Emergency Departments and the Inappropriate Attender - Is It Time For a Reconceptualisation of the Role of Primary Care in Emergency Facilities?  

Abstract
The appropriateness of Emergency Department (ED) usage is often questioned, with recognition at an international level of the growing prevalence of ‘inappropriate attenders’. This term is used to describe individuals who present for treatment that could more appropriately be provided in the primary health care setting. This is an issue of concern for staff working in New Zealand Emergency Departments. The present article offers a review of currently identified issues concerning ED attendance, and examines the core question of the role of primary care in the Emergency Department. It asks whether this is an appropriate use of ED resources, and if so, what are the implications for the role of the emergency nurse?  

Keywords
emergency nursing, inappropriate attenders, primary care  

Introduction
Emergency Departments (EDs) are experiencing increased patient volumes, with many clients presenting with minor medical or non-urgent accident related conditions (Dale, Green, Reid & Gluckman, 1995). Analysis of the literature reveals there has been debate concerning the appropriateness of providing primary care within emergency treatment facilities. The concept of ‘inappropriate attenders’ as regards care provided by New Zealand EDs is one of relevance to nurses working in both primary and secondary health care settings.  Continued