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Full-Text Articles in Medicine and Health Sciences
A Retrospective Analysis Of Integrative Group Medical Visits For Low-Income Patients With Anxiety Disorders In Primary Care, Annamma Udaya Thomas
A Retrospective Analysis Of Integrative Group Medical Visits For Low-Income Patients With Anxiety Disorders In Primary Care, Annamma Udaya Thomas
Walden Dissertations and Doctoral Studies
High utilization of the emergency department (ED) by patients with anxiety symptoms has brought attention to mental health access disparities among low-income racially/ethnically diverse populations. The health system in this study attempted to increase access to mental health care with integrative group medical visits (IGMVs), a nonpharmacological intervention with biomedical care consultation, health education, and peer support. The purpose of this retrospective comparative analysis, guided by integrative health equity in primary care framework, was to determine whether patients with diagnoses of anxiety who attended four or more IGMVs had reduced nonemergent ED utilization, reduced prescribed doses of benzodiazepine (BZD), and …
A Clinical Practice Guideline: Hospice Care In The Emergency Room, Samer Saad
A Clinical Practice Guideline: Hospice Care In The Emergency Room, Samer Saad
Walden Dissertations and Doctoral Studies
Hospice patients use the emergency department (ED) for the management of symptoms, making it necessary for ED nurses to be equipped with the knowledge and skills to care for hospice patients. EDs should have staff specially trained to address end-of-life needs due to ED staff’s minimal knowledge of treating and managing hospice patients. When healthcare organizations fail to provide clinical practice guidelines (CPG) and collaborate with significant stakeholders adequately, gaps in care delivery can occur, and hospice care is often not delivered safely. Standardized guidelines on end-of-life care in the ED should provide adequate guidance for ED nurses in bridging …
Barriers To Reporting Workplace Violence In Emergency Departments: A Systematic Review, Kari Gaston
Barriers To Reporting Workplace Violence In Emergency Departments: A Systematic Review, Kari Gaston
Walden Dissertations and Doctoral Studies
Underreporting of workplace violence by emergency department (ED) nurses is a global practice concern. When workplace violence is not reported, the breadth of the issue is not reflected in the data, which is necessary to support legislative action, regulatory requirements, and organizational changes to prevent violence. The purpose of this systematic review of literature was to appraise and synthesize evidence regarding ED nurses’ barriers to reporting workplace violence. The practice-focused question addressed the barriers to reporting workplace violence according to emergency nurses. The theory of planned behavior was the theoretical framework for this project. Melnyk and Fineout-Overholt’s critical appraisal of …
Improving Suicide Prevention In The Emergency Department, Crystal Hartis Andrews
Improving Suicide Prevention In The Emergency Department, Crystal Hartis Andrews
Walden Dissertations and Doctoral Studies
Suicide is a leading cause of death and a significant public health problem in the United States, especially among the youth population. The wide variability of screening practices and limited educational programs for nurses in terms of identification and management of individuals at risk for suicide exists. The purpose of this project was to conduct a systematic review to identify evidence available in support of adequately preparing nurses to conduct suicide screening and inform suicide prevention efforts for youth in emergency departments. Results from the literature review were correlated to formulate recommendations for improving suicide screening practices through the provision …
Compassion Fatigue In Emergency Department Nurses, Michelle Candice Lawrence
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 …
Relationship Between Post-Resuscitation Debriefings And Perceptions Of Teamwork In Emergency Department Nurses, Kerri Lyman
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 …
Best Practice Suicide Screening/Assessment Tools For The Emergency Department, Katheryn M. Spirito
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 …
Emergency Room Nurse Perceptions Of Emotional Intelligence, Ingrid Astralaga
Emergency Room Nurse Perceptions Of Emotional Intelligence, Ingrid Astralaga
Walden Dissertations and Doctoral Studies
The delivery of quality care has been a priority for the health care industry in the United States. Researchers have established positive correlations between the levels of emotional intelligence of registered nurses and their clinical performances. However, new evidence suggests the need to enhance the use of emotional intelligence (EI) in high-risk clinical units. With the intent to understand the use of EI, a phenomenological research approach was used to identify the emergency room nurse's understanding of EI. The Four-branch Model of Emotional Intelligence was used as the theoretical framework, while the research question identified the emergency room nurse's perception …
Perfecting Patient Bed Flow In The Emergency Department, Kim-Sun Moreira
Perfecting Patient Bed Flow In The Emergency Department, Kim-Sun Moreira
Walden Dissertations and Doctoral Studies
Emergency department (ED) crowding is a serious problem in the United States. Crowding in the ED can result in delays that may negatively affect patient outcomes and increase the cost of care. The purpose of this project was to understand strategies that can help to improve patient flow in the ED. The plan-to-do-study act model for process improvement influenced this project. Secondary data were collected for a 2-month period to determine the impact of workflow processes (patient boarding time in ED, surge capacity and workflow processes including the impact of ancillary departments) on the movement of admitted patients from the …
An Rn Sepsis Training Program That Supports Registered Nurses In The Emergency Room Setting, Daphne Marjorie Davis-Patrick
An Rn Sepsis Training Program That Supports Registered Nurses In The Emergency Room Setting, Daphne Marjorie Davis-Patrick
Walden Dissertations and Doctoral Studies
Sepsis is a severe blood stream infection that claim the lives of almost 220,000 Americans annually. Delayed patient treatment results in multi-organ failure, morbidity, mortality, and increased hospital length of stay. Timely sepsis management enables hospitals to have decreased expenses, increased patient survival, and judicious interventions. The problem addressed in this project was the lack of sepsis- training for registered nurses (RNs) working in the emergency department (ED) of a 628-bed hospital in the southeastern United States. Under the direction of the director of the ED, 269 patient charts were reviewed during 2014 to February 2015 for data related to …
Hourly Roudning In Th Emergency Department, Marie Chapnick
Hourly Roudning In Th Emergency Department, Marie Chapnick
Walden Dissertations and Doctoral Studies
The Affordable Care Act of 2010 increased the number of patients seen in a northeast, urban trauma emergency department by 34%. This created a problem as it occurred simultaneously with a nursing shortage. Consequently, patient satisfaction scores fell below the national average benchmark. The rate patients left the emergency department without being seen was 2.6% higher than the national average and patient fall rates increased by 20%. A review of the literature to search for solutions led to the support of an hourly rounding project and an educational workshop promoting proactive nurse behaviors as a way to address the quality …
Using Health Literacy To Improve Emergency Department Discharge, Alicia Ortiz
Using Health Literacy To Improve Emergency Department Discharge, Alicia Ortiz
Walden Dissertations and Doctoral Studies
Patients with limited health literacy often fail to understand verbal and written discharge instructions, and they frequently return to the emergency department (ED) for care. Patients returning to the ED and 30-day readmission rate are core quality performance measures. The purpose of this project was to decrease repeat visits and readmissions to the ED by implementing components of health literacy programs within the ED on patient education and written discharge instructions. Change implementation consisted of (a) use of teach back method (b) modifying medical terminology to language that patient could understand (c) limiting use of words with more than three …
Moving Evidence Into Practice: Early Sepsis Identification And Timely Intervention In The Emergency Department (Project Code Sepsis), Jonjon Macalintal
Moving Evidence Into Practice: Early Sepsis Identification And Timely Intervention In The Emergency Department (Project Code Sepsis), Jonjon Macalintal
Walden Dissertations and Doctoral Studies
Sepsis is the leading cause of death among hospitalized patients in the United States, is responsible for more than 200,000 deaths annually, and has as high as a 50% mortality rate. Sepsis requires prompt identification so that early goal-directed therapy can be instituted to lead to better outcomes. The purpose of this quality improvement project was to determine if implementing an evidence-based identification and intervention program, Project Code Sepsis, in the emergency department can increase the number of patients who receive antibiotics within the first hour of triage and decrease the length of hospital stay. Specifically, the primary project goals …
Implementing Relationship Based Care In An Emergency Department, Ruthie Waters Rogers
Implementing Relationship Based Care In An Emergency Department, Ruthie Waters Rogers
Walden Dissertations and Doctoral Studies
When patients and families come to the emergency department seeking medical attention, they come in with many mixed emotions and thoughts. The fast paced, rapid turnover of patients and the chaotic atmosphere may leave patients who visit the emergency department with the perception that staff is uncaring. The purpose of this project was to implement a patient care delivery model, relationship-based care, in the emergency department. The model is comprised of several caring theories including Jean Watson's model of human care and Kristen Swanson's middle range theory of caring. The main goals of the project were to help staff enhance …