To identify facilitators and barriers to quality, equitable discharge teaching by paediatric emergency department nurses during the COVID-19 pandemic, describe impacts of inequitable discharge teaching, and identify potential solutions to the barriers.
Twenty-two nurses in a single urban paediatric hospital participated in individual interviews from January to April 2022 via phone or videoconference. Interviews were transcribed and analysed using an inductive codebook.
Six barriers to equitable discharge teaching were identified: ED overcrowding, travel nurse training/knowledge, burnout and stress, increased role complexity, COVID precautions, and resource bottlenecks. Two facilitators were also identified: engagement and effective communication. Nurses described the impacts of these barriers along with proposed solutions to improve discharge teaching.
The COVID-19 pandemic created additional barriers to discharge teaching in the paediatric emergency department. Nurses identified barriers and facilitators, the impacts on patients and families, and potential solutions to improve equitable discharge teaching.
This study identifies how periods of high patient volumes or frequent process changes during a pandemic exacerbate inequities in discharge teaching.
This study identifies barriers and facilitators that shaped nurses' ability to provide quality, equitable discharge teaching during the COVID-19 pandemic and offers actionable guidance for hospital leaders and health systems to improve discharge teaching and enhance emergency preparedness for future public health crises.
This study conforms to the Standards for Reporting Qualitative Research.
This study did not include patient or public involvement in its design, conduct, or reporting.
ClinicalTrials.gov identifier: NCT04676490