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Unnecessary Emergency Department Admissions

In the selected scenario, there is a challenge concerned with nursing home patients being sent to an Emergency Department when there is no need for them to go. Such an issue complicates the work of a hospital team that has to deal with incoming patients whose health concerns could have been handled outside the ED setting. Thus, the main goal of a nurse leader is to reduce the number of unnecessary ED admissions with the help of improving staffing levels at the nursing home as well as implementing both patient and staff education and training.

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The lack of sufficient staffing and adequate collaboration between team members is among the critical concerns for nursing home settings. However, despite the established regulations and expectations of the nursing home laws and policies, determining the sufficient level of staffing depends on each facility separately. The nursing home in question needs adequate staffing not only because it deals with mainly Medicare and Medicaid patients but also because it includes a major medical center, outpatient dialysis, VNA, as well as a fully integrated network. It is likely that patients are getting sent to the ER without substantial reason because nurses do not have the capacity to address their healthcare concerns (Salmond & Echevarria, 2017). Besides, it is unreasonable to think that increasing the Medicare payment rate could be effective in raising nurse staffing because it will not increase staffing itself but rather increase expectations of performance. Thus, the most effective way of increasing staffing is for the manager to require more staff to the facility through its network.

Besides increasing staffing at the nursing home, it is necessary to facilitate patient and nurse education to help differentiate between avoidable ED cases and unavoidable ones. As to patients, it is important to inform them of the need to report health concerns as soon as they appear to implement prevention interventions to avoid ED visits. With regard to nurses, it is essential to educate them on the need to implement an assessment procedure with the help of a flow chart diagram to identify whether an ED measure is needed or not.


Salmond, S. W., & Echevarria, M. (2017). Healthcare transformation and changing roles for nursing. Orthopedic Nursing, 36(1), 12-25. Web.

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