Diffusion of Innovation for Documenting Asthma Severity Scores at Triage in a Pediatric Emergency Department

2.50
Hdl Handle:
http://hdl.handle.net/10755/157120
Category:
Abstract
Type:
Presentation
Title:
Diffusion of Innovation for Documenting Asthma Severity Scores at Triage in a Pediatric Emergency Department
Author(s):
Jackson, Lisa; Frese, Kristi; Gillespie, Gordon; Morris, Diane; Cooper, Sharon
Author Details:
Lisa Jackson, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA, email: lisa.jackson@cchmc.org; Kristi Frese; Gordon Gillespie; Diane Morris; Sharon Cooper
Abstract:
PURPOSE: It is important that emergency department (ED) documentation of asthma severity scores be included in the triage assessment and documentation of pediatric patients with asthma symptoms such as wheezing, difficulty breathing, or a persistent cough. The purpose of this study was to test a social marketing campaign based on the Diffusion of Innovation theory to see if triage nurses would increase compliance with documenting asthma severity scores. BACKGROUND: In the main ED treatment rooms, patients were prioritized based on their triage acuity category. If multiple patients arrive with the same acuity category, then patients were seen based on ED time of arrival. It was found that patients clinically could be significantly different within the same triage acuity category. Therefore it was critical that asthma severity scores be documented at triage so that emergency nurses could better prioritize the order that patients in treatment rooms are seen. METHODS: A prospective chart review was completed on all patients discharged with asthma diagnosis between ages 2 and 17. Triage documentation was audited to determine the triage nurse and documentation of an asthma severity score. Data were analyzed at baseline and biweekly until 2 weeks after the end of the social marketing campaign (27 weeks total). The social marketing campaign included a short PowerPoint presentation e-mailed to triage nurses, colored-informational flyers posted in staff restrooms and the breakroom, campaign logo placards placed on all six triage computer workstations, and logo ink pens distributed periodically to compliant triage nurses. Descriptive statistics were computed. RESULTS: ED charts meeting compliance increased from 11.1% (n=5) to 51.4% (n=55) at the end of the study. The percentage of compliant nurses increased from 6.3% (n=2) to 50% (n=25) at the end of the study. Initial increase in compliance was associated with the placement of placards on triage computers and the e-mailed PowerPoint presentation. After the initial month, minimal increases were seen after placing new placards or flyers. The only consistent marketing tool seen to increase compliance with triage nurse documentation of asthma severity scores was the in person delivery of colorful ink pens with the worm logo followed by the words "Get WARM-E in triage!" CONCLUSIONS: The desired documentation change was seen in this study using a social marketing campaign. Future campaigns aimed at changing practice would benefit by focusing on initial education of expected standards followed by periodic delivery of rewards such as ink pens or other items seen as valuable to triage nurses. However, if 100% compliance is essential due to patient safety or other standards, it may be necessary to include the practice change as a component of annual performance reviews.
Repository Posting Date:
26-Oct-2011
Date of Publication:
26-Oct-2011
Citation:
2009 National Teaching Institute Research Abstracts. American Journal of Critical Care, 18(3), e1-e17.
Conference Date:
2009
Conference Name:
National Teaching Institute and Critical Care Exposition
Conference Host:
American Association of Critical-Care Nurses
Conference Location:
New Orleans, Louisiana, USA
Note:
This is an abstract-only submission. If the author has submitted a full-text item based on this abstract, you may find it by browsing the Virginia Henderson Global Nursing e-Repository by author. If author contact information is available in this abstract, please feel free to contact him or her with your queries regarding this submission. Alternatively, please contact the conference host, journal, or publisher (according to the circumstance) for further details regarding this item. If a citation is listed in this record, the item has been published and is available via open-access avenues or a journal/database subscription. Contact your library for assistance in obtaining the as-published article.

Full metadata record

DC FieldValue Language
dc.type.categoryAbstracten_GB
dc.typePresentationen_GB
dc.titleDiffusion of Innovation for Documenting Asthma Severity Scores at Triage in a Pediatric Emergency Departmenten_GB
dc.contributor.authorJackson, Lisaen_GB
dc.contributor.authorFrese, Kristien_GB
dc.contributor.authorGillespie, Gordonen_GB
dc.contributor.authorMorris, Dianeen_GB
dc.contributor.authorCooper, Sharonen_GB
dc.author.detailsLisa Jackson, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA, email: lisa.jackson@cchmc.org; Kristi Frese; Gordon Gillespie; Diane Morris; Sharon Cooperen_GB
dc.identifier.urihttp://hdl.handle.net/10755/157120-
dc.description.abstractPURPOSE: It is important that emergency department (ED) documentation of asthma severity scores be included in the triage assessment and documentation of pediatric patients with asthma symptoms such as wheezing, difficulty breathing, or a persistent cough. The purpose of this study was to test a social marketing campaign based on the Diffusion of Innovation theory to see if triage nurses would increase compliance with documenting asthma severity scores. BACKGROUND: In the main ED treatment rooms, patients were prioritized based on their triage acuity category. If multiple patients arrive with the same acuity category, then patients were seen based on ED time of arrival. It was found that patients clinically could be significantly different within the same triage acuity category. Therefore it was critical that asthma severity scores be documented at triage so that emergency nurses could better prioritize the order that patients in treatment rooms are seen. METHODS: A prospective chart review was completed on all patients discharged with asthma diagnosis between ages 2 and 17. Triage documentation was audited to determine the triage nurse and documentation of an asthma severity score. Data were analyzed at baseline and biweekly until 2 weeks after the end of the social marketing campaign (27 weeks total). The social marketing campaign included a short PowerPoint presentation e-mailed to triage nurses, colored-informational flyers posted in staff restrooms and the breakroom, campaign logo placards placed on all six triage computer workstations, and logo ink pens distributed periodically to compliant triage nurses. Descriptive statistics were computed. RESULTS: ED charts meeting compliance increased from 11.1% (n=5) to 51.4% (n=55) at the end of the study. The percentage of compliant nurses increased from 6.3% (n=2) to 50% (n=25) at the end of the study. Initial increase in compliance was associated with the placement of placards on triage computers and the e-mailed PowerPoint presentation. After the initial month, minimal increases were seen after placing new placards or flyers. The only consistent marketing tool seen to increase compliance with triage nurse documentation of asthma severity scores was the in person delivery of colorful ink pens with the worm logo followed by the words "Get WARM-E in triage!" CONCLUSIONS: The desired documentation change was seen in this study using a social marketing campaign. Future campaigns aimed at changing practice would benefit by focusing on initial education of expected standards followed by periodic delivery of rewards such as ink pens or other items seen as valuable to triage nurses. However, if 100% compliance is essential due to patient safety or other standards, it may be necessary to include the practice change as a component of annual performance reviews.en_GB
dc.date.available2011-10-26T19:26:20Z-
dc.date.issued2011-10-26en_GB
dc.date.accessioned2011-10-26T19:26:20Z-
dc.identifier.citation2009 National Teaching Institute Research Abstracts. American Journal of Critical Care, 18(3), e1-e17.en_GB
dc.conference.date2009en_GB
dc.conference.nameNational Teaching Institute and Critical Care Expositionen_GB
dc.conference.hostAmerican Association of Critical-Care Nursesen_GB
dc.conference.locationNew Orleans, Louisiana, USAen_GB
dc.identifier.citation2009 National Teaching Institute Research Abstracts. American Journal of Critical Care, 18(3), e1-e17.en_GB
dc.description.noteThis is an abstract-only submission. If the author has submitted a full-text item based on this abstract, you may find it by browsing the Virginia Henderson Global Nursing e-Repository by author. If author contact information is available in this abstract, please feel free to contact him or her with your queries regarding this submission. Alternatively, please contact the conference host, journal, or publisher (according to the circumstance) for further details regarding this item. If a citation is listed in this record, the item has been published and is available via open-access avenues or a journal/database subscription. Contact your library for assistance in obtaining the as-published article.-
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