Medicine and Health Sciences Commons^™

An Interdisciplinary Code Sepsis Team To Improve Sepsis Bundle Compliance In The Emergency Department, Jill M. Delawder

Doctor of Nursing Practice (DNP) Final Clinical Projects, 2016-2019

Purpose: Sepsis is one of the leading causes of mortality with over 700,000 hospitalizations and 200,000 deaths annually. Various tools exist to aid in the early identification and treatment of sepsis including electronic alert systems, standardized order sets, nurse-initiated protocols and specialty trained teams. Despite available guidelines, mortality rates for severe sepsis and septic shock are near 50%.

Methods: The aims of this rapid cycle quality improvement project were 1) to develop and implement an interdisciplinary team to address early implementation of evidence-based sepsis bundles in the emergency department and 2) to compare sepsis bundle compliance three months pre-and three …

Effects Of A Crisis Intervention Team Assessment Center On Emergency Department Length Of Stay, Carlissa Lam

Doctor of Nursing Practice (DNP) Final Clinical Projects, 2016-2019

Introduction: Emergency departments are overburdened with mental health patients who lack adequate access to behavioral health resources. The influx of patients has led to an increased length of stay in the emergency department for patients who are being evaluated for mental health concerns. Overcrowding can lead to delays in treatment, undesirable medical events, and patient mortality. Crisis Intervention Team (CIT) models bring law enforcement, mental health providers, emergency departments, and individuals with mental illness together to improve care for patients in crisis. They have been instrumental in identifying patients in crisis and transporting them to a Crisis Intervention Team Assessment …

Improving Analgesia Administration For Pediatric Patients In A Rural Emergency Department, Alvin R. Walters

DNP Qualifying Manuscripts

When a child is in pain, parents often seek out treatment at an emergency department. After a detailed chart review it was determined that only 32.53% of the pediatric patients who present to a rural, northern California, ED in pain receive any documented form of analgesia during their time in the ED. A review of the literature revealed that triage nurse-initiated protocols can successfully manage to provide consistent and efficient analgesia to patients who present to an ED with pain. Therefore, a practice improvement project was undertaken to increase of the consistency and efficiency of analgesia administration for pediatric patients …

Evaluation Of A Youth Emergency Room Enhancement Program For Behavioral Health, Anne Thatcher

Dissertations

Problem. Pediatric mental health complaints and subsequent hospitalizations have been steadily increasing. The Behavioral Health Network (BHN) developed an intensive outreach case management program aimed at reducing youth mental health emergency department (ED) visits and inpatient psychiatric admissions. The Youth Emergency Room Enhancement (YERE) program was a process improvement initiative to provide immediate case management to youth and caregivers for mental health care.

Methods. A Plan-Do-Study-Act (PDSA) method utilizing a retrospective case record review occurred over a six-month period. A convenience sample of youth aged 6-20 years presenting to one of eight healthcare facilities for either ED or inpatient hospitalization …

The Effects Of Sepsis Management Protocols On Time To Antibiotic Administration In The Emergency Department, Margaret K. Lorch

Honors Undergraduate Theses

Sepsis is one of the leading causes of death in U.S. hospitals, resulting from organ dysfunction caused by an inappropriate inflammatory reaction to an infection. Timely treatment with empiric antibiotics in the emergency department is crucial to facilitate positive patient outcomes. The Surviving Sepsis Campaign (SSC) recommends initiating empiric antibiotic therapy within one hour of presentation to the emergency department. Some emergency departments have implemented sepsis management protocols to guide care and ensure timely treatment. The purpose of this study is to determine the effect of a formal sepsis protocol in the emergency department on the time to antibiotic administration. …

Emergency Nurses' Department Design Recommendations For Improved End-Of-Life Care, Elise Megan Corbett

Theses and Dissertations

Introduction: Death occurs frequently in emergency departments (EDs). Obstacles present in EDs can make providing end-of-life (EOL) care stressful and challenging for emergency nurses. Although death is common in EDs, there is a paucity of research regarding ED design as an obstacle to EOL care. The purpose of this study was to identify emergency nurses experiences and recommendations regarding ways ED designs negatively or positively impacted EOL care for dying patients and their families. Methods: At 25-item questionnaire regarding ED design and EOL care was sent to a geographically dispersed, national random sample of 500 emergency nurses. Inclusion criteria were …

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 …

Preventing Emergency Department Overutilization For Florida’S Seasonal Resident Population, Amanda Garcia

DNP Scholarly Projects

Background/Local Problem: Seasonal migration of elderly patients to Lee County, Florida result in overcrowding and prolonged wait times in emergency departments. Many of these seasonal residents dissociate the management of their chronic health conditions with a local provider, therefore utilizing the emergency department for non-urgent needs. Purpose: The Seasonal Resident Navigator Program was intended to enhance the coordination of primary care services for elderly seasonal residents by establishing appointments with local primary care providers (PCP) in order to reduce the overutilization of emergency services and improve patient throughput. Methods: A residency and provider assessment tool was incorporated into the Healthpark …

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 …

Barriers And Perceptions To Obtaining Palliative Care In The Emergency Department, Jacqueline Lucille Saucier

Dissertations

Background:

Purpose: This study explored barriers and perceptions of providing palliative care services while patients are in the emergency department (ED) in order to increase the>likelihood of caregivers to elicit palliative care methodologies for patients with chronic illness, who are not necessarily at the end of life, but rather who are identified through repeated visits to the ED.

Design and Methods: A mixed methods approach was used to explore the barriers and perceptions of providing palliative care services in the ED. By using a qualitative approach, evidenced by grounded theory, this study explored the barriers and perceptions of providing …

Emergency Nurses' Department Design Recommendations For Improved End-Of-Life Care, Elise Megan Corbett

Theses and Dissertations

Introduction: Death occurs frequently in emergency departments (EDs). Obstacles present in EDs can make providing end-of-life (EOL) care stressful and challenging for emergency nurses. Although death is common in EDs, there is a paucity of research regarding ED design as an obstacle to EOL care. The purpose of this study was to identify emergency nurses experiences and recommendations regarding ways ED designs negatively or positively impacted EOL care for dying patients and their families. Methods: At 25-item questionnaire regarding ED design and EOL care was sent to a geographically dispersed, national random sample of 500 emergency nurses. Inclusion criteria were …