Hiring a Nurse Practitioner reduces wait times (overcrowding) in the Emergency Department
estimation of the ED (Emergency department) compromise with care afforded to patients because of overcrowding from the perspective of the provider of services.
/I researched literature and bonafide / authenticated texts that chose to: Study causation, impacts and resolution tactics aimed at ED crowding; Collected and analyzed data using established methods; specifically target the ED scenario and the day-to-day crowding at the ED in care centers and hospitals. There is in each case a lot of reporting done on the circumstances ( like shortages of beds and staff) and that have led to the crowding that can be seen to increase with each passing day at ED centers, the overall impact that has had on the quality of care given to the patients as a result, and the solutions that have either been worked out or are being discussed ( like additional staffing, increase in furniture for boarding, administrative measures and increase in primary care facilities) to alleviate the problem that is taking a grim shape very fast.
Conclusions: The most easily perceived notion associated with crowding is that of inadequate service and care provided to the patients. There is no unanimity amongst doctors, physicians, nurses and the patients themselves over the exact cause of compromised care, in what way care was compromised and what was the identity of the real sufferer.
Introduction
Crowding pervades almost all the ED's (emergency Departments) across the nation as of date. The causation is multidimensional. The main factors that cause crowding include, but are not limited to: rapidly diminishing capacity of the hospitals clubbed with the fact that there are a number of hospitals that are themselves closing down or, are at least closing down their ED's; The patients that report to ED's are increasing; a perceptible shortage of trained nurses and skilled staff; health care services in general and administrative procedures that need to be followed by the service providers has become very involved and cumbersome and a very practical logistical problem of the inability of the hospitals to smoothly transfer the ED patients to the 'in-patients' section leading to stagnation of movement of patients and adding to the crowding.
This crowding of epidemical scales has adversely affected health care services to the patients in ED. It has also led to unacceptable delays in providing care to the patients. The waiting-period for the patients has increased considerably enough to cause concern. Staffing problems and boarding inadequacy are the two glaring causes that have to be assessed and addressed as a result of which crowding manifests. Many solutions to the problem have been suggested to alleviate the situation of the patients. Urgent care that needs to be given at times of emergencies superseding normal situations is found wanting in its resources most of the times.
On the face of it, it is a simple case of demand -supply gap. Incessantly increasing patients that want to or need to access ED and a shortage of adequately trained staff for the purposes couple with other logistical factors like boarding inadequacies and space constraints as also inability of the service providers to ease out the treated patients to less critical or 'general' departments are at the root of this malady that affects the nation. There are processes and steps that can be taken to improve the situation, though. Curtailment of stay duration of patients admitted to ED, once the progress is assured is one of the steps that need to be taken. Steps have to be taken for: screening those in absolute need of the ED treatment and immediate release of those who have been treated and need not be boarded in the ED. There are many more roles that are expected of the ED in addition to its being the care provider of those suffering trauma or in need of urgent attention in complex cases. A plausible way out suggested is to train and employ Nurse Practitioners who would be equipped to decide the merits of a case and help screening process, taking the weight of the resident physician who are already burdened with lot more.
Rationale and significance for advanced practice nursing (nurse practitioners)
The origin of Nurse Practitioners in the U.S. can be traced back to the delicate and careful handling required for the infants and toddlers- broadly termed as pediatrics (Silver and Ford, 1967). The scope evolved to provide specialist care in the fields that include family care, old-age caring and of late to extraordinary care to patients of acute illnesses. NP's now provide medical care to: infants and babies, incapacitated...
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