One of the issues that emergency nurses will run in to will be overcrowding in the emergency department. In 2013, there was a study done on the relationship between emergency department (ED) crowding and patient outcomes (Bernstein et al., 2008). More and more individuals are using ED services. From 1999 to 2009 there was a 32% increase in visits to the ED. With this increase there was also a substantial increase in hospital admissions and ICU admissions, indicating that there was an increase in acutely ill patients that sought care in the ED. The increase in acute patients and the lack in hospital capacity for these admissions only adds to the problem of overcrowding.
This study is a systematic review conducted to examine the relationship between emergency department crowding and patient outcomes. The authors looked at research from 2002 through 2012 that pertained to this issue. Ultimately they ended up using eleven studies for this research article. Their findings included several important conclusions. In situations where there was ED crowding, 30-day mortality was significantly greater for pediatric patients than the 30-day mortality for pediatric patients where there was no crowding. The 10-day mortality for patients admitted during crowding periods was 34% higher than those admitted when there was no crowding. For those discharged, the 7-day death rate for those who visited during crowded periods were higher than those who visited during times that weren’t crowded. In addition, crowding played a role in patient’s likelihood of recommending the ED to others. Extra waiting time or receiving care in the halls increased the perception that the patient was receiving compromised care. The second study was done in 2013 and it looked more specifically at the effects of crowding on the Institute of Medicine’s six domains of quality of care: safety, patient-centeredness, timeliness, efficiency, effectiveness, and equity (Carter, Pouch, Larson). A total of 41 studies were used, many of which were observational research studies at single institutions. There was an increase in the risk of 2-day, 7-day, and 30-day mortality associated with ED and hospital crowding. Mortality rate is shown to increase during high volume periods in the ED. This finding is somewhat limited however as the studies used for the above conclusions relied on crowding being defined as a visits per week, as opposed to variations within shifts or even for smaller periods of time. …show more content…
Emergency nurses should be a voice for quality patient care and advocate that solutions be put in place to mitigate the negative effects crowding in the ED. They may be involved with investigating and implementing solutions. It may be that they advocate for the expansion of EDs and the adjustment of staffing ratios. In addition to these actions, extra care must be taken to provide accurate, timely care to all patients, even in high-pressure situations when the department is overcrowded. Knowing when to ask for help and how to help others is an important part of teamwork that allows a department to function efficiently. I personally want to be a nurse who works hard on my assigned patients so that I can be available, when time allows, to assist the nurses around me. I’ve seen firsthand the importance of teamwork in crowded EDs. It affects the quality of patient care in many ways. When a department is overcrowded, the doctors and nurses must rely on each other and take care to be attentive and sharp when providing care to the
This study is a systematic review conducted to examine the relationship between emergency department crowding and patient outcomes. The authors looked at research from 2002 through 2012 that pertained to this issue. Ultimately they ended up using eleven studies for this research article. Their findings included several important conclusions. In situations where there was ED crowding, 30-day mortality was significantly greater for pediatric patients than the 30-day mortality for pediatric patients where there was no crowding. The 10-day mortality for patients admitted during crowding periods was 34% higher than those admitted when there was no crowding. For those discharged, the 7-day death rate for those who visited during crowded periods were higher than those who visited during times that weren’t crowded. In addition, crowding played a role in patient’s likelihood of recommending the ED to others. Extra waiting time or receiving care in the halls increased the perception that the patient was receiving compromised care. The second study was done in 2013 and it looked more specifically at the effects of crowding on the Institute of Medicine’s six domains of quality of care: safety, patient-centeredness, timeliness, efficiency, effectiveness, and equity (Carter, Pouch, Larson). A total of 41 studies were used, many of which were observational research studies at single institutions. There was an increase in the risk of 2-day, 7-day, and 30-day mortality associated with ED and hospital crowding. Mortality rate is shown to increase during high volume periods in the ED. This finding is somewhat limited however as the studies used for the above conclusions relied on crowding being defined as a visits per week, as opposed to variations within shifts or even for smaller periods of time. …show more content…
Emergency nurses should be a voice for quality patient care and advocate that solutions be put in place to mitigate the negative effects crowding in the ED. They may be involved with investigating and implementing solutions. It may be that they advocate for the expansion of EDs and the adjustment of staffing ratios. In addition to these actions, extra care must be taken to provide accurate, timely care to all patients, even in high-pressure situations when the department is overcrowded. Knowing when to ask for help and how to help others is an important part of teamwork that allows a department to function efficiently. I personally want to be a nurse who works hard on my assigned patients so that I can be available, when time allows, to assist the nurses around me. I’ve seen firsthand the importance of teamwork in crowded EDs. It affects the quality of patient care in many ways. When a department is overcrowded, the doctors and nurses must rely on each other and take care to be attentive and sharp when providing care to the