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Full proposal document on stroke knowledge and prevention practice
Problems with emergency room overcrowding
Problems with emergency room overcrowding
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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 ... ... middle of paper ... ... 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
Stroke survivors or anyone with chronic illness and health providers remain hopeful and “realistic” by counting on each other. The patients while being realistic about the outcome of their disease, stay hopeful that each of their health care providers will give them the appropriate care and will make sure that they can live with their disease in the best way possible.
Monitoring staff levels is an important factor. Also leveling the flow of patients in and out institutions could help to reduce wide fluctuations in occupancy rates and prevent surges in patient visits that lead to overcrowding, poor handoffs, and delays in care. Studies show that overcrowding in areas such as the emergency rooms lead to adverse outcomes, because physicians and nurses having less time to focus on individual patients. One study found that for each additional patient with heart failure, pneumonia, or myocardial infarction assigned to a nurse, the odds of readmission increased between 6 percent and 9 percent (Hostetter and Klein, 2013). All of which costs the hospital money.
The challenges that all acute care hospitals and facilities faces are the demand for highly specialized services has increased. The US population is constantly aging and the elderly tend to need more acute care services. Because many people lack health insurance, they tend to use emergency rooms in the hospitals as their source of care. The increase demand in acute care prompted hospitals to expand their facility
Because of the lack of organization with the health care providers in Canada, the wait times are too long and can cause serious complications to any condition the patient went in for in the first place. This situation of how the health care system can resolve wait times was brought to the government but they continue to ignore the proposals brought to them. It is possible to resolve the problems of wait times without extreme change and expenses in the health care system. The solution is to be found in the reorganization of the health care providers. Lack of assistance in the emergency room can make ones illness to become worse, therefore, causes the patient to be forced to wait in emergency rooms for an extended period of time and when they are finally seen by a health care provider, the outcome is very poor due to lack of registered staff, physicians and proper assessment(Goldman & Macpherson, 2005, p.40). The objective of this paper is to discuss and critically analyze the conditions of emergency waiting rooms. The specific issue this paper intends to explore is extensive and prolonged waiting times for patients accessing health care, patients who need urgent treatment and the vulnerability of elderly patients and children. With an in-depth critique of the barriers to health care and shortcomings of emergency rooms, strategies will be provided to enhance a health care system that makes it more accessible and efficient.
1. What is the difference between a. and a. Introduction The main aim of this report is to present and analyse the disease called Cerebrovascular Accident, popularly known as stroke. This disease affects the cerebrovascular system, which is a part of the cardiovascular system.
Pham, J. C., Seth, T. N., Hilton, J., Khare, R. K., Smith, J. P., & Bernstein, S. L. (2011). Interventions to improve patient-centered care during times of emergency department crowding. Academic Emergency Medicine, 18(12), 1289-1294. doi:10.1111/j.1553-2712.2011.01224.x.
Emergency care has always been an important part of history all over the world. It has been said that medical assistance has been around and prevalent since as far back as 1500 B.C. Around the 1700’s is when EMS systems first began to experience large advancements, and ever since then, the field continues to grow and improve every year.
The state of emergency medical care currently practiced in this community involves an excellent pre-hospital phase under the jurisdiction of Los Angeles City paramedics. The paramedics have jurisdiction of about thirty-five emergency rooms to which their patients can be transferred after beginning medical treatment at the scene of the accident. This is where the problem occurs. To provide the best possible emergency care at the hospital, two factors play an important part. First, the staff must work on at least two to three severely injured patients daily to maintain their technical skill at top level. Second, surgeons and operating rooms must be available within 15 minutes notice, twenty-four hours a day, 365 days a year. In the San Fernando Valley, this level of care is not met anywhere. In greater Los Angeles, this level of care is met at less than six hospitals. The problem involves too many emergency rooms for the population. The cost of maintaining an operating room on fifteen minute standby day and night would put hospitals out of business, since even the busiest hospitals only receive three to four severely injured patients each week. The patient load would not support the very high cost of this service.
The World Health Organisation (2013) explains that an Ischaemic stroke occurs as a result of a blood vessel becoming blocked by a clot, reducing the supply of oxygen to the brain and, therefore, damaging tissue. The rationale for selecting Mary for this discussion is; the author wishes to expand her evidenced based knowledge of stroke since it is the principal cause of disability and the third leading cause of mortality within the Scottish population (Scottish Intercollegiate Guidelines Network (SIGN), 2008) and, therefore, a national priority. In response to this priority, the Scottish Government (2009) produced their ‘Better Heart Disease and Stroke Care Action Plan’. Additionally, they have introduced a HEAT target to ensure 90% of stroke patients get transferred to a specialised stroke unit on the day of admission to hospital (Scottish Government, 2012).
Patient safety is a major issue in health care, especially in the public sector. Studies show that as many as 10 patients get harmed daily as they receive care in stroke rehabilitation wards in hospitals in the United States alone. Patient safety refers to mechanisms for preventing patients from getting harmed as they receive health care services in hospitals. The issue of patient safety is usually associated with factors such as medication errors, wrong-site surgery, health care-acquired infections, falls, diagnostic errors, and readmissions. Patient safety can be improved through strategies such as improving communication within hospitals, increasing patient involvement, reporting adverse events, developing protocols and guidelines, proper management of human resources, educating health-care providers on the need for patient protection, and commitment of the leadership to the task. This paper talks about patient safety and how it can be improved in stroke rehabilitation wards of both public and private hospitals.
“Time is brain” is the repeated catch phrase when addressing the treatment and management of stroke (Saver, 2006). Access to prompt and appropriate medical care during the first few hours of stroke onset is critical to patient survival and outcomes. Recent changes in the guidelines for acute stroke care released by the American Heart Association (AHA) and the American Stroke Association (ASA) have improved patient access to treatment. Stroke treatment now follows the model of myocardial infarction treatment. Hospitals are categorized into four levels based on stroke treatment capability. The most specialized treatment is available in comprehensive stroke centers followed by primary stroke centers, acute stroke-ready hospitals, and community hospitals. The use of telemedicine now enables even community hospitals, with limited specialized capabilities, to care for stroke patients. Telemedicine puts emergency hospital personnel in contact with neurologists providing expertise in the evaluation of a stroke patient and determination of their eligibility for treatment with thrombolytic medication (Jefferey, 2013).
Stroke is a serious medical condition that affects people of all ages specifically older adults. People suffer from a stroke when there is decreased blood flow to the brain. Blood supply decreases due to a blockage or a rupture of a blood vessel which then leads to brain tissues dying. The two types of stroke are ischemic stroke and hemorrhagic stroke. An ischemic stroke is caused by a blood clot blocking the artery that brings oxygenated blood to the brain. On the other hand, a hemorrhagic stroke is when an artery in the brain leaks or ruptures (“About Stroke,” 2013). According to the Centers for Disease Control and Prevention (CDC), “Stroke is the fourth leading cause of death in the United States and is a major cause of adult disability” (“About Stroke,” 2013). Stroke causes a number of disabilities and also leads to decreased mobility in over half of the victims that are 65 and older. The CDC lists several risk factors of stroke such as heredity, age, gender and ethnicity as well as medical conditions such as high blood pressure, high cholesterol, diabetes and excessive weight gain that in...
Meredith, J.W (2008, May). The Lack Of Hospital Emergency Surge Capacity: Will The Administration's Medicaid Regulations Make It Worse? Presented at The House Committee On Oversight And Government Reform. Retrieved March 2014, from
In the event of a natural crisis such as a hurricane or an earthquake it’s possible that large hospitals would be overwhelmed. In 2005, Hurricane Katrina inundated New Orleans and many of the city’s hospitals experienced power outages. Those outages left the medical staff scrambling to care for patients who required life support. One of the hospitals was Memorial Medical Center they were so desperate they requested help from the National Guard. The National Guard was quick to send back-up generators to ensure the hospital could stay in operation.
Offering acute care services 24 hours a day, my chosen organization’s hospital affiliate is designated as a Level II Trauma Center, rendering emergency services for injuries and diseases to more than fifty-thousand patients every year ("Emergency and Trauma," 2017). Although not all emergency department (ED) patients does not require hospital admissions, patients who are critically ill with life-threatening conditions typically require inpatient care in either one of the hospital’s two 16-beds intensive care units (ICU) ("Critical Care," 2017). However, the need for ICU services is usually high, that the amount of beds and licensed personnel available is not enough to fulfill the needs of the critical ill patients. Therefore, prioritization