Pathways and transitions for patients admitted to an emergency department after self‐harming events

Author:

Sandahl Malene1ORCID,Lassen Annmarie Touborg12ORCID,Stenager Elsebeth234ORCID,Østervang Christina12ORCID

Affiliation:

1. Department of Emergency Medicine Odense University Hospital Odense Denmark

2. Department of Clinical Research University of Southern Denmark Odense Denmark

3. Mental Health Research Unit, Children and Adult Psychiatry Region of South Denmark Aabenraa Denmark

4. Department of Regional Health Services University of Southern Denmark Odense Denmark

Abstract

AbstractThe frequency of people presented in emergency departments (EDs) after self‐harming events is increasing. Previous studies have shown that the complexity of the disorders of patients admitted to the ED after self‐harming events can be overwhelming for ED healthcare professionals (HCPs) to handle. The objective of this study was to observe and investigate the pathways for patients admitted to the ED after self‐harming events to either transition or discharge. Participant observation and interviews were selected as the methods to generate insight into the pathways of patients admitted to the ED after self‐harming events. The data were analysed using interpretative phenomenological analysis. A sample size of 20 patients was analysed, and a total of 213 h of observation took place during the data collection. Three main themes appeared: (1) patients' mental stress versus high expectations, (2) uncertainty about how to address the self‐harming event and (3) a system of chaos. Patients admitted to the ED after self‐harming events struggle with difficult mental stress. Despite this, they face high expectations that they will fit in and cooperate in the ED. The healthcare system is organised with unclear responsibilities and without systematic ways to care for self‐harm patients and so provides chaotic patient pathways. There is a need for improved cross‐sectional competencies, mutual agreements and systematic communication for discharge, transitions and follow‐up care between those involved in the patient's pathway and care.

Publisher

Wiley

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