Medicine and Health Sciences Commons^™

Why Doesn't She Just Leave? Improving Identification And Response To Victims Of Intimate Partner Violence In The Emergency Room, Elizabeth Berry

Doctor of Nursing Practice Projects

The purpose of this project was to improve identification and response to victims of intimate partner violence (IPV) presenting to the emergency department. Project participants completed a pre-education questionnaire prior to the project leader providing intimate partner violence educational materials and a presentation entitled Recognizing and Responding to Victims of Intimate Partner Violence in the Emergency Room. The project participants then completed a mirrored post-education questionnaire. Evaluation of the project included a comparison of the participant's responses to the mirrored questionnaires. Project participants reported an increase in the:

• recognition of the prevalence of intimate partner violence among their patients, …

Improving Handoff Communication In The Emergency Department, Amy Shepherd

Doctor of Nursing Practice Projects

Ineffective handoff communication has been recognized for years as a practice issue and is the most frequently reported cause of sentinel events in U.S. hospitals (Dufault et al., 2010) and responsible, at least in part, for 30% of all malpractice claims (Fucik, 2019). The development of standardized tools has been identified as a key component to improving handover practice. For this project, a standardized SBAR tool was modified for a local emergency department. The intervention was a process change in the emergency department to utilize an SBAR tool during handoff reports. The project was implemented by educating staff on the …

Proposal For A Formal Pediatric Abuse Screening Tool For The Emergency Department, Christina Bolin

Master of Science in Nursing Theses and Projects

Implementation of a quick, reliable pediatric child abuse assessment tool for use in the emergency department is of great importance. A thorough assessment of all pediatric patients presenting to the emergency department (ED), regardless of complaint, should become second nature in order to recognize the signs of child abuse. Because a tool of this nature is lacking in many ED's, the Escape Instrument is needed. This instrument is a successful, efficient screening tool that can be applied to all pediatric patients during triage in the emergency department. This tool will allow the emergency department staff to quickly identify children under …

Enhancing The Accuracy And Effectiveness Of The National Institute Of Health Stroke Scale In A Rural Emergency Departmennt, Emily Nicole Addington

Doctor of Nursing Practice Projects

A rural facility in the foothills of North Carolina found a need for process improvement regarding the emergency department and completion of the NIHSS. The DNP student and the Stroke Coordinator along with the Quality Improvement Coordinator agreed with the need for education of staff concerning accurate assessment and documentation of the NIHSS. The DNP project implemented additional training for the emergency department nurses and paramedics in the form of face-to-face classes with a PowerPoint. A pre-and post-survey was conducted to gauge the comfort level of staff with the NIHSS and stroke processes of the rural emergency department. The Stroke …

Improving The Relationship Between Emergency Nurses And The Behavioral Health Patient, Alea Bundy

Master of Science in Nursing Theses and Projects

There is an increasing number of behavioral health patients entering through the emergency department for behavioral health treatment and crisis intervention every day. Workplace violence against nurses has also increased leaving some nurses feeling anxious and fearful of interactions with behavioral health patients. The increase of behavioral health patients and unstable situations have created a gap in communications and has strained the nurse patient relationship yielding poor patient outcomes. The purpose of this project is to educate nurses on the care of the behavioral health patients and improve nurse-patient relationships for better outcomes for the patient. The framework for this …

Implementing Safeplan: A Communication Template For Emergency Nurses Caring For Psychiatric Patients, Michele Leigh Rudisill

Doctor of Nursing Practice Projects

This DNP Project explored the impact of introducing a communication template for emergency department (ED) nurses to use during handoff when caring for psychiatric patients. This need was identified as ED nurses are now caring for psychiatric patients for longer periods of time in the ED setting, sometimes weeks to months, due to limited inpatient mental health resources and resources in the community. ED nurses’ perceptions were surveyed and the need for a standardized, yet flexible communication template was identified. The literature was reviewed, and no such template was identified specific to ED nurses caring for the psychiatric patient population. …

Case Managers’ Perceptions Of Effective Interventions, Julia Williamson

Nursing Theses and Capstone Projects

Case managers (CM) identify patients with high emergency department (ED) utilization and barriers to healthcare services. CM interventions need to be evaluated related to high ED utilization, identification of effective interventions, and improving patients’ self-management skills. Current literature supports the review and implementation of identified CM interventions to reduce non-emergent ED utilization, and improved patients’ health literacy, and self-management abilities. There is a lack in research related to CM perceptions’ of effective interventions to reduce ED utilization. The purpose of this study was to examine CM perceptions’ of patients’ low health literacy and self-management skills, identify barriers to self-care, and …

Evidence-Based Interventions To Address Workplace Violence In The Emergency Department, Gari Leigh Adams

Nursing Theses and Capstone Projects

Workplace violence, as a result of violent patient behavior, is a problem in health care settings and the incidence is increasing. The vulnerability of the emergency department (ED) contributes to the high incidence of violence and includes long waits, crowded spaces, high anxiety levels, substance abuse, and a large number of behavioral health patients seeking treatment. ED team members admit they do not always feel safe when caring for patients due to the risk of violent behavior. Workplace violence effects team member productivity, job satisfaction, and burnout. Team members are at risk for injury or harm and coping challenges as …

Compassion Fatigue: Exploring The Impact On Emergency Department Nurses, Lauren E. Pittman

Nursing Theses and Capstone Projects

The purpose of this thesis project was to explore levels of compassion fatigue in emergency department nurses. Compassion fatigue has directly affected many nurses’ lives as well as impacting the field of nursing in various ways. Jean Watson’s Theory of Human Caring served as the theoretical framework for the study. The literature maintains that the prevalence of compassion fatigue has been established, yet severity varies among institutions and specialties. A quantitative study to determine the level of compassion fatigue in ED nurses was conducted by utilizing a group on the social media site Facebook that is specific to travel nurses …

Discharge Education In The Emergency Department: Are We Effectively Teaching Chest Pain Patients?, Emily Edwards Nishiyama

Nursing Theses and Capstone Projects

Millions of individuals visit the emergency department (ED) each year with complaints of chest pain. Many chest pain patients do not have an underlying condition of Acute Coronary Syndrome (ACS) but the health and well-being of these patients is indispensable. Research has indicated soaring costs, an increased demand in medical resources, and an increasingly poor quality of life for these patients after discharge. Although research encourages quality education at discharge, very few studies have been conducted on ED discharge education for non-ACS chest pain patients. Using a cross-sectional descriptive research design, this quantitative study discovered the frequency of education provided …

Patient Education In The Emergency Department, Bryan K. Devinney

Nursing Theses and Capstone Projects

Patient education is a core component to the practice of nursing in many countries, including the United States. Emergency department nurses are often overwhelmed with the number of patients they must care for in short amounts of time. The patients are often in varying stages of evaluation and treatment, and the nurse may be involved in one-on-one interventions with these patients. This can leave little time for patient education, especially if the nurse does not feel like the patient education is meaningful or useful. Various factors can influence the ability and desire of the emergency department nurse to provide proper …

Improving Patient Flow Through The Implementation Of A Results Pending Treatment Area, Heather L. Bryant

Nursing Theses and Capstone Projects

Abstract

The purpose of this research study is to retrospectively evaluate whether the implementation of a Results Pending Treatment Area (RPTA) altered patient flow patterns and therefore reduced patient length of stay (LOS) for ambulatory patients in a Level One Trauma Center Emergency Department. The research is justified because a reduction in the length of stay for patients is shown to decrease overcrowding, ED wait times, loss of revenue, and diversion while improving patient safety and patient satisfaction. The Roy Adaptation Model was the overarching theoretical conceptual framework utilized to support the research, with a more detailed emphasis on Swanson's …

Emergency Departments And Stemi Care, Are The Guidelines Being Followed?, Dawn W. Hendren

Nursing Theses and Capstone Projects

The purpose of this study examined if an Emergency Department (ED) in a small rural hospital in western North Carolina is compliant with the American College of Cardiology (ACC) and the American Heart Association (AHA) guidelines for obtaining Electrocardiogram's (ECG's), administering fibrinolytics, and performing Primary Percutaneous Coronary Intervention (PCI) on patients with chest pain diagnosed with ST-Elevation Myocardial Infarction (STEMI). The national standards for ECGs is less than 10 minutes from arrival to first medical contact (FMC) with triage nurse; for fibrinolytics, less than 30 minutes from arrival to FMC; and for FMC to PCI, less than 90 minutes. The …

The Effect Of Emergency Department Length Of Stay On Clinical Outcomes For Critically Ill Or Injured Patients, Sheila Radcliff

Nursing Theses and Capstone Projects

The purpose of the study was to identify the effects of the emergency department length of stay on clinical outcomes for critically ill or injured patients in the regional referral community hospital. Delays in transfer have been associated with increased mortality rates, prolonged length of stays, and poor outcomes. Emergency departments are designed to respond to immediate life or limb threatening emergencies.

A quantitative, descriptive, retrospective design was used in this study. Data was collected from APACHE II, trauma databases, and ED logs. The study was conducted in a 752 bed hospital in the western North Carolina. Data was analyzed …

What Is The Experience Of Emergency Department Nurses With Lateral Verbal Aggression?, Wendi Harper-Lonabaugh

Nursing Theses and Capstone Projects

This descriptive study investigated the incidence of lateral verbal aggression among emergency department nurses. A sample of registered emergency department nurses currently working in western North Carolina with more than one year of full time work experience was surveyed (N=68). Roy's adaptation model was used as a theoretical framework for this qualitative study. A survey was utilized to collect the frequency, source, and incidences of reporting the lateral verbal aggression that occurred. Nurses also reported personal and professional ramifications to the lateral verbal aggression. Aggregate data was examined; no specific individual data was analyzed. The most common perpetrators of lateral …