Ethical dilemma This essay will narrate a nurse’s ethical dilemma as experienced in a local emergency department. In addition, the paper will discuss the relevant codes of conduct and law and make recommendations based on the nurse’s ethical dilemma.
The subject in this case is a 93-year-old Alzheimer patient who was by then in an extended care facility. As the ailment worsened, she became unable to eat or drink anything, and this was a great threat to her health. It reached that point where the patient would not respond to any touch or voice. The physician in charge of her at this extended care facility had indicated that she would not thrive with that condition. The granddaughter to this ailing patient was the power of attorney. To make matters worse, the elderly patient had no advanced directive. The patient’s family had earlier been directed to send her to the emergency care department….

Emergency oom Efficiency
Improving Emergency Department Flow by Using a Provider in Triage

Emergency room triage plays an essential role in the speed and quality of the emergency room departments. Triage represents only one small part of the process that determines quality of patient care. Emergency rooms can be crowded. Busy times are often unpredictable, making it difficult to avoid bottlenecks in the system. This has an affect on the amount of time between arrival and when the patient sees a physician. Patients can be in for frustrating long waits while sitting in the hospital lobby.Patients often leave the emergency room waiting areas without being seen because they get tired of waiting. These patients are referred to as left-without-being seen (LWBS). educing LWBS rates is crucial for improving quality of patient care in emergency rooms. Long waits also cause a potential liability for the hospitals, as patients that are critically ill may….

Emergency Departments (EDs) have the highest levels of violence of any hospital units, and according to a 1994 survey, 97% or nurses in these reported verbal violence and 87% physical violence. All EDs have large numbers of uninsured patients, many of them with drug, alcohol of psychiatric problems, which increase the normal stress and anxiety of this environment and make violence far more likely. This problem is compounded by the fact that only 3% of EDs had full-time security on-site, which means that "prevention is the best method to deal with violence in the ED" (Hoag-Apel, 1998, p. 60). All EDs should do a risk assessment that includes the location, design, history and security measures in the facility; the type of in-house security staff, training and weapons, communications with local police and hospital security; nighttime lighting, parking areas, numbers of chemically dependent patients. It should note whether access is monitored….

ange Nursing Theories
As a profession, nursing presents many challenges. Indeed, it is one of the most stress inducing jobs in the world, not only in terms of the physical toll and long hours, but also because of the emotionally exhausting nature of the work. For this reason, personnel turnover tends to be high and there is a general shortage of nursing personnel at hospitals. Because of the vital nature of the profession to the healthcare field and to humanity in general, many researchers have addressed the problem of high personnel turnover in the nursing profession, as well as factors like leadership, work efficiency and interpersonal relationships.

Of all the work environments within the nursing profession, the Emergency oom is probably the most stressful, which also leads to high personnel turnover. One approach towards a resolution is to find ways of enhancing nursing staff satisfaction. Increased satisfaction at work would lead….

ED Boading Plan
Emegency Depatment Ovecowding Due to Boading: Poposed Solution

The poposed solution fo the noted poblem of emegency depatment ovecowding due to the pactice of boading patients in the emegency depatment athe than admitting them to othe aeas of the hospital is elatively simple and staightfowad. In essence, the solution that is most suppoted by cuent eseach is to simply cease the pactice of inpatient boading in the emegency depatment, inceasing thoughput by stabilizing and admitting to othe depatments those patients that cannot be teated on an outpatient basis, and inceasing the numbe of beds and staff available in othe depatments to meet this shift (Gason et al. 2008; Viccellio et al. 2009). This solution has been found to be beneficial to medical staff and patients alike, and simply inceasing the amount of beds and staffing that exists in the emegency depatment does not have a simila effect (Walsh et….

Running head: Quality of Care in the emergency department provided by nursing practitioners Quality of Care in the emergency department provided by nursing practitioners 5Quality of Care in the Emergency Department provided by Nursing PractitionersDue to demographic aging, comorbidity, and scarce resources in primary and acute care, emergency departments around the globe see an increase in enrollment, significantly impacting care delivery and results. There have been calls for Emergency Department performance improvement techniques, highlighting the need to discover cost-effective care approaches in terms of cost-effective care schemes in terms of workforce optimization. The addition of additional care contexts, such as HSCP teams, necessitates well-established institutional culture. People, institutions, services, and platforms must all change to introduce effective practices. To discover implementation variables based on access to healthcare, stakeholders who obtain or deliver health care have become highly relevant.Roles of stakeholdersStakeholders are vital individuals who play an important role in the….

2010; McCarthy et al. 2009; Zimmerman 2004). These studies have also shown that a reduction in boarding numbers and crowding can eliminate or reduce these problems.
After all of these considerations, the fourth step in osswurm and Larrabee's (1999) model for change is to design the actual changes to practice that should be implemented. In this case, this requires few additional resources other than learning materials for hospital staff to acquaint themselves with new procedures and practices -- there is no equipment necessary, and supplies used by the emergency department should actually decrease pretty much across the board as patients are more quickly sent to other departments of the hospital after stabilization (AEM 2008). The design, then, is one that is purely procedural, and should consist of clear triage and stabilization practices that effectively assess patients and determine the appropriate continuation of their care, whether that be on an outpatient….

For effective fulfillment of duties by health care professionals which will, in turn, give a quality service to patients under their care, there is a need for effective inter-professional communication among personnel in a hospital environment. While the concept of territory exists within a sector, that, however, should not be a barrier to a fluid collaboration among health workers of different backgrounds. There is a need to formulate a working communication strategy to solve the lingering inter-professional problems in hospital environments generally, and particularly, in the emergency department. As important as it is, a look at inter-professional communication in emergency department shows a seemingly unfavorable situation among practitioners involved in this one of the most significant subsectors of health profession (Varjoshani, Hosseini, Khankeh, & Ahmadi, 2014). Among other numerous issues in the department, this paper looks at the problem of boisterous atmosphere in the emergency department, explores the contributing barriers….

The quality of care provided by the nurse practitioner in the emergency departmentAbstractOver the last two decades, Emergency department crowding has become an increasingly common occurrence. Longer wait durations in the emergency room are linked to higher disease and death and lower client satisfaction. Reducing emergency room wait times is complex, and clinicians' predicted needs have shown a sustained scarcity. There is a surge of attention in having advanced practice nurses engage in clinical care to a significant level as part of the attempts to find new ways to boost the staff. Providing quality care requires providing both the scientific and humanitarian aspects of nursing.The Rogers theory of unitary human beings enables nurses to function from a position of factual certainty while emphasizing the care they deliver. Personnel such as health care professionals, executives, and other professionals who undertake medical and non - medical roles play a significant role in….

Workflow chart criticism: "A patient arrives in the ER"
First and foremost, this workflow could benefit from a clearer title. The flow does not merely delineate what happens when a patient is admitted to the ER but rather what transpires when a patient with a suspected cardiac condition is admitted via emergency medical services. As well as a more coherent title, this workflow could benefit from greater description in the different boxes of the flow. While it is true that a workflow chart is designed to be relatively economical in terms of verbiage, this workflow needs greater explanation of acronyms such as 'CP via EMS.' It is unclear what CP refers to at first. Presumably it refers to a suspected cardiac patient but the meaning of the acronym is ambiguous given the title and the fact that CP could refer to a variety of different things.

The next square notes that the….

HSBC Information Systems
asked write organization,: bank . information system problems useing switched information system. write introduction organization . background organization case HSBC bank, information system problems information system helped solve problems information system helped make business easier.

n information system is a combination of any forms of information technology and activities which are carried out by the people in the organization in order to support the management, operations and decision making process in the organization Sawy & Nanus, 1989.

The term information system frequently refers to any interaction that happens between the processes, people, technology and data in the organization hituv, 1980.

It does not only refer to the technology in use in the organization. It also refers to the processes, technology, and data that are in the organization West, 1994()

HSBC group is one of the largest financial and banking service providers in the whole wide world. The company has over 9,500 offices….

AbstractThe problem is extended wait times among paediatric patients at the selected Paediatric Emergency Department (PED). This is a result of failure by nurses and clinicians to effectively educate patients at discharge, which causes many patients to return for complications listed in their discharge instructions. The extended wait times lead to patient dissatisfaction and poor organizational outcomes as patients may leave without care. Hospital readmission within 30 days of discharge remain a serious health concern in the US. Statistics indicate that 1 in five Medicaid patients return to hospital within 30 days of discharge. Cumulatively, readmissions alone account for approximately $42 billion in health spending annually. A literature review was conducted to gather evidence-based knowledge on strategies for enhancing the effectiveness of discharge procedures. Evidence was gathered by searching for US-based primary research articles in the JAMA Network, Cochrane Open Access, the Directory of Open Access Journals, and the Digital….

U.S. Handling of Pandemic-Level Mass Fatality Event
A pandemic is classified as an event that takes place across a wide geographic area and has the capacity to affect an exceptionally high percentage of the population. A mass fatality event usually generates numerous casualties to an extent that clinical personnel, emergency services, and referral systems work collaboratively to offer adequate and timely response. The United States has experienced some pandemic-level mass fatality event in its history such as the 1918 pandemic influenza that led to the death of over 650,000 people across the country. Since the Civil War, the United States has not experienced a pandemic-level mass casualty or fatality event. While the 9/11 attacks was a tragedy with far reaching impacts, it was not necessarily a pandemic-level mass fatality event. Actually, the closest the country has come to a mass fatality event is during the flu season, which usually utilizes its….

(Shactman; Altman, 2002)
4. ecommendations for Overcoming these Barriers:

Some of the suggestions for overcoming these barriers are (i) appointment of a General Practitioner -- GP officers to work as a Liaison Officer between the ED and the community so that the communication is streamlined as well as processes of referral and feedback and development of clinical pathways. (ii) Expansion of community off-peak facilities, including the setting up of the capacity for community access to X-rays, Scanning, ultrasound, blood tests and observation beds. (iii) Initiation of a project to deal with frequent attenders to the ED through the development of management plans contributed to by the patient, their GP, the ED as also their specialist (iv) Education of the local community such that are aware as to when and under what situations to access ED care or alternative care in the community. (Ardagh; ichardson, 2004)

eferences

Ardagh, Michael; ichardson, Sandra. (2004) "Emergency department….

EMEGENCY DEPATMENT COSTS: FIXED AND VAIABLE COSTS 1Case 5.3: Costs of Care in the Emergency DepartmentWhat is an example of a fixed cost in an emergency department? A variable cost?Fixed costs are costs that do not change with changes in output levels (Smith, 2013). In the emergency department, fixed costs would remain constant regardless of the number of patients. An example of fixed costs in the emergency department would be the monthly salary of permanent staff such as emergency nurse practitioners and physicians. The salary is a constant amount agreed upon at the start of the contract period and would be a standard amount regardless of the number of patients one treats in a given period. The facility incurs the cost even when no patients visit.Conversely, variable costs are costs that change with changes in output or activity levels (Smith, 2013). They increase with increases in activity levels and vice….