Clinicians' experiences of caring for people brought in by police to the emergency department: A qualitative interpretive study

Abstract

Aim: To explore nurses' and doctors' experiences of providing care to people brought in by police (BIBP) to the emergency department (ED). Design: A qualitative interpretive study using in-depth individual interviews. Methods: Semi-structured interviews were conducted with nurses and doctors who worked in various EDs in one Australian state and were involved in the care of people BIBP. Interviews were undertaken between May and October 2022 and focused on the structures (i.e., what), processes (i.e., how) and outcomes of care for people BIBP. Data were analysed using deductive and then inductive content analysis. Results: Nine nurses and eight doctors were interviewed. Structures described by participants included human structures (staff) and organizational structures (areas for assessment, involuntary assessment orders, investigations, chemical/physical restraints). For processes, participants described practices including risk/mental health assessments, legal considerations, and increased/decreased levels of care compared to other presentations. Communication processes were largely between police and health care staff. Service outcomes pertained to discharge location (custody, community, hospital admission) and length of stay. Conclusion: The current care delivery for people BIBP to the ED is unique and complex, often occurring in high traffic, resource-intensive areas. There is a need to strengthen structures and processes, to improve service outcomes. Implications for the Profession: Understanding the care requirements for people brought into ED by police enables the delivery of targeted care alongside appropriate resource allocation. Impact: This study provides a comprehensive understanding of the health care requirements for people BIBP to EDs. Interventions delivered in the ED to support health care delivery for people BIBP and foster clinician and police relationships are required to optimize patient and health service outcomes. Reporting Method: This study adheres to the COREQ checklist (Table S1) of the EQUATOR guidelines. Patient or Public Contribution: This study focused on ED staff experiences.