety attitudes of healthcare staff. In particular, critical subdimensions such as teamwork, safety recognition, and job satisfaction weaken as crowding increases.

Conclusion:

This study revealed that overcrowding in the EDs has a significant effect on the safety attitudes of healthcare staff and that healthcare systems should develop multidisciplinary solutions to this problem.

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