The Impact On Patient Flow After The Integration Of Nurse Practitioners Essay

Major studies in the last three decades have confirmed an association between the registered nurse to patient ratio and adverse patient outcomes such as mortality, morbidity, length of stay, failure to rescue (Hunt 19). For example, bed sores or patient falls, are considered an adverse outcome because it is a complication that occurred after the patient was admitted to a healthcare facility, Nonetheless, the key to

A visit to the emergency department (ED) is usually associated with negative thoughts by most people. It creates preconceived images of overcrowded waiting rooms and routine long waits for treatment (Jarousse, 2011). From 1996 to 2006, ED visits increased annually from 90.3 million to 119.2 million (32% increase). During this same time period, the number of EDs has declined by 186 facilities creating the age old lower supply and greater demand concept (Crane & Noon, 2011). There are many contributing factors that have led to an increase in ED visits. A few of these key drivers include lack of primary care access, rising of the uninsured population, dwindling mental health services, and the growing elderly

In the past two decades, there has been a push for appropriate staff to client ratios. However, measuring client needs and nursing efforts have been around since 1922 (Lewinski-Corwin, 1922, pp. 603-606). The earliest recorded effort was by the New York Academy of Medicine. Superintendents and nurses from ten training schools documented the time spent providing bedside care. From complied information, the researchers revealed each client required an average of five hours and four minutes of care in a 24-hour period. From these observations, they evaluated staffing issues in New York City. At that time, none of the hospitals were sufficiently staffed (Lewinski-Corwin, 1922, pp. 603-606).

For over a decade researchers have been performing studies examining the effects patient-to-nurse ratios have on adverse outcomes, mortality rates, and failure-to-rescue rates of patients and on job dissatisfaction and burnout experiences of nurses. Aiken, Sloane, Sochalski, and Silber (2002) performed a study which showed that each additional patient per nurse increased patient mortality within 30 days of admission by 7% and increased failure-to-rescue by 7% as well. This same study also showed that each additional patient per nurse resulted in a 23% increase in nurse burnout and a 15% increase in job dissatisfaction. Additionally, Rafferty et al. (2007) performed a study in which the results showed that patients in hospitals with higher patient-to-nurse ratios had a 26% higher mortality rate and nurses were twice as likely to have job dissatisfaction and experience burnout. Blegen, Goode, Spetz, Vaughn, and Park (2011) performed a study where results showed that more staffing hours for nurses resulted in lower rates of congestive heart failure morality, infection, and prolonged hospital stays. The same study also showed that increased nursing care from registered nurses resulted in lower infection and failure to rescue rates and fewer cases of sepsis.

The role of nurse practitioner is valuable when discussing collaborative care. There are so many levels of care, so many health entities, and so many insurer criteria involved that it is instrumental to have a role that can work towards help bring all aspects together. In addition to diagnosing, treating, and managing care, the role of the nurse practitioner is to manage simple and episodic acute health issues along with chronic disease (Sangster-Gormley, Martin-Misener, & Burge, 2013). It is important to note that although this is a function of this role, nurse practitioners also practice from a holistic point of view which allows them to help manage patient conditions or wellness in a more complete fashion. This includes helping patients have access to care beyond primary and secondary care settings. This encourages nurse practitioners to work alongside other health care and allied health professions, and families to create an individualized plan for every patient (van

14 million Canadians visit Emergency Departments (ED) every year, and also reported to having the highest use of EDs (Ontario Hospital Association, 2006). ED overcrowding in Canada has become an epidemic. ED overcrowding has been defined as “a situation in which the demand for emergency services exceeds the ability of an (emergency) department to provide quality care within acceptable time frames” (Ontario Ministry of Health and Long Term Care, 2014). This has been an ongoing problem across Canada. Ontario has developed an initiative to reduce ED wait times by implementing a variety of strategies and collaborating with other institutions. This paper describes the Emergency Room National Ambulatory Intuitive (ERNI), an

A Nurse Practitioner has a very serious job. Being a nurse practitioner is not a job for someone who is not willing to work hard and be ready for anything at any moments notice. There are many different specialties to being a nurse practitioner such as emergency care, pediatric. Nurse practitioners work long hours and can work anywhere, from a doctor’s office to a hospital.

Emergency departments are considered an important aspect of the health care system. For many years, wait times have been an area of concern for many Canadians and remain a significant issue. One of the major concerns within the Canadian health care system is the amount of time spent as waiting time in the healthcare services. Wait times are the length of time from when the patient is triaged and registered, to when the patient leaves from the emergency room (Affleck, Parks, Drummond, Rowe, & Ovens, 2013). Whether waiting for a doctor, waiting for prescription medication, or even waiting to get tested, the reasons for wait time in Canada are caused by many factors (Cole, Hopman, & Kawakami, 2011). This paper will seek to examine the factors contributing to longer wait times in the emergency department, examine the ways in which wait times impact society, and conclude by presenting possible solutions to reduce wait times.

In this article, the authors investigated the vulnerabilities in emergency department to internal medicine patient transfers through self-administered surveys of all emergency medicine house staff. More specifically, the survey investigated adverse events due to faulty communications during handoffs. According to this survey, 29% of the emergency staff reported either an adverse or near-miss event due to errors during handoffs. Furthermore, the survey respondents identified inaccurate or incomplete information, cultural and professional conflict, crowding, and many other factors as the contributors to handoff errors. By identifying specific contributors to handoff errors, this article serves as guidance for handoff intervention.

A Nurse Practitioner is a registered nurse that has additional education and training in diagnosing and treating illnesses in specialty areas such as family, geriatric, neonate, or pediatrics. Nurse Practitioners prescribe medication, which usually RN’s cannot do, as well as treat illnesses and administer physical exams. Nurse practitioners have a master's degree or doctorate in nursing and board certification in their specialty. A pediatric NP has higher education, skills, and training in caring for infants, children, and teens than an RN. As licensed nurse practitioners, NPs follow the policy and regulations of the Nurse Practice Act of the state in which they work. As health care shifts away from the traditional hospital setting to within

Emergency room overcrowding is a major issue throughout not just the United States but in many countries. There have been many strategies on how to combat this issue as patient satisfaction is often being a major variable on hospitals being reimbursed, which interventions are most helpful? One intervention that is gaining more and more popularity is advertising wait times. Through a PICO search with key words of “ED triage” and “patient satisfaction” or “wait times” provided some great original research over the past five years that has been peer reviewed in the Journal of Canadian Association of Emergency Physicians. While multiple research papers came up, the methodology and potential of taking this particular study further was of great interest.

Since the implementation of the Affordable Care Act, emergency department (ED) volume has expanded, exceeding 15% over budget in our hospital in approximately one-year. This phenomenon is not isolated to our organization, it is a nationwide issue (American College of Emergency Physicians, 2014). In addition, ED lobby wait time has increased and the left without being seen (LWBS) numbers have climbed to over 6%. Furthermore, the ED has been to a greater extend, boarding admitted patients.

Igor Georgievskiy, Alcorn State University Zhanna Georgievskaya, Alcorn State University William Pinney, Alcorn State University ABSTRACT This paper examines the wide-spread problem of extended waiting times for health services, in the context of the Emergency Department (ED) at a regional hospital. In the first phase of the study, a field observation was conducted to document the current operation of the ED. The second phase of the study will be the building and validation of a Flexsim computer model of the ED for modeling, analysis, visualization, and optimization of the patient flow within the ED. The validity of the model will be established by

The research question for this study is, can the addition of a nurse practitioner into an emergency department have an impact on patient wait times, length of stay, and patients who leave without being seen? The hypothesis of this study is that there will be a reduction in wait time, length of stay, and patients who leave without being seen by adding a nurse practitioner as a provider to the emergency department. The dependent variable in this study is the addition of a nurse practitioner, while the independent variables are the patient wait times, length of stay, and patients who leave without being seen. A conceptual framework was used in this study, since the authors were specific about their idea of study. The related literature shows that there is an overcrowding issue in emergency departments and show that wait times and length of stay can be impacted by nurse practitioners. This study was performed by using a quantitative, experimental study design, in which a nurse practitioner was introduced into an emergency department, then the results were obtained by comparing before and after data. For this study data was collected from 3238 emergency department

Quality of care is one of the most important key for the success of health care system. It is unfortunate that the Pennsylvania hospitals are facing workforce shortages especially, the skilled/registered nurses and primary care physicians (PCP’s). Of these, nurses represent the first largest group of health care workers in hospitals, and thus, the shortage of nurses can potentially affect quality of care (U.S Department of Health and Human Service). The American Hospital Association estimated in June 2001 that 126,000 U.S. nursing positions were unfilled. It is estimated that by the year 2020, the gap could widen to at least 400,000 nurse vacancies. This is higher than the average nurse vacancy rate of 9.3 percent for the northeastern United States as reported by the American Organization of Nurse Executives (AONE) in its 2000 report. When the number of nurse staffing reduce, work pressure increases where nurse-to-patient ratio is high leading to more patient infections, injuries and patients will be sent home too early without adequate education about how to take care of their illness or injury, and thus, will cause readmission of patients. Second one is, the increasing demand for primary care physicians which is projected to grow more rapidly than physician supply. Based on current utilization process, the total demand for primary care physicians will