How to manage an overcrowded emergency department waiting room

RATIONALE AND KEY POINTS: As the emergency department (ED) comes under increasing pressure from rising patient numbers, waiting times for a bed or trolley increase, leading to overcrowding in the waiting room. Many patients in the ED waiting room will be at risk of deterioration - some will be waiting to be triaged, while others will be awaiting further assessment and/or treatment. Nurses need to understand how to manage an overcrowded ED waiting room to mitigate the risks posed to patient safety. • Nurses overseeing an overcrowded ED waiting room need to maintain continuous awareness of who is in the room, why they are there, what their level of risk is and who is most in need of a bed or trolley. • Regular and targeted patient reassessments are crucial, since the risk of missing signs of deterioration or adverse events tends to increase the longer patients wait. • Proactive management of the environment, considering patients' location in the waiting room and how easy it is to get to them, can reduce the time to intervention in cases of deterioration. • Clear communication with patients, families and colleagues can enhance patients' satisfaction with their care, minimise safety risks and support timely escalation. REFLECTIVE ACTIVITY: How to articles can help to update your practice and ensure it remains evidence based. Apply this article to your practice. Reflect on and write a short account of: • How this article might improve your practice when managing an overcrowded ED waiting room. • How you could use this information to educate nursing students or your colleagues on the appropriate approaches and evidence base for managing an overcrowded ED waiting room.