Influences on Patient Satisfaction Among Patients Who Use Emergency Departments Frequently for Pain-Related Complaints.

INTRODUCTION: The primary purpose of this study was to assess relationships between opioid prescribing practices, patient and ED attributes, and patient satisfaction ratings of nursing and physician care among patients with high utilization of the emergency department for pain relief.

METHODS: A retrospective cohort study was conducted to examine 305 individual patient satisfaction surveys from users with high ED utilization for pain complaints. Responses were compared with an age-matched control group (n = 305) of nonfrequent ED users. Patient satisfaction survey responses and electronic medical records were used to model relationships between patient satisfaction and predictor variables.

RESULTS: ED frequent users with pain complaints were 75% less likely to return a satisfaction survey compared with other patients (odds ratio = 0.2488; P < .0001). Patient satisfaction with physician behavior was largely accounted for by ED cleanliness, pain control, wait time for the physician, satisfaction with nursing, and feelings that ED staff cared about the patient personally. On the other hand, patient satisfaction with nursing care was largely accounted for by perceptions that nursing care was compassionate, feelings that the patient mattered personally, perceptions of safety precautions, and wait times. Receipt of prescriptions for scheduled drugs did not significantly influence patient satisfaction with physician or nursing behaviors.

DISCUSSION: Emergency nurses can influence patient satisfaction scores by promoting clean, caring environments and prioritizing patient flow and pain management. ED providers can withhold opioids when appropriate without fear of a significant impact on patient satisfaction.