Quality emergency care (QEC) in resource limited settings: A concept analysis

This analysis aims to understand the concept of Quality Emergency Care (QEC) and its provision to patients with life-threatening conditions in resource-limited areas. Providing appropriate high-QEC commensurate with patients' needs is critical for continuity of care, patient safety, optimal clinical outcomes, reduced mortality, and patient satisfaction. Care provided by trained emergency personnel who can make timely, patient-centered decisions supported by the family, systems, processes, diagnostics, appropriate equipment, and facilities is essential for high-quality emergency care [1].

Most people worldwide cannot access high-quality emergency care services; it is estimated that 90% of emergency care is inadequate in low- and middle-income countries, resulting in enormous disparities in outcomes [2]. Prehospital and emergency care complications claim the lives of 24 million people per year in low and middle-income countries [3]. According to the World Bank’s Disease Control Priorities Project, more than half of deaths in low and middle-income countries (LMIC) are caused by illnesses that might have been addressed with appropriate emergency care [4]. Barriers to high-quality emergency care (QEC) in these settings are lack of provider education and training, broken or unavailable equipment, inadequate supplies, lack of transportation and infrastructure, poor communication, and protocols and guidelines [5], [6], [7].

Nurses are often the first clinicians to interact with patients in emergency care settings since they make up the majority of healthcare professionals in resource-constrained areas [8], [9]. These expose nurses to diverse patient populations with rapidly changing and unpredictable clinical conditions [10]. This concept analysis aims to identify, define and assist in understanding the concept of QEC in resource-limited settings.

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