Medicine and Health Sciences Commons^™

Human Trafficking And Resources Provision In The Ed, Kathryn Patrick

Doctor of Nursing Practice Projects

Human trafficking is both a human rights violation and a national health crisis. Despite nearly 165,000 identified cases in the United States since 2007, studies hypothesize that many more victims remain undetected despite up to 88% of trafficked persons interacting with the healthcare system during the time they are being trafficked. The lack of identification of these victims has often been attributed to healthcare providers' lack of knowledge regarding human trafficking indicators and lack of confidence in how to address trafficking situations when they are encountered. Emergency department care providers of a 500-bed central Illinois hospital received education and resource …

Implementation Of A Patient Care Specialist Role To Enhance The Patient Experience In A Pediatric Emergency Department, Jillian Brodeur

Doctor of Nursing Practice Projects

Background: Patient-centered care (PCC) has been an emerging trend in healthcare for the past two decades (Walsh et al., 2022). PCC and the patient experience have become essential measures of the quality of care provided and are linked to reimbursement dollars and improved patient outcomes (Rapport et al., 2019).

Purpose: The purpose of the Doctor of Nursing Practice (DNP) project was to improve the patient experience in the Emergency Department (ED) of a metropolitan hospital. The DNP project focused on the benefit of a patient advocate in the ED to improve the patient experience. The project sought to improve …

Improving Early Sepsis Recognition And Treatment By Utilizing The Surviving Sepsis Campaign In Emergency Department Patients, Rebecca Smith

Doctor of Nursing Practice Projects

Background: Sepsis is a physical reaction to infection that can cause bodily injury, organ deterioration, and death (Sepsis Alliance, 2022). Early sepsis identification and intervention requires staff engagement in quick recognition and implementation of care (Jorgensen, 2019). Septic patients require prompt initiation of intravenous fluids, hemodynamic observation, and appropriate laboratory testing (Evans & Rhodes, 2021). Rapid detection of sepsis can prevent patients from progressing to severe sepsis and septic shock, increasing the risk of mortality (Jorgensen, 2019). As a result of the high mortality rates and complications associated with this health disparity, evidenced-based care bundles were developed to improve care …

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 …

Providing Education To Staff Members On Implementing Follow-Up Education At Discharge To Patients With Low Heart Scores, Daniel Burton

Doctor of Nursing Practice Projects

Background: The Joint Commission on Accreditation of Healthcare Organizations (JCAHO) provides accreditation to hospitals, including “heart certification.” The facility was successful at meeting the four measures previously assigned to them. As a result, they were given four new measures. One of these standards is providing discharge education based on “heart scores.”. Only 35% of patients are receiving discharge/follow-up education at discharge from the emergency department (ED).

Purpose: The purpose of this study is to increase the number of patients receiving chest pain education and follow-up instructions in the ED as evidenced by the improvement in documentation of the interventions.

Methods: …

Implementation Of A Tele-Triage Protocol In An Emergency Department Setting, Megan Tuetken, Sierra Hamlin, Sydney Spaulding

Doctor of Nursing Practice Projects

Nationwide, the volume of emergency department (ED) visits has steadily increased over the last several decades. This steady increase in volume frequently causes ED crowding and considerable delays in patient evaluation and treatment. Recently, teletriage has been used in emergency departments to evaluate less emergent patient needs while freeing up in-house providers to care for more critical patients. The goal of this DNP project was to develop a protocol for the utilization of teletriage in an Emergency Department in a level 1 trauma center in central Illinois using nurse practitioners to assess patients in the waiting room and order appropriate …

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 …

The Evaluation Of The Brøset Violence Checklist (Bvc) And Interventions To Reduce Patient Violence Incidents Occurring In The Emergency Department, Grace D. Yoon, Dnp, Rn, Fnp-Bc

Doctor of Nursing Practice Projects

Background: Patient violence in healthcare is an issue across many departments, but many staff members in the emergency department (ED) are directly affected by violent incidents.

Objectives: Three primary purposes determined the success of this Quality Improvement (QI) project: 1) to evaluate the effectiveness of utilizing the Brøset Violence Checklist (BVC) and implementing appropriate interventions to reduce the number of physical assault occurrences against healthcare providers in the ED; 2) to assess if there was an increase in reporting patient violence incidents; and 3) to assess for any improvements in perceived safety in the ED among the nurses.

Methods: Adult …

Case Management Of Primary Care Patients, Bernadette Webster

Doctor of Nursing Practice Projects

Case management (CM) offered in primary care is a collaboration, guided by the registered nurse, working to coordinate all aspects of care for the patient and the family. The purpose of this quality improvement/assurance project was to provide nurses in primary care with the education and methods of CM to assist in more effectively managing care for a patient after testing positive for COVID-19. An intervention was delivered to registered nurses (RN) in the primary care setting designed to improve knowledge and skill with case management for patients with high care needs or recently diagnosed with COVID-19. A templated note …

Fascia Iliaca Blocks For The Treatment Of Hip Fractures In The Emergency Department, Megan Hahn

Doctor of Nursing Practice Projects

Due to the aging population, the number of falls are increasing, leading to an increased number of individuals with hip fractures presenting in emergency departments (ED). Opioids are often administered for intraoperative pain related to hip fractures, which may result in a number of adverse effects, especially in the elderly. There is strong evidence suggesting that the use of fascia iliaca blocks (FIBs) in the ED can minimize opioid use, and improve patient outcomes and recovery. FIB is a compartment block that delivers local anesthetic around the lumbar plexus to provide analgesia associated with hip fractures.

The purpose of this …

Implementation Of A Provider In Triage Program In A Level Iii Emergency Department, Rachel Parmer Mph, Msn, Fnp- Bc

Doctor of Nursing Practice Projects

Background: This project implemented a Provider in Triage (PIT) system in a small emergency department (ED) in Washington State. The employment of a PIT to decrease patient waiting time and improve ED flow was supported by a literature review. A needs assessment was conducted, which indicated potential benefit from a PIT system, particularly because several ED metrics are worse than national average.

Aims/Objectives: This project aimed to develop, implement, and evaluate a PIT system by employing ED Advanced Practice Clinicians (APCs). The objectives consist of evaluating the impact of a PIT system on the percentage of patients who leave without …

Alcohol Screening, Brief Intervention, And Referral To Treatment Protocol In The Emergency Department, Malvis Ndips Achonduh Tamon, Dnp, Aprn, Fnp-Bc

Doctor of Nursing Practice Projects

Background: The impact that results from inappropriate alcohol consumption poses challenges to public health. The rate of alcohol-related visits to the Emergency Department (ED) has increased, which has resulted in an increased annual cost of alcohol-related visits. ED serves as a common portal of entry into the healthcare system for many patients and offers a unique opportunity to impact drinking behaviors.

Objectives: To increase the number of alcohol screenings and brief interventions when indicated to adult patients who visit the ED and increase ED nurses' knowledge regarding alcohol misuse and indications for brief interventions.

Methods: An educational module was delivered …

Preparing For Obstetrical Emergencies In The Emergency Department, Tracy Littlehale

Doctor of Nursing Practice Projects

Emergency Department nurses must maintain the skills to manage OB emergencies in the ED, especially in hospitals with no OB unit. Limited contact with OB patients diminishes the self-confidence, knowledge and skill of ED nurses, which may minimize their ability to recognize OB problems in a timely manner. As increasing numbers of patients with OB emergencies are expected to seek care in rural EDs due to closure of rural OB units and rising OB risk factors, maintenance of OB skills by ED nurses is critical. Simulation has been identified in the literature as an effective strategy to help nurses advance …

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. …

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 …

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 …