community consists of the patients including insurance status and age of the population. Also this includes access to primary care which contributes to the demand of ED. The ED processes the impact of the flow. Along with this comes the triage, staffing, availability of specialists and diagnostic services including technological resources. If any of these fall short it creates a dilemma in the services provided causing patients to wait which then causes overcrowding. The rest of the hospital has to do its part as well by discharging patients as effectively and efficiently as possible. The lack of beds available can cause backup in admitting patients and using resources to treat incoming patients. It is stated, “Hospitals become ill equipped to handle fluctuations in demand when the average hospital
census remains at or above 90% of capacity, resulting in an inpatient bed shortage and ED boarding” (Gallagher, 1990). Everyone wants to be healthy and live as vigorous as possible. So it’s not a mystery when one gets unwell the first thing they do is either go to the pharmacy store and purchase a treatment of their choice or if they feel it is something beyond their control and cannot find a solution on their own, the emergency room is their next best chance. Patients seeking care for non-urgent problems can be recognized as one of the leading factors. “Of the 119.2 million ED patient visits reported to the National Ambulatory Medical Care Survey in 2006, for example, 5.1 percent were triaged as needing immediate attention, 10.8 percent as emergent, 36.6 percent as urgent, 22 percent as semi-urgent, and 12.1 percent as nonurgent” (Moskop, 2010). Experienced nursing staff is vitally important to the provision of high quality care in the ED. According to Moskop, “This is partly due to a shortage of qualified nurses and partly because congestion has made the ED a frustrating work environment. Increasingly, limited resources prevent emergency staff from providing the care our patients need” (2010). It becomes difficult for physicians and especially nurses to do their jobs when the required supplies are not available and also create an uneasy environment because the more people not serviced on top of the incoming patients to the ER cause an overwhelming feeling. Some nurses choose to work in a different department or seek a job elsewhere. Another factor is the move of some hospitals to staff the ED with part-time nurses to lower costs. This creates shortages within the department as experienced personnel move into full-time jobs outside of the ED. A corollary to this problem is the high staff turnover in some EDs, leading to a higher percentage of new, inexperienced emergency nurses, who may not be as efficient in the delivery of care. Patients, often those who are uninsured or lack adequate access to primary care services end up in the ED for non-urgent care or for serious conditions that could have been treated earlier or even prevented. “In the absence of a national universal health benefits program, hospital EDs are essentially the only place in our current health care system at which all patients are guaranteed medical care” (“Pediatrics”, 2004).
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