NSG 6101 W2A1 -Nursing Research Methods

NSG 6101 W2A1 -Nursing Research Methods

NSG 6101 W2A1 -Nursing Research Methods

Grafstein, E., Wilson, D., Stenstrom, R., Jones, C., Tolson, M., Poureslami, I., & Scheuermeyer, F.X. (2013). A Regional Survey to Determine Factors Influencing Patient Choices in Selecting a Particular Emergency Department for Care. Academic Emergency Medicine, 20(1), 63-70.  doi:10.1111/acem.12063

Main Purpose and Scope

To maintain efficiency in overcrowded emergency rooms by shifting patients to less busy ED’s.  Ambulatory patients in urban areas choose an ER based on distance and wait times.

Description of Research

Seventeen cross-sectional survey questions relating to patient decisions in choosing a speci?c ED was administered in each of six EDs in a single urban Canadian health region at all hours of the day. A face to face interview was performed.  Ambulatory patients with a Canadian Triage and Acuity Scale (CTAS) level three to five and nineteen years and older were surveyed via convenience sampling and qualitative focus group methodology.

Value and Significance

With the development of ambulatory centers, patients have more of a choice of where to seek care.  Overcrowding can cause a deficit in adequate care and lead to life threatening situations.  Announcing wait times can help patients make a more informed decision.

Shortcomings or Bias

Patients self-reported data.  Mental health and intoxicated patients were excluded.  Interviews only occurred during busy daytime hours.  Questions regarding health insurance and finances were not included.  Redirecting patient could be an EMTALA violation.

Conclusions and Summary

The development of freestanding emergency rooms is helpful to provide patients with better access to care and help to reduce overcrowding.  Patients chose where to go based on distance to them and wait times.

Keizer Beache, S., & Guell, C.  (2016).  Non-urgent accident and emergency department use as a socially shared custom: a qualitative study.  Emergency Medicine Journal, 33(1), 47-51.  http://dx.doi.org/10.1136/emermed-2014-204039

NSG 6101 W2A1 -Nursing Research Methods

Main Purpose and Scope

To understand why patients use emergency rooms (ER’s) as opposed to primary care facilities in a middle-income healthcare setting in Saint Vincent and the Grenadines in the Caribbean.

Description of Research

Two semi-structured interviews with a purposive sample of men and women with non-urgent complaints from a variety of social backgrounds. A grounded theory approach was used to analyze the interviews.

Value and Significance

Overcrowded ER’s are a worldwide problem.  Services and perception of urgent versus nonurgent by patients differs from that of healthcare providers.  Society shapes decision making process and habits form to choose ER’s rather than primary care for convenience and financial reasons.  Understanding patients perceptions and figuring out human behavior is essential in order to make changes in healthcare, including relieving overcrowded emergency rooms.

Shortcomings or Bias

Parents seeking help for their children were excluded.  A small sample size was used.  Only patients with non-urgent conditions were included.

Conclusion and Summary

Patients chose the ER because they knew a nurse or physician would always be there.  Patients do not know what constitutes an emergency but rather are in fear with high anxiety over their symptoms.   Patients choose ER’s because of ease of access, dissatisfaction with primary care providers and cost.

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References

Grafstein, E., Wilson, D., Stenstrom, R., Jones, C., Tolson, M., Poureslami, I., & Scheuermeyer, F.X. (2013). A Regional Survey to Determine Factors Influencing Patient Choices in Selecting a Particular Emergency Department for Care. Academic Emergency Medicine, 20(1), 63-70.  doi:10.1111/acem.12063

Keizer Beache, S., & Guell, C.  (2016).  Non-urgent accident and emergency department use as a socially shared custom: a qualitative study.  Emergency Medicine Journal, 33(1), 47-51.  http://dx.doi.org/10.1136/emermed-2014-204039