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How Have Stroke Patients Been Affected By Emergency Department Overcrowding In Hospitals?

1357 words - 6 pages

Emergency departments of hospitals are fundamental in the treatment of time sensitive conditions such as acute stroke (Trzeciak & Rivers, 2003). A stroke occurs when there is an interruption of blood flow to brain tissue, and therefore is a condition that relies on apt and adequate access to healthcare (Panagos, 2006). Patients who have experienced a stroke will most often present to emergency departments in order to receive treatment (Kothari et al, 1998). However it has been found by Chan et al (2010) that approximately 48% of American hospitals are operating over capacity and therefore not providing satisfactory healthcare. Overcrowding can be defined as the overabundance of patients requiring treatment and may be attributable to the misuse of the emergency area by non-critical patients (Chan et al, 2010; Trzeciak & Rivers, 2003). This has the potential to negatively affect outcomes for stroke patients. The aim of this essay is to investigate factors such as patient knowledge, wait times and patient safety in order to examine the effects of overcrowding of emergency departments on stroke patients.
Patient knowledge has been shown to influence outcomes for stroke patients. A number of studies have indicated that delays to emergency department presentation due to a lack of patient knowledge regarding stroke is the main reason for exclusion from treatment (Chan et al, 2010; Kothari et al, 1997; Panagos, 2008). A prospective study performed by Kothari et al (1997) showed that 40% of stroke patients questioned had no knowledge of any stroke symptoms. Both Chan et al (2010) and Kothari et al (1997) propose that public education regarding stroke is needed to increase the positive outcome for these patients. In the study performed by Chan et al (2010) where participants were educated about stroke signs and symptoms whilst waiting in the emergency department, participants showed increased knowledge after being informed about stroke. However this study did not collect pre-education test scores and therefore the scores may not be directly attributable to the education from the study but from the patients’ base knowledge. In addition to this, it is important to consider that the type of people who are willing to participate in a study are the people who may already have knowledge of stroke and therefore may not be representative of the average population. While a key concern for stroke patients is the time taken to present to emergency departments due to a lack of knowledge, a further issue is the wait time that is experienced once a patient enters the hospital.
Overcrowding of emergency departments cause an increase in patient wait times (Richardson, 2006). It has been shown that in-hospital delays impact negatively on the ability of stroke patients to be treated (Chan et al, 2010; Kothari et al, 1998; Panagos, 2008). Patients that have had an acute stroke can be treated with tissue plasminogen activator (TPA) however this treatment is only effective...

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