Overcrowding in the Emergency Department
In this paper I discuss how holding patients in the Emergency Department (ED) has a negative effect on patients. To many patients in the ED , medication errors and patients lingering in the ED instead of being in the Intensive Care Unit (ICU) are the main cause of mortality and morbidity. For this assignment, I gathered information to figure out if the increased number of patients in the ED, medication errors, and the length of time ICU patients are held in the ED at Ohio Valley Medical Center (OVMC) is an actual issue that is effecting our patients. After doing a complete assessment and gathering the needed ...view middle of the document...
I find it a big problem when a very ill patient that is on the ventilator, has several tubes and several different medication drips running is held in the ED longer than necessary. These critically ill patients require one on one care. Most of the time the first so many hours of their stay can be the most important and time consuming while trying to stabilize the patient. The ED is not the place for this to happen when we have several other patients. These patients need ICU where they have one nurse for every two patients. Since this is not an option in the ED it puts the patients at danger, especially being so critical. Since the nurses in the ED can have 4-5 patients plus the one ICU patient, it can be very easy to miss a medication dose or simply administer the wrong dose because they are pushed for time.
While working on this project, I tried to get the number of medication errors that happened in the ED that could be related to holding patients in the ED, but it was difficult. I did obtain a number for how many medication errors, but not for specific departments or what caused the errors. For the week that I gathered data, there was 3 medication errors in the hospital.
While gathering information about medication errors, it was found that medication administration might have been given correctly, but was delayed at times. A delay in medication administration may seem like no big deal but for certain medical conditions, medication can save a life or affect the outcome of their illness. For example, a patient that is experiencing a heart attack needs a baby aspirin and started on a nitroglycerin drip as soon as possible. Also, when a patient comes in with pneumonia, there are certain medications that are supposed to be administered within a certain time frame along with obtaining a blood culture before the antibiotics are give.
Spending prolonged time in the ED instead of being on ICU can have a significant effect on patient because the patient needs strict monitoring and this may not be possible with a ED full of other critically ill and injured patients. While continuing to gather needed information, I went on to determine how long some patient’s were actually held in the ED and reasons for this. I found that a few of the reasons that patients were held in the ED was because of lack of staff on the ICU and the lack of beds that are available. It was a constant issue while spending time in the ED that there was never any beds on ICU and if there was, there was not enough nurses. This is a problem because of not enough staff or the hospital not wanting to pay overtime. It never made much sense to me why it was ok for a nurse in the ED to have one critically ill patient needed ICU, a trauma and then three other patients with other illnesses but it is not okay to give a nurse on ICU more than two patients. It is not safe for the patient or the nurse that is put in that situation. The ED found that after the patient is admitted, they...