#106 Staff stress at work in the emergency department – a cross-sectional comparative study at Cork University Hospital between 2015 and 2023

<h3>Introduction</h3> Hospital emergency department (ED) staff experience high stress levels. Although numerous studies have investigated staff stress in the ED, there is a lack of prospective data. This study aimed to investigate ‘real-time’ stress levels among ED staff, identify influencing factors, and examine changes over time by comparing data collected before and after the COVID-19 pandemic. <h3>Methods</h3> The study included all staff (clinical and non-clinical) onsite in the ED over the 24-hour working day at Cork University Hospital for a 2-week period in June 2015 and again in September 2023. Staff were approached at different locations in the ED while at work and at different times of day and invited to complete a brief self-administered questionnaire on an iPad. <h3>Results</h3> A total of 508 and 516 questionnaires were completed in 2015 and 2023, respectively. Mean stress levels showed a significant increase between the two time points (37.5 vs. 45.4; p &lt;0.0001), as did the proportion of staff reporting at least moderate stress levels (48% vs. 56%; p &lt;0.01). Non-clinical staff, particularly porters and administrative personnel, consistently reported the highest stress levels across both time points. In 2023, staff cited more reasons for stress than in 2015, with workload and staffing remaining key concerns. ‘Workload’, defined as new patients, was endorsed by more ED staff (49.6%) in 2023 than any other reason for stress compared to 2015 (31.8%). COVID-19/Infection control measures were the least cited reason for stress (5.6% staff) in 2023. Different stressors identified in 2015 and 2023 are presented in figure 1. <h3>Conclusion</h3> Stress levels among ED staff assessed while at work increased significantly between 2015 and 2023, with non-clinical staff continuing to report the highest stress. Whereas COVID-19 infection control measures are infrequently reported as a source of stress, changes in ED patient flow post-pandemic are perceived by ED staff as especially stressful. Improved patient flow, research, and intervention to mitigate ED staff stress are needed.