Quality of care provided by nursing practitioners at the emergency departments.

Abstract

Over the previous couple of decades, overcrowding in emergency rooms has now become progressively typical. Longer wait durations in the emergency room are linked to higher disease and death and lower client satisfaction. Providing quality care requires providing both the scientific and humanitarian aspects of nursing. The Rogers theory of unitary human beings enables nurses to function from a position of factual certainty while emphasizing the care they deliver. Personnel such as health care professionals, executives, and other professionals who undertake medical and non - medical roles play a significant role in evaluating the healthcare services delivered by nurse practitioners in the urgent care context. They assess the actions involved in providing quality care, make recommendations, and maintain quality.

The studys primary objective is to report, review relevant, and consolidate the highest quality data on the quality of treatment, patient-to-provider time, duration of stay, and patient satisfaction delivered by nurse practitioners in the emergency department compared to not utilizing nurse practitioners. A qualitative study gets undertaken in the Emergency department of hospitals and questionnaires, patient treatment charts. After the extraction of data synthesis of data, the results and findings are summarized and reported. According to the study, nursing practitioners involvement in emergency and crucial healthcare improves hospital stay length, treatment duration, mortality, and client satisfaction. Its enticing to use nurses in specialized treatment to improve patient care. According to the study, implementing nursing practitioners in the emergency room enhances patient care. The predicted surge in healthcare care needs might get mitigated by the revolution of healthcare provision and inadequate staff use.

Background

In the United States, nursing practice stands at a fork in the path between convention and invention. High-fidelity modeling is gaining traction as a way to satisfy the needs of 21st-century medical teaching and propel healthcare into a modern generation of knowledge and rational reasoning (Hayden et al.,2014). Due to demographic aging, comorbidity, and scarce resources in primary and acute care, emergency departments around the globe see an increase in enrollment, significantly impacting care delivery and results. There have been calls for the emergency department performance to improve techniques, highlighting the need to discover cost-effective care approaches in terms of cost-effective care schemes in terms of workforce optimization. The addition of additional care contexts, such as health and social care professionals (HSCPs) teams, necessitates well-established institutional culture (Chouinard et al.,2017). People, institutions, services, and platforms must all change to introduce effective practices. To discover implementation variables based on access to healthcare, stakeholders who obtain or deliver health care have become highly relevant.

Stakeholders are vital individuals who play an essential role in organizational success or those impacted by the organizations operations. A stakeholder is an entity or an individual with a strong interest in a therapeutic choice and the facts to support it. Stakeholders in the healthcare setting include diverse personnel, including health care professionals, executives, and other professionals who perform clinical and non-clinical responsibilities. Internal stakeholders play a critical role in assisting the successful implementation of the planned change by contributing their skills and experience and suitable leadership in the organization (Kaur & Victoria,2017). Patients, providers, and financial institutions, such as the state and healthcare insurance companies, are external shareholders. They contribute significantly to the implementation of change by providing the necessary resources. Stakeholders generate capacity building, make suggestions, and engage in assessment and quality assurance activities when they are involved at each level.

The responsibility of caring for complicated patients with chronic illnesses is putting a strain on the primary care system, which is already overburdened due to the aging population and the rise in chronic disease prevalence. Reducing emergency room wait times is complex, and clinicians predicted needs had shown a sustained scarcity. There is a surge of attention in having nursing practitioners engage in clinical care significantly due to the attempts to find new ways to boost the staff. Nursing practitioners perform legally authorized services to follow the state laws and meet such training, education, and experience as regulations prescribe. In the emergency department, nursing practitioners are an essential source of primary care. Over the years, much has evolved on the role of nursing practitioners and the settings of nursing practitioners. The part has developed somewhat arbitrarily, and changes have influenced it in the health care delivery models. With the increased demand for emergency nurse practitioner services globally since the previous evaluations and the need to improve emergency department service quality, it is critical to assess the changing evidence on emergency nurse practitioners medical and operational efficiency.

Literature review

Critical and emergency care services are essential services offered by nursing practitioners in hospitals. The most beneficiaries of such services are the elderly, the sick, children, and people with acute diseases. There has been a more significant increase in the demand for critical care services worldwide in the past decades. It comes with the rise in the need for qualified personnel to provide such services to the people. Nurses extended their scope of expertise via training and accreditation to address the populations demands due to a shortage of primary care available for patients. Nursing practitioners currently provide treatment in various areas, including primary, secondary, and tertiary settings (Jennings et al.,2015). Subspecialty areas including emergency, cardiovascular, endocrinology, and oncology have embraced the nurse practitioner role to provide high-quality treatment as the nurse practitioner job has grown in popularity. Nursing practitioners receive training in a nursing model, and their activity is based on a bachelor nursing education that compels learners to select a specialization program.

The nursing practitioners role was created in the 1960s to address a shortage of primary care physicians in rural and underserved areas (Woo, Lee &Tam, 2017). Primary care is the first point of contact for patients, and it then provides continuity of care throughout the healthcare system by coordinating care based on the patients needs. Among the most breakthroughs in nursing in current history is the nurse practitioner service model, which offers the potential for considerable healthcare change. Different studies evaluating the quality of maintenance by nursing practitioners in terms of consistency and security are equivalent to specialists.

Standard of care and patient outcomes supporting evidence

Several studies have found that the quality of treatment delivered by nurse practitioners is comparable to that provided by physicians. In non-randomized studies reducing patient risk, patient satisfaction and remission of pathological diseases were higher for NP patients, according to a meta-analysis of NPs in primary care. The current demand for primary care professionals, combined with rising economic trends, has created service models whose principal goal is to effectively respond to clients ever-changing requirements (Woo, Lee & Tam,2017). Epidemiological studies of the safety and effectiveness of medication satisfaction in a primary healthcare context led by a nurse practitioner have found that the operation of a nurse practitioner has a favorable impact on clinical results, client experience, and expenditures.

A previous study shows that there has been an introduction of a regulatory body in the accreditation for graduates who can provide such services and a recommendation of a model of care comprising 24-h physicians. A study done in the USA shows that, with the increase of demand of critical care services providers, there is a prediction of shortfall of the workforce come 2030, which has led to the increased investment in the essential care profession (Woo, Lee & Tam,2017). With the rise in the demand for healthcare services providers, workforce utilization is crucial in providing quality and effective healthcare services.

Purpose and Aims of the study

This study compared the quality of care of emergency room treatment provided by nursing practitioners to that offered by all those who did not employ nurse practitioners. The researchers will look at the most recent research to see if advanced practice nursing in emergency and critical care impacts care quality, patient trials, and client experience. Patient satisfaction reports will assess the quality of treatment provided, emphasizing the time spent by the patient with the provider, the duration of stay, and general patient satisfaction with their visit.

Theoretical Model Framework

Martha E. Rogers theory of Unitary Human Beings

Most professions are based on theories that provide concepts that present specific knowledge to the specified disciplines (Indra, 2018). The nursing practice also adopts theories that guide, provide and define the scientific basis of the profession (Indra, 2018). Nursing theories are the tools that help increase the comprehension of values within the profession and simultaneously define nurses roles and positions during service delivery. A robust theoretical background in nursing is associated with improved care delivery, backed by enhanced critical thinking and decision-making skills (Salifu et al., 2018). Moreover, nursing theories are essential for nurses to determine and provide care based on the needs of the patients and the goals of care holistically and professionally (Hagerty et al., 2017).

Rogers theory of unitary human beings has been considered as an art and a science. It provides...

…all ages and walks of life, the elderly account for the most significant spending. A growing number of older Americans and many from different countries suffer from chronic illnesses and multimorbidities, increasing their care complexity. In emergency departments, the demand for emergency and critical care has increased, which has led to increased workforce needs for such services. Thus the purpose of this review is to examine quality care provided by the nurse practitioners in the emergency setting, as compared to not using nurse practitioners (Kleinpell & Kapu, 2017).

A cost-effective, high-quality approach to health care delivery is a must as the demand for health services is expected to rise dramatically. A majority of healthcare expenditures in some countries are paid to healthcare workers. Therefore, to contain costs, workforce involvement must be taken into account. Increased productivity can be achieved through the greater capacity of the workforce. They continue treating patients using the most important current information, including empirical data from controlled therapeutic trials, scientific proof from various scientific methodologies, research papers, cosmic ideas, and direct observations.

Stakeholders interested in the project

Stakeholders impacted by this project include the National and local government that plays an essential role in providing healthcare infrastructure by providing resources for training of the nursing practitioners. The project has caught the attention of patients, caregivers, and civil rights organizations since it increases illness treatment, exercise, patient engagement, and judgment calls in the treatment process. Professional healthcare professionals, such as community hospitals and healthcare facilities, are assisting it (Woo, Lee &Tam, 2017). Insurance companies provide patients with health coverage plans that enable them to receive high-quality care.

Expected outcomes

Nurse practitioners should be used in the emergency department since inefficiencies in the assessment will inevitably impair patient treatment, results, and outcomes. Nurse practitioners shorten the time it takes for a patient to be seen by a clinician in the emergency department, allowing for a speedier assessment and improving the patients situation (Suler, 2017). As per Jennings et al. (2015), a satisfaction survey of individuals diagnosed to the emergency department or the next available medical officer revealed that the emergency nurse practitioner group provided better care, had shorter wait times, and had higher patient satisfaction. Compared to patients seen by physicians, studies reveal that emergency departments reviewed and treated by nursing practitioners had a significantly shorter length of stay.

Nursing practitioners outperform physicians in answering questions, listening, and pain treatment, increasing patient satisfaction. Many people said they were less worried about their injuries after seeing a nurse practitioner, according to a survey conducted by Griffin & McDevitt (2016). These patients may have been less anxious about their impairment as a result of adequate information and reassurance. According to the poll, the vast majority of the patients visited by NP agreed that they would follow nurse practitioner advice if they thought it was good.

Anticipated Conclusions

Reliable evidence on the value assessment tool significantly impacts service allocation for urgent nurse practitioner operations. Because NPS does not have to rotate as frequently as junior physicians, they could provide better access to treatment to the chronically ill. As a result of nurses ability to form more personal and concrete communication with patients than specialists, the NPS developed a more substantial familiarity with the environment and patient expectations. When patient treatment required cross-disciplinary contentment, medication management, follow-up treatment, and bureaucratic effort, the usefulness of NPS was demonstrated. Patients length of stay was reduced when NPS was involved. According to Jennings et al. (2015), emergency nurse practitioner treatments seem to have such a considerable influence on patient assessment waiting lists and, as a result, enhanced patient accessibility.

In inpatient training, nursing practitioners are ranked higher than healthcare professionals, responding to questions, attentiveness, and medication management. Emergency departments are trying to adapt and to react to the various methods that are being used. The predicted surge in healthcare activities could be mitigated by transforming healthcare delivery through effective personnel management. Capitalization on nurses in advanced practice must be encouraged to enhance patients access to critical and emergency care. The previous reviews indicate that the introduction of the nursing practitioners has brought great help to the patients and improved their outcomes enormously. When the workforce is appropriately utilized in the health by the use of nursing practitioners, then there will be a significant improvement of the emergency and critical care provided by the health facilities with the rise in the demand for health care services worldwide. A receptive context needs to be…