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
Click here to unlock this and over one million essaysShow More
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.
The film, The Waiting Room, paints a clear picture of the variety of obstacles that commonly occur in the emergency department. The majority of patients are uninsured, are using the hospital as their primary care physician, long wait times and communication challenges. This paper will outline challenges displayed in the documentary paired with different ideas working to create a more effective health care experience.
Cerebrovascular disease or the term stroke is used to describe the effects of an interruption of the blood supply to a localised area of the brain. It is characterized by rapid focal or global impairment of cerebral function lasting more than 24 hours or leading to death (Hatano, 1976). As such it is a clinically defined syndrome and should not be regarded as a single disease. Stroke affects 174-216 people per 10,000 population in the UK per year and accounts for 11% of all deaths in England and Wales (Mant et al, 2004). The risk of recurrent stroke within 5 years is between 30-43%. One problem is that the incidence of stroke rises steeply with age and the number of elderly people in the UK is on the increase. To date people who experience a stroke occupy around 20 per cent of all acute hospital beds and 25 per cent of long term beds (Stroke Association, 2004). The British Government now identifies stroke as a major economic burden on the National Health Service (DoH, 2002).
Stroke is the third leading cause of death and the brain injuries caused by stroke are a huge cause of disability in older adults. There are over 1.2 million stroke survivors in the UK and half of all stroke survivors have a disability following their stroke. A person’s age increases their risk of having a stroke. Most strokes occur between the ages of 65 and 75. There are three main types of strokes. 85% of strokes are ischaemic and occur when a blood clot forms in an artery leading to the brain, stopping the blood supply causing a neurological defect lasting more than 24 hours (Alexander et al., 2011). 15% of strokes are haemorrhagic and result from a weakened blood vessel that has ruptured and bleeds into the surrounding brain. It can be
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).
“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...
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.
According to the Centers for Disease Control and Prevention (CDC) (2012), the average time patients spend in the U.S. emergency department (ER) before they can see a doctor has increased to 25% between 2003-2009. The main cause of longer wait times (WT) in the ER is overcrowding. Overcrowding has been found to be closely related to both subjective and objective patient satisfaction (Miro’ et al, 2003). Longer wait times in the ED is such an important issue because its consequences are detrimental not only to the ER patients, but also to providers. As a health care provider, decreasing patients’ WT in the ED is essential, although challenging, to improve patient’s health outcomes and increase patients’ satisfaction. Although it is a very challenging issue to tackle, hospitals that have initiated some quality improvement (QI) strategies are experiencing some positive outcomes in that area of care. The outcomes are measured by decreased waiting times, improved patients’ clinical outcomes and increased patients’ satisfaction.
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
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.
Commonly throughout most countries of the world, citizens of the society at large establish the system for Emergency Medical Services. In the case that the public is not willing or capable of summoning such a service, the country often finds other emergency services, businesses, or the government and authorities who act to employ a system. In other parts of the world, the emergency medical service additionally takes on the role of transporting patients from one medical facility to an alternative one. This occurs with some frequency because once a patient is analyzed and provided care at the immediate hospital; it may be more appropriate for a variety of reasons the patient needs to move to another facility. As one can see, the relat...