Medicine and Health Sciences Commons^™

Registered Nurses’ Perceptions Of The Electronic Canadian Triage And Acuity Scale In A Community Hospital, Andrea De Jong

Electronic Thesis and Dissertation Repository

In 2017, several hospitals in Ontario implemented the Electronic Canadian Triage and Acuity Scale (eCTAS). This new technology affects a critical area of the Emergency Department: triage. There is no research on Registered Nurses’ (RNs) perceptions of eCTAS. A quantitative non-experimental descriptive survey obtained and quantified RN perceptions of eCTAS at a hospital with a 23 bed Emergency Department. The Diffusion of Innovation Theory was used as the theoretical framework to help guide study development. Results indicate both positive and negative perceptions of eCTAS and that younger RNs are more likely to think eCTAS cues them to collect the relevant …

Improving Sepsis Bundle Compliance Through Comprehensive Education, Stacy Mikel

Doctor of Nursing Practice Projects

Purpose: The purpose of this project was to improve emergency department compliance with sepsis bundles by educating registered nurses and licensed practical nurses on the proper use of sepsis screening tools, make changes to screening tools identified through chart reviews, and finally to evaluate the impact of these changes once initiated. This project sought to increase staff knowledge using an educational module.

Methods: This project began with the delivery of a pre-test questionnaire. The facility's target audience was asked to complete this to determine their current knowledge level regarding sepsis. Once these questionnaires were completed, they were reviewed, and information …

Early Information Access To Alleviate Emergency Department Congestion, Anjee Gorkhali

Theses and Dissertations in Business Administration

Alleviating Emergency Department (ED) congestion results in shorter hospital stay which not only reduces the cost of medical procedure but also increase the hospital performance. Length of patient stay is used to determine the hospital performance. Organization Information Processing (OIPT) Theory is used to explain the impact of information access and availability on the information processing need and ability of a hospital. Technical devices such as RFID that works as “Auto Identification tags” is suggested to increase the information availability as well as the information processing capability of the hospitals. This study suggests that the OIPT needs to be further …

Emergency Nurse Perceptions Of Disaster Preparedness After The Implementation Of A Department Emergency Operations Plan, Angela R. Gentry

Theses and Dissertations from 2019

Emergency departments (ED) are the entryway into the healthcare system during a disaster event and patients often arrive in the first thirty minutes after an event has occurred. This creates unique challenges for ED nurses. The purpose of the Quality Improvement (QI) project was to measure the impact of a Department Emergency Operations Plan (DEOP) on the ED nurse’s perception of disaster preparedness. This study included a convenience sample of 126 full time and part time registered nurses working in the ED at a Level 1 Trauma hospital. Institutional Review Board (IRB) approval was obtained by both Arkansas Tech University …

Implementation Of Emergency Severity Index Training To Improve Accuracy Of Triage Levels, Erinn Hileman, Douglas Mckain

Doctor of Nursing Practice Projects

This quality improvement project was created to help increase knowledge of the Emergency Severity Index (ESI) in the Emergency Department (ED), a form of triage used to categorize patients by their acuity. Proper ESI use shortens the length of stay times, door to provider times and reduces the number of patients that leave without being seen.

The goal of this project was to develop an online learning module that would increase the nurses’ knowledge of triage to enhance triage accuracy. Nineteen (19) emergency department nurses were given a pretest, an ESI educational presentation, and a follow-up post-test.

Data analysis indicated …

Turf For Teams: Considering Both The Team And I In The Work-Centered Design Of Systems, Vickie Nguyen

Dissertations & Theses (Open Access)

Teams are an inherent part of many work domains, especially in the healthcare environment. Yet, most systems are often built with only the individual user in mind. How can we better incorporate the team, as a user, into the design of a system? By better understanding the team, through their user, task, representational, and functional needs, we can create more useful and helpful systems that match their work domain. For this research project, we utilize the TURF framework and expanded it further by also considering teams as a user, thus, creating the TURF for Teams framework. In addition, we chose …

Clinical Decision Making: A Case Study Of The Effects Of Evidence Based Medicine And Past Empirical Experience In The Emergency Department, Olivia Zeman-Renner

Theses/Capstones/Creative Projects

With a growing number of medical malpractice suits and the passage of policy that focuses on patient advocacy, an emphasis has been placed on research regarding the decision-making processes of physicians in everyday practices. Over the past decades, scholars have looked to specific clinical decision-making philosophies, how they can be implemented into practice, and the effects of such implementation, but little research has been done into the culmination of decision-making philosophies on a day-to-day basis. By focusing on single-case study of a Midwestern Emergency Department and asking Attending physicians to self-report their decision-making philosophies, this study serves as a transition …

An Integrated Model Of Palliative Care In The Emergency Department To Improve Referrals, Jennifer L. Schlatter

Doctoral Projects

Introduction: The emergency department plays a critical role in the trajectory of in-hospital patient care. The Center to Advance Palliative Care (CAPC) along with the American College of Emergency Physicians (AECP) recommend early referral to palliative care for patients with life limiting illnesses that present to the emergency department. Research demonstrates that early palliative care consultations result in patient directed goals of care, improved symptom management, decreased length of stay, and reduced direct costs for inpatient hospitalizations.

Objectives: The goal of this project was to implement evidence-based recommendations for early palliative care referrals in an adult emergency department to improve …

Improving Patient Handover From The Pediatric Emergency Department To The Pediatric Intensive Care Unit, Kathryn Devinney

Doctoral Projects

Patient safety can be at risk during registered nurse handover, particularly when transitioning between high risk areas. According to The Joint Commission (2017), a standardized transition process should be implemented during patient handover. The purpose of this paper was to evaluate the effect of a standardized process with a cognitive aid on handover between a pediatric emergency department and an intensive care unit. Objectives of the project were to decrease conversion time in the emergency department, increase standardized process utilization, and improve patient outcomes, registered nurse perception and satisfaction, and patient proxy satisfaction. This evidence-based quality improvement project took place …

Characteristics And Outcomes Of Patients Discharged Home From An Emergency Department With Acute Kidney Injury: A Population-Based Cohort Study, Rey Acedillo

Electronic Thesis and Dissertation Repository

We designed a population-based cohort study to describe the characteristics and outcomes of 6346 adults discharged home from an emergency department (ED) with acute kidney injury (AKI). Within 30 days of discharge, 149 (2.3%) patients died (stage 1: 2.1%, stage 2: 5.2%, and stage 3 AKI: 15.9%). We also compared 30-day mortality to patients hospitalized with AKI and patients discharged home with no AKI in two separate propensity score-matched analyses. An ED discharge versus hospitalization was associated with lower 30-day mortality (3.0% vs. 11.9%, relative risk (RR): 0.25, 95% confidence interval (CI): 0.21-0.30). An ED discharge home with AKI versus …

Emergency Department Nurses: Post Code Pause, Lynn Alice Hauck

Student Theses, Dissertations and Capstones

Background: The consistent witnessing of death and critical incidents takes an emotional toll on the emergency department (ED) nurses. In addressing critical incident events, research has shown us that debriefing nurses after a traumatic event helped reduce stress and, in turn, decreased staff turnover in the ED at an acute care facility (Hirschinger, Scott, & Hahn-Cover, 2015). Purpose: The purpose of this DNP project was to implement a Post Code Pause (PCP) debriefing tool in conjunction with the hospital’s Unit Practice Council (UPC) members and the ED direct patient care nurses for use after adult and pediatric cardiopulmonary resuscitation (CPR), …

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 …

Compassion Fatigue In Emergency Department Nurses, Michelle Candice Lawrence

Walden Dissertations and Doctoral Studies

Compassion fatigue (CF) is defined as a sudden onset of the inability to experience feelings or compassion for others that is triggered by a nurse's inability to separate his/her feelings of stress and anxiety associated with caring for patients who have suffered from a traumatic event. The practice problem addressed in this doctoral project was the lack of knowledge of emergency department nurses (EDNs) related to CF in the work setting, resulting in a negative impact on a nurse's ability to provide quality care to patients. The purpose of the project was to present an educational program on how to …

Improving Emergency Department Nurses' Self-Perceived Self-Efficacy In Early Recognition Of Patients In A Mental Health Crisis, Mary Kay Silverman

DNP Scholarly Projects

Abstract

The two largest counties within Southwest Florida (SWFL) are Lee and Collier where mental health evaluations for children under the state’s Baker Act have more than doubled between 2011 and 2017 (Gluck & Zeitlin, 2019, p. 4). Given the marked increase in mental health evaluations, early recognition, assessment with initiation of treatment by nurses in the pediatric emergency department (ED) who present with behavioral health complaints must be a priority for emergency department leaders. Purpose: This quality improvement (QI) project proposed to improve a nurses’ self-efficacy through expanding knowledge in the recognition and identification of the signs and symptoms …

The Role Of The Physicians' Assistant In Trinidad And Tobago's Healthcare System, Martha Ann Pamponette

Walden Dissertations and Doctoral Studies

The profession of physicians' assistant was introduced in the 1960s to assist with physician shortages in the United States of America. Since then, some countries have introduced this profession to fill the gaps that exist in the physician shortages problem in their health care system. Yet, in many countries like Trinidad and Tobago, this role remains absent from the health care system. The objective of this study was to assess how professionalization supports the introduction of the physicians' assistant role in Trinidad and Tobago. Using the theory of profession as a theoretical framework, and through an evaluation of institutional, regulatory, …

Relationship Between Post-Resuscitation Debriefings And Perceptions Of Teamwork In Emergency Department Nurses, Kerri Lyman

Walden Dissertations and Doctoral Studies

Emergency department nurses are faced with traumatic patient events while functioning as members of multidisciplinary teams. Critical incident debriefing has been shown to benefit health care professionals and patient clinical outcomes. The purpose of this quantitative correlational study was to examine the relationship between the use of formal post-resuscitation debriefings and perceptions of teamwork in emergency department nurses. The study also addressed the type and timing of debriefing to determine whether these factors impacted perceptions of teamwork. The nurse as wounded healer theory served as the theoretical framework. Data from the Nursing Teamwork Survey were collected from 68 emergency department …

Evaluation Of Adolescent Adherence Treatment Following An Emergency Department Visit, Marcus Seaton

DNP Projects

Mental Health disorders affect 1 of 5 youth in the United States and are chronic conditions that affect adolescents’ ability to function at home, school, work, and with interpersonal relationships. Follow up adherence is imperative to ensure treatment goals are met. The purpose of this Doctor of Nursing (DNP) project was to examine factors associated with adherence to outpatient mental health (MH) treatment following an emergency department (ED) visit among adolescents admitted to an ED of a large hospital in a multi-system healthcare organization located in a metropolitan area of the southeastern United States (U.S.). This DNP project aims were …

Staff Perception Of Workplace Violence In The Ed: Implementing Egress Education And Cue Recognition, Kelsey Jobe

DNP Projects

Purpose: The purpose of this DNP project was to examine staff perception of workplace violence before and after an educational intervention provided to bedside staff members in the ED of a Level-1 trauma center. The project focused on assessing the impact of an educational intervention on staff perception of WPV related to safety and overall awareness.

Methods: This project was a single site project designed to examine the impact of an educational intervention using egress education and cue recognition in the ED setting using a pre- and post-survey. The survey examined staff perception of safety related to WPV before and …

Best Practice Suicide Screening/Assessment Tools For The Emergency Department, Katheryn M. Spirito

Walden Dissertations and Doctoral Studies

Patients presenting to the emergency department (ED) often suffer from more than physical ailments when seeking care and treatment. Some of these patients have emotional ailments and suicidal ideation when they come to the local ED. The lack of recognition of at-risk patients by health care providers can lead to poor patient outcomes and death. The focus of this project was to understand which valid and reliable suicide assessment tools described in the literature were considered the best evidence-based instruments to identify ED patients who were at risk for suicide. Peplau's theory of interpersonal relations guided this project. A systematic …

Endogenous Policy Design In Healthcare : A Case Study Of Emergency Department Crowding, Katrina Alexandra Hull

Legacy Theses & Dissertations (2009 - 2024)

The United States’ health care system has faced growing per capita use, and subsequent crowding, of the emergency department since the 1990’s, evidenced by longer wait times and the institution of ambulance diversions. Emergency departments are but one element of a complex system, with difficulties which persist despite policy efforts.

A Pilot Of Emergency Department-Initiated Buprenorphine For Opioid Withdrawal And Opioid Use Disorder: A Quality Improvement Project, Jason Lucey

DNP Scholarly Projects

Background: Emergency department (ED) visits for opioid related visits have increased dramatically during the opioid epidemic. Buprenorphine is an evidence-based therapy for treating opioid use disorder (OUD) and withdrawal. Unfortunately, lack of access to pharmacotherapy for OUD, including buprenorphine, remains a challenge. Research supports ED-initiated buprenorphine as a practical, cost-effective strategy which engages patients in treatment better than non-pharmacologic alternatives.

Purpose: The aims of this improvement project were to 1) develop a pilot process in an ED for providing buprenorphine to patients in opioid withdrawal or for OUD; 2) recruit and train a cohort of ED staff on the process; …