Work-based strategies/interventions to ameliorate stressors and foster coping for clinical staff working in emergency departments: a scoping review of the literature

Abstract

Background: Exposure to occupational stressors is an issue for staff working in emergency departments, managers and health services. The aim of this review was to identify, map, and synthesise the range and scope of current evidence for work-based strategies or interventions used in emergency departments to reduce occupational stressors and/or improve staff coping. Methods: The framework proposed by Arksey and O'Malley guided this review. A search of CINAHL, MEDLINE, Scopus, Cochrane and PsycINFO databases from January 2007 to June 2019 was applied. A total of thirty-one articles were included in this review. Quality appraisal was undertaken. Results: Exposure to or impact of occupational stress and workplace violence were common foci. A range of outcomes (such as burnout levels, stress levels and quality of life) were measured in the included studies. All studies demonstrated some improvement in outcomes measured although most were evaluated for relatively short duration. Quality of evidence varied. Conclusion: Strategies ranging from mindfulness to organisational redesign have been trialed to diminish stress and enhance coping of emergency department staff. Understanding the effectiveness of strategies is an important early step in improving the working environment for emergency department clinicians in an evidence-informed manner. Such information may be of use to managers to inform decision making regarding the most appropriate strategy to implement in their emergency department.