Organizational outcomes of the Caring Nurse in the Emergency Department in a major metropolitan hospital: a retrospective study protocol

Abstract

BACKGROUND:  Waiting in the Emergency Department (ED) is a critical moment for user experience and the relationship with the healthcare system. Overcrowding, aggression, and early departures are well-known issues that have significant clinical, organisational, and economic impacts. Literature suggests that communication- and relationship-centred interventions can improve user experience and reduce aggressive behaviour. 

OBJECTIVES: This study aims to evaluate the impact of introducing the Caring Nurse (CN) role in ASST Niguarda's Emergency Department (ED). Primary objectives are: 1) to quantify aggressive incidents toward healthcare staff; 2) to quantify the number of patients leaving without being seen. Secondary objectives include measuring satisfaction among users, caregivers, and healthcare professionals. 

METHODS: A retrospective, descriptive, single-centre study will be conducted using data collected from May 2023 to May 2025. Data will be drawn from hospital records and ad hoc questionnaires, which will undergo validation and verification. Statistical analysis includes normality testing, exploratory factor analysis, and reliability assessment (Cronbach's alpha). 

EXPECTED RESULTS: It is hypothesised that the CN will lead to a reduction in aggression and early departures, as well as an increase in perceived satisfaction. The findings will contribute to the national literature on the effectiveness of CN and may support the adoption of innovative care models. 

CONCLUSIONS: This study will help evaluate the impact of a relational and communication-focused intervention in a high-complexity emergency care setting.