How Have Stroke Patients Been Affected by Emergency Department Overcrowding in Hospitals?

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Emergency departments of hospitals are fundamental in the treatment of time sensitive conditions such as acute stroke (Trzeciak & Rivers, 2003). A stroke occurs when there is an interruption of blood flow to brain tissue, and therefore is a condition that relies on apt and adequate access to healthcare (Panagos, 2006). Patients who have experienced a stroke will most often present to emergency departments in order to receive treatment (Kothari et al, 1998). However it has been found by Chan et al (2010) that approximately 48% of American hospitals are operating over capacity and therefore not providing satisfactory healthcare. Overcrowding can be defined as the overabundance of patients requiring treatment and may be attributable to the misuse of the emergency area by non-critical patients (Chan et al, 2010; Trzeciak & Rivers, 2003). This has the potential to negatively affect outcomes for stroke patients. The aim of this essay is to investigate factors such as patient knowledge, wait times and patient safety in order to examine the effects of overcrowding of emergency departments on stroke patients.
Patient knowledge has been shown to influence outcomes for stroke patients. A number of studies have indicated that delays to emergency department presentation due to a lack of patient knowledge regarding stroke is the main reason for exclusion from treatment (Chan et al, 2010; Kothari et al, 1997; Panagos, 2008). A prospective study performed by Kothari et al (1997) showed that 40% of stroke patients questioned had no knowledge of any stroke symptoms. Both Chan et al (2010) and Kothari et al (1997) propose that public education regarding stroke is needed to increase the positive outcome for these patients. In the study performed by ...

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... the American Heart Association, 28, 1871−1875. doi:10.1161/01.STR.28.10.1871
Kothari, R., Jaunch, E., Broderick, J., Brott, T., Sauerbeck, L., Khoury, J. & Liu, T. (1998). Acute stroke: Delays to presentation and emergency department evaluation. Annals of Emergency Medicine, 33, 3−8. doi:10.1016/S0196-0644(99)70431-2
Panagos, P. (2008). The approach to optimising stroke care. The American Journal of Emergency Medicine, 26, 808−816. doi:10.1016/j.aejm.2007.11.014
Richardson, D. (2006). Increase in patient mortality at 10 days associated with emergency department overcrowding. Medical Journal of Australia, 184, 213−216. Retrieved from https://www.mja.com.au/
Trzeciak, S. & Rivers, E. (2003). Emergency department overcrowding in the United States: An emerging threat to patient safety and public health. Emergency Medicine Journal, 20, 402−405. doi: 10.1136/emj.20.5.402

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