Reducing Emergency Department Overuse Through Patient Education

Document Type

Final Project

Graduation Date

Spring 5-7-2026

Degree Name

Doctor of Nursing Practice

First Advisor

Dr. LeAnn Holmes

Abstract

Background/Introduction

Emergency departments (EDs) are designed to provide rapid evaluation and management of acute, life-threatening, and time-sensitive conditions. However, EDs are frequently used for nonemergent or low-acuity concerns that could be managed in primary care or urgent care settings. This overuse contributes to rising healthcare costs, resource strain, longer wait times, and overcrowding. Underserved populations may rely more heavily on ED services because of barriers such as limited primary care access, language differences, low health literacy, restrictive work schedules, transportation challenges, and difficulty navigating the healthcare system. These factors can make the ED seem the most accessible source of care. Targeted nurse-led education may help address knowledge gaps and encourage appropriate healthcare use.

Purpose/Aim

The purpose of this pilot project was to examine patterns of ED utilization among underserved adult patients, identify perceived barriers to healthcare access, and evaluate an educational intervention designed to improve understanding of appropriate healthcare facility selection.

Methods

A pre-post pilot design was implemented in a community-based outpatient clinic serving underserved populations. A convenience sample of adult patients was recruited. Limited demographic data were collected, including age, primary language, and English proficiency. Participants completed a 16-item Likert-scale survey before and after the intervention. Survey domains included perceived barriers to care, understanding of appropriate ED use, confidence navigating the healthcare system, and awareness of alternative care settings. The intervention consisted of an informational pamphlet outlining appropriate use of emergency departments, primary care providers, and urgent care facilities for specific health concerns. Pre and post responses were compared using descriptive analysis to evaluate changes in participant perceptions.

Results/Findings

Eighteen participants enrolled, and 15 completed both surveys and were included in the final analysis. Post-intervention findings showed improvements across several domains. Participants reported greater confidence navigating the healthcare system, better recognition of appropriate ED use, and reduced intention to seek ED care for low-acuity conditions. These results suggest that a brief, low-cost educational intervention may positively influence healthcare decision-making.

Discussion/Implications

This project highlights the important role of nurses in addressing healthcare access disparities through patient education and navigation support. Integrating structured educational materials into routine outpatient visits may provide a scalable strategy to promote appropriate ED utilization. Implications for nursing practice include emphasizing health literacy, clarifying care setting differences, and strengthening interprofessional referral pathways. Nurse leaders and advanced practice nurses can champion sustainable workflow changes that support equitable access and reduce unnecessary ED strain.

Conclusion

A targeted educational pamphlet showed potential to improve patient understanding of healthcare facility use and confidence navigating care options. Although limited by small sample size, findings support further research with larger, more diverse populations to evaluate long-term impact and sustainability. Nurse-driven educational interventions may help reduce nonemergent ED use and promote more efficient healthcare delivery. Future studies should incorporate longitudinal follow-up, broader demographic data, and system-level outcomes such as cost and utilization trends. Continued collaboration between nurses, community organizations, and healthcare systems may strengthen education efforts and improve access to appropriate care resources for underserved populations. Ultimately, sustained education and accessible primary care services remain essential to reducing emergency department use.

Keywords: emergency department overuse, underserved populations, patient education, healthcare navigation, health literacy

Rights

The author holds the copyright to this work and any reuse or permissions must be obtained from the author directly.

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