What is the health, social, and ethnic characteristics of the two ED practice contexts?
Read Chapters 14-15, pages 304-354, CASE STUDY: Laura is a nurse in the emergency department at a large, not for profit urban hospital. The pace is fast because the ED is used by many residents for most of their health care needs. Most of these patients have only poverty-level incomes and no health insurance. Chris is a nurse at a regional medical center in an upscale location. She also works in the emergency department. Most patients seeking services here are upper middle-class residents with health care insurance. Laura and Chris meet at a research conference and begin discussing how they both would like to decrease wait times for ED services. A. What is the health, social, and ethnic characteristics of the two ED practice contexts? B. Laura describes how patients may wait 8 hours or longer to be seen in the ED. Staffing patterns haven’t changed over the past 5 years, but they have experienced a 27% increase in the use of the ED for health care services. Laura has found research data to support a program in which the triage nurse could refer patients to a fast-track clinic, to the ED, or to a nurse practitioner clinic. She thinks that this would move patients through faster. So far, administration will not listen to her proposal, citing lack of funding. What barriers or facilitators might be present for Laura’s new program? C. Chris wants to “flex” schedules of the physicians and nurses based on the volume of patients seen. Currently, the ED has too many staff standing around or they are stretched too thin. She has found several research studies that support this initiative. What barriers and facilitators might be present concerning her proposal? D. Chris and Laura have different approaches to solving the same problem—wait times in the emergency department. Is it possible that the same clinical question could have two different responses? Explain your answer.
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