RESCUE - Rapid, Effective, Safe Communication in Emergency Departments: A cross-sectional e-survey.

Background: Effective staff-to-staff and patient-provider communication in the Emergency Department (ED) is essential for safe, quality care. Routine wearing of Personal-Protective-Equipment (PPE) has introduced new challenges to communication. We aimed to understand the perspectives of ED staff about communicating while wearing PPE, and to identify factors contributing to communication success, breakdown, and repair.

Methods: Study design was a descriptive cross-sectional online survey with convenience sampling. Categorical data were analysed using descriptive statistics and qualitative data analysed using content thematic analysis.

Results: Across nursing, medical and allied health, 78 staff responded with mean age= 38.8 years and mean ED clinical experience= 8.8 years). Respondents reported PPE impacted communication with patients/family members (81 %) and staff (61 %), with almost three-quarters of patient interactions rated as "somewhat difficult" or "extremely difficult". Content themes were: (i) impacts of mask-wearing on communication, (ii) impacts of mask-wearing on patient care quality and safety, and (iii) strategies for repairing communication breakdown. Health impacts of communicating in PPE (50 %) included voice fatigue, skin irritation, and throat dryness.

Conclusion: ED staff perceived that wearing PPE impacted communication and compromised safe and efficient quality care delivery. Staff reported using increased voice volume, repetition, gestures, increased proximity, and emphasised facial movements to enhance their communication.