Research Problem/Purpose
Abir et al. (2019) focus on the challenge of crowding, which is a significant challenge among emergency departments and will be associated with poor outcomes. The purpose of Abir et al., (2019) study is to evaluate the effects of high occupancy in the emergency department on the different disposition decisions, hospitalizations, and return emergency department visits among patients. Abir et al. (2019) has therefore placed the study problem in the context of existing nursing knowledge by highlighting that only a few scholarly studies have tried to investigate the effects of crowding in the emergency department on patient disposition decisions. Past studies have therefore been conducted on small healthcare facilities and have provided no association between the likelihood of patient admission versus discharge and crowding. The findings of previous studies need to be confirmed in a larger setting. Abir et al. (2019) seek to solve a problem relevant to nursing in that the study seeks to fill the knowledge gap related to the effect of crowding in the emergency department on disposition patterns of patients and the subsequent outcomes among the discharged patients.
Review of the Literature
Abir et al., (2019) study explore various concepts in the literature review, including the increase in the number of patients in the emergency department visits in the US by more than twice in the past two decades. According to the literature I explored in Abir et al. (2019) study, the increase in the number of people visiting the emergency department in various healthcare facilities across the US has therefore contributed significantly to the challenge of crowding patients and has also experienced numerous challenges related to the timely access of emergency care. According to the literature reviewed by (Abir et al. (2019), the challenge of emergency department crowding is of great concern because such crowding will be associated with adverse clinical outcomes. Studies across the US have therefore shown that crowding correlates significantly to increased mortality and morbidity among patients’ non-compliance to treatment guidelines, delays in treatment, low length of stay, and high provider errors. Emergency department crowding also contributes significantly to high costs, high return visits, and readmissions elopement, and decreased patient satisfaction. According to the literature reviewed in Abir et al.’s (2019) study, emergency department crowding will also be a significant concern because it will significantly affect the disposition decisions among healthcare practitioners to either admit or discharge patients.
Abir et al. (2019) rely on current studies published within ten years of the studies conducted, with only two exemptions of studies being older than ten years. The two exemptions of the studies that are older than ten years include a practice guideline that had not been revised.
Theoretical Framework
Abir et al. (2019) do not identify a theoretical framework for their study but highlight the main assumptions of their study, which include providing a null hypothesis that high emergency department occupancy will have a significant impact on this position decision, hospitalizations, and return emergency department visits in a healthcare facility.
Abir et al., (2019)) study does not clearly identify a nursing theory that it relies on. One of the formal theories that can be applied to Abir et al., (2019) study includes Nightingale’s environmental theory. Nightingale’s theory focuses significantly on the environment in which nursing care is provided among patients. According to Nightingale, altering the patient’s environment can therefore go a long way in providing a lasting change in the health care of such patients. Different environmental factors can therefore affect the health of patients, which include pure water, fresh air, sufficient food supply, cleanliness, efficient drainage, and light. The lack of a clean environment in healthcare settings can therefore play a significant role in diminishing the health of patients (Gilbert, 2020). The role of nurses in patient recovery is to modify the environment so as to create the optimal conditions that might be necessary to allow the patient’s body to heal itself. In some cases, this would mean a better diet, minimal noise, or delivery of timely health care services. Nightingale’s theory can therefore be applied in Abir et al., (2019)) study because the study focuses on environmental factors that can affect the quality of healthcare services in the emergency department. Abir et al.’s (2019)) study highlights that crowding is a significant challenge in the emergency department that can be associated with poor outcomes among patients. The application of Nightingale
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