Translational Research

Hospital emergency room wait times are the talk of the United States right now. Long wait times can contribute to the problems that decrease the quality of our health care system. Emergency room wait times depend on how busy the day is going, how long it takes for each patient to be seen, and how much staff is on duty. Wait times are also based on your injury as well. If you are there for a broken toe versus a head injury, you are going to be seen after the patient with the head injury despite the fact that you were there first. A case study researched and and written by Kevin Tuttle explains a challenge with a mission to decrease the wait times in the emergency room department.

A.1. Identify and Describe a Current Nursing Practice within your Healthcare Setting that Requires Change.

2. An 56-year-old established patient presents to her doctor's office with chest pain and shortness of breath. The doctor orders an ambulance to take the patient to the ED to be checked out. From the ED the patient is admitted for some

Internal method will be the interdisciplinary team such as hospitalist, therapists, dietician, pharmacist, case managers, discharge planners and house supervisors. These stakeholders performed a thorough discussions about patient’s admission, transfer, and discharges. Upon discussing with the patient’s overall health concerns, the evidence-based practices of bedside reporting can be part of the daily discussions because this is where the basis of patient’s health outcomes can be obtained. The goal of bedside reporting is to promote safety and highest quality of care. Therefore, the input and opinions of the whole team is very essential for the successful implementation of the bedside reporting. The bedside reporting will be more stronger tools

The admittance process in of itself is a relatively simple one provided all things are equal. Granted the human performance aspect is integral to the task completion. The authorization for admittance is provided once all test results are received and reviewed. Durng this time little to no ongoing communication between the patient and the attending physician or nurses. The patient is required to complete several documents as well as provide documentation i.e. medical insurance card. This is a hand-off from the hospital ER team to the normal hospital staff. As there is a significant amount of human interaction, just completing the admittance process in a step by step manner does not account for

Constant patient turnovers, visitors and numerous workers in and out of the emergency area can make it difficult for staff to maintain patient confidentiality. Due to lack of space and to give quick group report,

The emergency room (ER) has been receiving a lot of complaints recently and the chief executive officer, it was decided to find out the root cause of the complaints. This was done in two ways. First is that two individuals were granted the role of observing customers in various locations for about 2 hours per location for a period of one week. They were required to note any issue that arose leading to problems. The second way was that customer feedback forms were introduced in all major rooms of the ER to capture the customer experiences. The observations and feedback was collected, collated, prioritized and discussed. The ER was found to be receiving an average of 9.8 complaints per day which was higher than the average for many other facilities ADDIN EN.CITE Zuckerman20041264(Zuckerman & Shen, 2004)1264126417Zuckerman, StephenShen, Yu-ChuCharacteristics of Occasional and Frequent Emergency Department Users: Do Insurance Coverage and Access to Care Matter?Medical CareMedical Care176-1824222004Lippincott Williams & Wilkins00257079http://www.jstor.org/stable/464071510.2307/4640715( HYPERLINK l "_ENREF_7" o "Zuckerman, 2004 #1264" Zuckerman & Shen, 2004).

Upon review of the HCAHPS scores, the area in most need of improvement is the Emergency Department (ED). “Given the increasing importance placed on patient satisfaction in EDs nationwide, extensive efforts have been made to identify factors that contribute to patient satisfaction; and interventions have been developed to improve overall satisfaction” (DeLaney, Page, Kunstadt, Ragan, Rodgers, & Wang, 2015, p. 1089). Thus, the ED was a good starting point for this project. An investigation of the ED reveals that there are three areas the Nurse Leaders can focus their rounding: ED treatment area, ED waiting area and ED boarding patients. Consequently, three different scripting tools should be developed based on each of these areas. The ED manager, an ED physician, an ED nurse and the Nurse Project Leader should work together in the creation of these scripts. This scripting deadline should be added to the timeline. Once the scripting is developed, the Nurse Project Leader with the Team Project Leader will work with the CipherHealth Lead to make the necessary changes to the software. This step will be added to the timeline.

This was my last day in the hospital I dedicated to observe the skills and procedures performed in the emergency room after the doctor evaluates and places medical orders. I could evaluate the electronic medical orders, preparation of medicines, the use of pixie for dispensing the necessary drugs necessary for dispensing pixie and control them. I was in the guidance given by the nurse to the patient prior treatment, patient identification, how the EHR is used, also observe the canalization, blood test, the placement of cardiac monitor and oxygen mask. How patients are placed according to their condition whether in the general observation area, in cardiac, CPR or OB /

In a future condition of conveyance of services, the facility can be organized that gives both services next to each other in a position to address a few issues that plaque the scene right now. By having a physical preference of the ER, or the Urgent Care facility, the patient can first self-select the level of administrations they feel is most required, or pertinent to their issue. Upon therapeutic leeway, the ER or Urgent Care center can decide the real level of consideration essential and securely and proficiently deal with the patient and lead them to the proper department. This will guarantee

Furthermore, standardized terminology played a large role in maintaining this patient’s care throughout his hospital stay.

inflow of patients is higher than the available beds. You are treating an elderly man who is breathless and cyanosed. While you assess whether he has chronic obstructive pulmonary disease or heart failure, he becomes drowsy and starts gasping. You quickly intubate him with some difficulty, prolonging his period of hypoxia, and put him on ventilator support. You then get a phone call from a senior consultant in the hospital that an important social activist is about to arrive with chest pain and will need to be admitted. You are directed to

With an increase demand for an emergency service, the ED has been pushed to it’s maximum capacity putting patients at risk of safety due to overcrowding. The scope of this project is to group patients into two component, that is; critical and non critical helping to reducing the overcrowding and increase patient flow in the system. According to Cowan et Trzeciak (2004), “overcrowding leads to long waiting times, especially for those patients classified as a non critical, which leads leads to patient dissatisfaction, patient walkout, and the potential for compromised medical care”.

In the United States, between 1996 and 2003 emergency room visits rose from 9.3 million visits to 113.9 million visits; an increase of 26 percent with an annual visit rate of 35.7 visits per 100 persons in 1992 and 39.6 per 100 persons in 2005 (Hunt, K., Colby, D., Grimes, B., Bacchette, P., Callaham, M., 2008). As the demand for ED services increase, wait times increase, over-crowding occurs, resources are strained and poorer patient outcomes are often the result.

Upon arrival a patient should have been made aware about a delay therefore he/she would not get inpatient. The appointment itself should not be rushed. A health proffessional should have explained everything in a clear and precise manner giving patient the opportunity to voice any concern or ask any additional questions. In regards to the appointment itself, the