Iranian Journal of Nursing and Midwifery Research1735-906614420100106211211MSc, Department of Operating Room Nursing, School of Nursing and Midwifery, Isfahan University of Medical Sciences, IsfahanMD, Department of Surgery, School of Medicine, Isfahan University of Medical Sciences, IsfahanMD, Department of Internal Medicine, School of Medicine, Isfahan University of Medical Sciences, IsfahanBSc in Nursing, Emergency Department, Al-Zahra Hospital, Isfahan University of Medical Sciences, Isfahan20101113<p>BACKGROUND: Speed of giving services in medical centers, especially in emergency department, play an important role in reducing death and handicap. The action of emergency department can have a great effect on other wards actions.</p><p><br />METHODS: This triangulation study conducted in 2005 in three steps. In the first step, problems of the emergency department of Al-Zahra hospital were extracted using an open questionnaire filled by employed personnel. In the second step, 14 managers of the center attended a meeting discussing those problems. Based on the gathered data, a closed questionnaire was designed and in the third step it was given to 64 hospital employee. Data were analyzed using SPSS software.</p><p><br />RESULTS: In the first group (managers), 5 problems were scored more: security problem (70%), not paying attention to educational hierarchy (70%), absence of on-watch resident in the emergency department (60%), absence of a standard clinical protocol (60%), and absence of team work (38%). The second group (employed personnel of emergency department), gave more scores to nonscheduled transfers from other centers (70.6%), absence of on-watch resident in the emergency department (61.8%), not determining the correspondence attending for a multiple-trauma patient (58.9%), absence of team work (52.9%).</p><p><br />CONCLUSION: Emergency ward has increased the chance of living for patients receive urgent medical services, in the first hours after an accident or a disease attack, known as "golden time"; so absence of on-watch resident in the emergency department of educational hospital has a negative effect on making decisions and functioning and mostly.</p><p><br />KEY WORDS: Emergency department, hospital emergency services, triage, clinical protocol.<br /></p>http://ijnmr.mui.ac.ir/index.php/ijnmr/article/view/211http://ijnmr.mui.ac.ir/index.php/ijnmr/article/download/211/239