DNP student working to improve emergency room transfers for elderly patients – – Tulsa, Oklahoma

Tulsa, Oklahoma 2021-09-16 12:22:28 –

All over the United States and around the world Emergency department (ED) frequently bursts at seams – The corridor is crowded with sick people who have been waiting for hours on stretchers or suffering from uncomfortable chairs. Such images do not stimulate confidence in the health care system.

One of the most frequent contributors to ED overcrowding is elderly patients transferred from nursing homes and other long-term care facilities. “When these patients are seen in ED, they stay longer than other adults, undergo more comprehensive examinations, and consume more resources (such as staff time),” said a student at the University of Tulsa. Amy Thomas, who is, observed. Doctor of Nursing Practice (DNP) Program (((Family nurse practitioner stream) This fall, the person who entered her third and final research year.

Thomas explained that the frequent lack of communication and information about the resident’s health and history at the time of the transfer was the cause of the problem. “Given that by 2030, older Americans are expected to make up about 20% of the country’s population, and patients over the age of 85 make up almost 22% of ED visits, it’s important to address this issue now. is.” She said.

Better information, better care

Thomas will investigate bridging this gap using standardized report forms for patients transferred from nursing homes to emergency rooms for DNP research projects. Thomas’ decision to focus on this particular population was driven by the fact that 75% of nursing home residents are transferred to ED each year.

However, according to Thomas, “There is no standard process or format that healthcare professionals can use to relay important health information for these patients. Three types of key information that ED staff can help have. Details about the patient’s dosing list, baseline mental state, and their advanced instructions. “ Studies have shown that information gaps associated with such transfers are associated with longer stays, increased medical costs, and increased adverse events.

Health system scholars have identified the potential value of standardized report forms for transfer from nursing homes to EDs., And the use of such tools for the transfer of various patients has been attempted in other jurisdictions. For example, New Jersey has a state-wide policy that requires the use of universal transfer forms when moving an individual from one medical facility to another. “This is an example of a successful quality improvement strategy that has had good results for vulnerable people.” Thomas pointed out.Near the house, she draws lessons learned from similar initiatives that have been successfully implemented. Community care transition team In Bartlesville, Oklahoma, she plans to adopt a validated form used by the group.

Project method and design

Thomas planned her three-stage research project as a joint venture involving Tulsa’s 12-bed emergency room. St. Francis Hospital South (She works as a emergency nurse), staff in two regional nursing homes and emergency medical services (EMS). In the first phase, Thomas needs to educate nursing home, EMS line, and ED staff about the purpose and use of standardized forms.

“I was very excited to hear about Amy’s project,” said Dee Crew Come, clinical manager at St. Francis Hospital South ED. “This provides standardized documentation used to obtain the information needed to care for patients who come to care from a nursing home. We welcome such patients frequently, but before arrival. Reports rarely come. Often, you will receive minimal information about your medication (such as last dose time), related medical history, family contact, and resuscitation ban status. A standardized method for obtaining such details that is used at all institutions that send patients to ED will make the transition of care flow much smoother, “she said.

“We are deeply grateful for the support of all our community partners,” said Thomas. “I am especially grateful to Dee Crewcam. She was very excited when I first told her, and she invested in the success of my project as I did. doing.”

Phase 2 of Thomas’ project will last for three months and will take place in the spring of 2020. It involves using a form for the transfer of the patient from the nursing home to the ED.Patient length of stay (LOS) – hours and minutes from enrollment to admission or discharge – is calculated using data collected by the patient EPIC electronic medical record.. “Patients without a transfer form are a control group that allows direct LOS comparisons,” she explained. At the final stage of the project, Thomas analyzes the data and disseminates the results.

Impact of system changes

“Amy’s project has the potential to have a positive impact on patient care by reducing malpractice and facilitating ethical decision-making by healthcare providers,” said Cheryl Stansifer, director of TU. Says. Faculty of Nursing.. In fact, Crookham volunteered to consider this initiative as a “change project” for St. Francis Hospital South ED.

“The change project is a systematic effort that can change the practice of the entire healthcare system, not just the facilities of choice,” said Thomas. Once she has the opportunity to evaluate her project and evaluate the results, Thomas’ work is a system-wide pilot project to bring about beneficial practice changes that can affect the lives of thousands. Will be evaluated as. “My goal as an ED nurse and a future nurse practitioner is to always provide more efficient and timely care. I hope this project will help make that happen. I can’t wait. “

Become a nurse practitioner through TU Nursing Practice Program Doctor A three-year journey towards healthcare excellence. If you have a BSN and want to improve your knowledge and career as a nurse practitioner, TU offers two routes. Family nurse practitioner When Adult Gerontology Acute Career Practitioner..There is also Postmaster path For advanced practice nurses.

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