Nursing Research

When patients stay in the emergency department (ED) for extended time periods it leads to overcrowding and compromises patient safety. When patient flow is impacted patient safety, quality care and the patient experience are at risk. Moving patients smoothly through the ED ensures that once an admission decision has been made, the ED is ready to move the patient to the floor. The focus then becomes the inpatient hospital-wide flow, and the ability of those units to pull the patient to the floor. Facilitating unit-to-unit reports in a timely manner is very important to reduce the time patients wait to move to the floor (Baker, 2015). The earlier patients can get to the care units they need to be on, the earlier they can get the acute care interventions needed for them to get better. The issue I would like to address is the delays in getting patients to the floors and the problem of patients waiting in the ED for inpatient beds.

With any research, there is a need for an argument or purpose to that research. The explanation for the study must be clear to all. When evaluating research there are four areas for consideration and to keep in mind:

• Significance
• Research ability
• Feasibility
• Interest

The significance of the research is important with the hopes that it contributes to nursing and helps improve patient care (Polit, 2015). Is this an important next step? Improving flow from the ED to the inpatient units strives to reduces delays and get the patient treated more quickly and more efficiently. Researchability evaluates the scope of the problem and whether it is a fit for a study. Not all problems are appropriate for research or “amenable to research inquiry” (Polit, 2015, p. 73). Feasibility can be quite broad and include many different areas including: time, research experience, participant’s availability, ethical consideration and money. The last evaluation of research is interest and how important the topic is to the researcher. A lot of time will be focused on this problem and so it is important to have enthusiasm about the subject matter. This is a subject I am passionate about. I also see how many problems are generating from this one area. If we can improve this flow, then we can also impact many other processes.

The admission process at my hospital is streamlined for communication with all the key players to ensure everyone is updated on patient flow. Setting a standard for getting report and pulling the patient to the unit would help further reduce delays.  Currently the units attempt to call each other and play a back and forth tag game with phones calls between the ED and the inpatient units. This leads to frustrations from staff and increases delays when nurses are not available to get report. I would like to look at setting an expectation around that report time and evaluate the impact that would have on ED to inpatient admission times.

 

Reference

Baker, S. J. (2015). Partnering Effectively With Inpatient Leaders for Improved Emergency Department Throughput. Advanced Emergency Nursing Journal, 65-71.

Polit, D. F. (2015). Nursing research: Generating and assessing evidence for nursing practice (10 ed.). Philadelphia, PA: Wolters Kluwer.