Page 176 - Encyclopedia of Nursing Research

EMERGENCY NURSiNG n 143

the public that emergency nurses are compe- (ENA, n.d.-e). For this reason, the research
tent caregivers who are accountable for the agenda for emergency nurses is robust.
care they deliver, responsible, and able to Data from the 2007 National Hospital E
communicate and act with autonomy while Ambulatory Medical Care Survey show
at the same time able to work in a collabora- that in 2007 there were 116.8 million visits
tive relationship with others (ENA, n.d.-e). it to hospital EDs or 39.4 visits per 100 persons
is through emergency nursing research that (Niska, Bhuiya, & Xu, 2010). in that same
emergency nurses are able to be responsive study, 12.5% of ED patients were admitted to
to changes in health care in order to deliver the hospital and approximately 39 million of
state of the art care to this very important the visits were injury related. in a study of
group of patients and their families. workforce in emergency care, Counselman
Because emergency patients often come et al. (2009) found that EDs’ annual volumes
to the emergency department (ED) with con- have increased by 49% since 1997, with a
ditions that pose a threat to life and limb or mean ED volume of 32,281 in 2007. The aver-
have a significant risk of morbidity or mor- age reported ED length of stay is 158 min-
tality, competent emergency nursing prac- utes from registration to discharge and 208
tice is a unique combination of rapid triage minutes from registration to admission. As a
and assessment of life-threatening problems, result of this surge of ED visits, many EDs
simultaneous prioritization of care, and across the nation do not have the capacity to
effective and efficient implementation of the serve the volume of patients that come for
appropriate interventions (ENA, n.d.-e). With treatment. EDs spent an average of 49 hours
the increasingly complex diagnostic and per month diverting ambulances to other
management strategies available, emphasis EDs in 2007. Boarding or holding patients for
on resource-efficient patient care requires extended length of time waiting for a hospi-
research strategies that maximize quality tal bed to open is common practice, with an
care while also controlling resources. average of 318 hours of patient boarding per
Not all patients come to the ED for life- month (Counselman et al., 2009).
threatening conditions. it is often through The 2008 National Sample Survey of
the ED that patients access the tertiary health Registered Nurses conducted by the U.S.
care system. Therefore, emergency nurses Department of Health and Services (Health
are often the first health care practitioners Resources and Services Administration,
who foster entry into the health care system 2010) found that approximately 218,339 reg-
for the general population. istered nurses were employed in an emer-
Patients often come to the ED because it is gency setting in 2008, a significant increase
the only access they have for health care and from approximately 117,514 in 2004 (Health
require primary care services during their Resources and Services Administration,
ED visit (Delgado et al., 2010). Emergency 2006). Emergency nurses enter ED practice
nurses are required to have knowledge about with a broad range of educational prepara-
the care and treatment of patients seeking tion. A study by Counselman et al. (2009)
primary care and health promotion services. found that many emergency nurses (46%)
They need to be aware of social and com- have an associate degree as their highest
munity services and must have the ability to level of education, 28% have a BSN, and 3%
collaborate effectively with prehospital and have a graduate degree (MSN or higher).
in-hospital care providers. The advanced professional nursing roles
Emergency nurses provide care to per- in the ED include nurse administrators, clini-
sons of all ages, across all levels of the health/ cal nurse specialists, and nurse practitioners.
illness trajectory, and work in an environ- The educational preparation for advanced
ment that is complex and unpredictable practice nurses requires graduate education