The Translational Research Graphic Organizer Comprehensive Nursing Essay Example
State the nursing practice problem for your evidence-based practice project. If your nursing problem has not yet been approved, make any required changes or revisions to your nursing practice problem prior to starting the assignment. Using your proposed topic, conduct a literature search and complete the tables below.(The Translational Research Graphic Organizer Comprehensive Nursing Essay Example)
Nursing Practice Problem: Overcrowding in emergency department (ED)
Emergency department overcrowding is a situation in which there is a higher demand for emergency services than physicians and nurses’ ability to offer quality care within a reasonable time. It is often associated with excessive patient numbers waiting to be seen, undergo assessment or treatment, or waiting for release. Various factors, including prolonged length of stay, delayed consultancy and laboratory and imaging tests, staff shortage, and lack of enough inpatient beds in the ED, cause overcrowding. ED overcrowding has significant effects on the patients and staff, such as increased ambulance diversion, waiting period, length of stay, medical errors, patient mortality, and financial losses. Hospitals need to take drastic measures to control ED overcrowding to avoid unpleasant consequences to patients, staff, and the hospital.(The Translational Research Graphic Organizer Comprehensive Nursing Essay Example)
Comparison 1: Translational Research vs. Qualitative Research
| Criteria | Peer-Reviewed Translational Article and Permalink/Working Link: Rasouli, H. R., Esfahani, A. A., & Farajzadeh, M. A. (2019). Challenges, consequences, and lessons for way–outs to emergencies at hospitals: a systematic review study. BMC emergency medicine, 19(1), 1-10. https://doi.org/10.1186/s12873-019-0275-9 https://bmcemergmed.biomedcentral.com/articles/10.1186/s12873-019-0275-9#citeas Translational Research Type: T1 translational research (The Translational Research Graphic Organizer Comprehensive Nursing Essay Example) | Peer-Reviewed Traditional Article and Permalink/Working Link: Yarmohammadian, M. H., Rezaei, F., Haghshenas, A., & Tavakoli, N. (2017). Overcrowding in emergency departments: A review of strategies to decrease future challenges. Journal of research in medical sciences : the official journal of Isfahan University of Medical Sciences, 22, 23. https://doi.org/10.4103/1735-1995.200277 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5377968/ Traditional Qualitative Research Type: Systematic Review | Observations (Similarities/Differences) |
| Methodology | The researchers searched original research articles on emergency department overcrowding published between 1st January, 2007 and 1st August 2018. They assessed relevant studies from PubMed and EMBASE databases using suitable keywords. They reviewed study titles, abstracts, and methodological validity of the findings, utilizing data extraction format. (The Translational Research Graphic Organizer Comprehensive Nursing Essay Example) | The researchers performed an initial electronic database search to identify relevant articles. They searched in bibliographic databases such as ISI Web of Science, PubMed, Science Direct, Scopus, Google Scholar, Wiley Online library, and governmental, national, and international databases and websites for published and ready-to-publish articles. They also conducted a literature search of identified papers and relevant information using keywords.(The Translational Research Graphic Organizer Comprehensive Nursing Essay Example) | The two research papers conducted an article review by searching from databases such as PubMed. They both used keywords in their article search. The qualitative research paper searched for articles in more databases that the translational research paper. |
| Goals | The study aims to perform a systematic review of studies addressing challenges, lessons, and solutions to emergency department overcrowding.(The Translational Research Graphic Organizer Comprehensive Nursing Essay Example) | The goal of the study identify and present strategies that have been validated to minimize delay and overcrowding in emergency departments.(The Translational Research Graphic Organizer Comprehensive Nursing Essay Example) | The translational research paper addressed challenges, lessons, and solutions to emergency departments’ overcrowding while the qualitative research paper focused on strategies of minimizing delay and overcrowding in emergency departments. |
| Data Collection | The authors included 117 articles in the final record, excluding 11 of them for poor quality. The systematic review encompassed findings from 106 original articles. They recorded 14, 55, and 29 reviewed articles referring to cause, effects, and solutions of emergency overcrowding, respectively. They also recorded four articles referring to causes and effects and four articles referring to causes and solutions.(The Translational Research Graphic Organizer Comprehensive Nursing Essay Example) | Independent reviewers evaluated abstracts and titles for eligibility. They retrieved full copies of articles after confirming eligibility. The inclusion criteria involved 1. Not evaluating any real patient flow in emergency departments and 2. Examining patient flow outside hospitals or hospitals’ specialized services. They recorded 1006 articles in the initial electronic database search and selected 136 of them as eligible articles based on titles and abstracts. After full article review, they concluded that only 30 of them met the inclusion criteria, excluding 106 papers. (The Translational Research Graphic Organizer Comprehensive Nursing Essay Example) | Both papers involved an inclusion criterion in selecting eligible articles for review. Both papers used titles and abstracts to examine eligibility. |
Comparison 2: Translational Research vs. Quantitative Research
| Criteria | Peer-Reviewed Translational Article and Permalink/Working Link: Peltan, I. D., Bledsoe, J. R., Oniki, T. A., Sorensen, J., Jephson, A. R., Allen, T. L., … & Brown, S. M. (2019). Emergency department crowding is associated with delayed antibiotics for sepsis. Annals of emergency medicine, 73(4), 345-355. https://doi.org/10.1016/j.annemergmed.2018.10.007 https://www.annemergmed.com/article/S0196-0644(18)31361-1/fulltext Translational Research Type: T0 and T1(The Translational Research Graphic Organizer Comprehensive Nursing Essay Example) | Peer-Reviewed Traditional Article and Permalink/Working Link: Jung, H. M., Kim, M. J., Kim, J. H., Park, Y. S., Chung, H. S., Chung, S. P., & Lee, J. H. (2021). The effect of overcrowding in emergency departments on the admission rate according to the emergency triage level. Plos one, 16(2), e0247042. https://doi.org/10.1371/journal.pone.0247042 https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0247042 Traditional Quantitative Research Type: Causal-Comparative/Quasi-Experimental(The Translational Research Graphic Organizer Comprehensive Nursing Essay Example) | Observations (Similarities/Differences) |
| Methodology | The researchers undertook a retrospective cohort study of emergency department (ED) sepsis patients in two community hospitals. ED occupancy rate was the primary exposure, referred to as registered ED patient to licensed ED beds ratio. They defined overcrowding as an ED occupancy rate greater or equal to 1. The researchers utilized multivariable regression to assess the adjusted association between ED crowding and door-to-antibiotic time. The Markov multistate models helped the researchers investigate ED crowding association to pre-antibiotic care processes. (The Translational Research Graphic Organizer Comprehensive Nursing Essay Example) | The authors conducted a retrospective cohort study in a single emergency department from January 1st and December 31st, 2018. They enrolled patient 19 years and over and divided them into groups based on the degree of overcrowding, high, low, or non, depending on the total patient number in the ED. They used an emergency triage tool, the Korean Triage and Acuity Scale, to categorize patients into five different levels. They examined whether the degree of admission rate change according to the overcrowding extent was different for each triage group. SAS (version 9.3, SAS Institute Inc., Cary, NC, USA) was utilized for statistical analysis.(The Translational Research Graphic Organizer Comprehensive Nursing Essay Example) | Both papers involved a retrospective cohort study of emergency departments in specific hospitals. The translational research paper utilized tools such as multivariable regression and the Markov multistate models while the quantitative research paper used tools like the Korean Triage and Acuity Scale and SAS. |
| Goals | The study aims to investigate the association between emergency department crowding and door-to-antibiotic time in emergency department sepsis.(The Translational Research Graphic Organizer Comprehensive Nursing Essay Example) | The goal of the study was to assess the characteristics of the patient group whose admission rate is affected by ED overcrowding.(The Translational Research Graphic Organizer Comprehensive Nursing Essay Example) | Both papers sought to assess cause and effect relationships, with the translational research investigating the association between emergency department crowding and door-to-antibiotic time in emergency department sepsis and the quantitative research paper assessing the characteristics of the patient group whose admission rate is affected by ED overcrowding |
| Data Collection | The paper included 3,572 eligible sepsis patients, with 70% of them arriving when ED occupancy rate was greater than or equal to 0.5 and 14% arriving when the ED was overcrowded.(The Translational Research Graphic Organizer Comprehensive Nursing Essay Example) | The researchers collected data from 73,776 patients, 19 years and over. The hospital used had 2,400 beds, divided into an adult area and pediatric area, with the adult area having 45 beds and 20 clinical chairs. Some patients were excluded due to canceled registration, visiting ED for other reasons other than medical, and analysis variables omission. Patients who died in ED were also excluded because they could not be considered for admission or discharge.(The Translational Research Graphic Organizer Comprehensive Nursing Essay Example) | Both papers utilized convenience sampling as they collected data from patients visiting EDs in the chosen hospitals. |
References
Jung, H. M., Kim, M. J., Kim, J. H., Park, Y. S., Chung, H. S., Chung, S. P., & Lee, J. H. (2021). The effect of overcrowding in emergency departments on the admission rate according to the emergency triage level. Plos one, 16(2), e0247042. https://doi.org/10.1371/journal.pone.0247042
Peltan, I. D., Bledsoe, J. R., Oniki, T. A., Sorensen, J., Jephson, A. R., Allen, T. L., … & Brown, S. M. (2019). Emergency department crowding is associated with delayed antibiotics for sepsis. Annals of emergency medicine, 73(4), 345-355. https://doi.org/10.1016/j.annemergmed.2018.10.007
Rasouli, H. R., Esfahani, A. A., & Farajzadeh, M. A. (2019). Challenges, consequences, and lessons for way–outs to emergencies at hospitals: a systematic review study. BMC emergency medicine, 19(1), 1-10. https://doi.org/10.1186/s12873-019-0275-9
Yarmohammadian, M. H., Rezaei, F., Haghshenas, A., & Tavakoli, N. (2017). Overcrowding in emergency departments: A review of strategies to decrease future challenges. Journal of research in medical sciences : the official journal of Isfahan University of Medical Sciences, 22, 23. https://doi.org/10.4103/1735-1995.200277
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