Health education and the inappropriate use of accident and emergency departments: the views of accident and emergency nurses

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Abstract
PATIENTS who refer themselves to accident and emergency (A&E) departments with primary care problems are generally described as making inap propriate use of the service. Health education in vari ous forms has been widely advocated as a means of reducing this misuse. One suggestion is that the pub lic be given clear guidelines about appropriate re sponses to health problems. A questionnaire was developed to examine the views of A&E nurses on inappropriate attendance. These were assessed, and case vignettes simulating A&E patient presenta tions were used to measure the level of agreement about the inappropriate use of A&E. The results sug gest that nurses view health education as important, but their response to the case vignettes also suggests that consensus about the definition of the 'appropri ateness' of A&E attendance may be limited. The dis agreement evident amongst experienced A&E nursing staff makes it highly unlikely that written guidelines for the public could be developed in any thing but the broadest of terms.