2.50
Hdl Handle:
http://hdl.handle.net/10755/162355
Type:
Presentation
Title:
How Long is Enough? Decreasing Time Patients Spend on Backboards
Abstract:
How Long is Enough? Decreasing Time Patients Spend on Backboards
Conference Sponsor:Emergency Nurses Association
Conference Year:2010
Author:Wolfe, Barbara, RN
P.I. Institution Name:MetroHealth Medical Center - Emergency Dept.
Title:Clinical Nurse
Contact Address:2500 MetroHealth Drive, Cleveland, OH, 44109, USA
Co-Authors:Carol Klekota, RN, MSN, ACNS-BC; Laura Bobrowski, RN, MSN, ACNS-BC
Leadership Conference - Evidence-Based Practice Abstract: How Long is Enough? Decreasing Time Patients Spend on Backboards


Purpose: Backboard immobilization is commonly used for transport and stabilization of the trauma patient en route to emergency departments. Upon arrival in the emergency department (ED), patients remain on the backboard until the physician determines that spinal integrity will not be compromised. The length of time a patient remains on the backboard varies among facilities. This situation provides a challenge to ED management, as a delay in backboard removal results in increased waiting times for treatments and admissions, decreased patient throughput, potential adverse effects to the patient --specifically, comfort levels (Cross & Baskerville, 2001; Hauswald, Hsu & Stockoff, 2000; Lerner, Billittier & Moscati, 1998) skin breakdown (Cordell, et al 1995) and decrease in patient satisfaction (Brown et al, 2005; Cook et al, 2006; Sun et al, 2005).

Design: An evidence-based, quality improvement project was created to address this concern.

Setting: A mid-west urban teaching hospital, level 1 trauma center.

Participants/Subjects: All adult patients ages 18 years and over who are conscious, able to communicate, and were brought in to the ED on a backboard were asked about their pain and comfort levels related to backboard immobilization. During a 2-week time period, nurses assessed the back boarded patients on randomly selected days and included all 3 shifts.

Methods: Real time assessment of patientsÆ level of comfort on and off backboard was done, using a 1 to 10 scale: 1= no comfort; 10= great comfort. Patients were asked to differentiate between discomfort from injuries and discomfort caused from backboard. Data shows a 4-point increase in comfort after backboard removal. A retrospective chart review showed an average time of 90 minutes on the backboard. Reasons for delay in removal of backboards were explored by the ED staff. The reasons were: nurses lack of knowledge of when to remove patient from backboard; physicianÆs lack of communication that backboard can be removed; influx of high acuity patients leading to lack of available staff to remove backboard; lack of staff to transport patient to radiology; patient's impaired cognition. Staff from the ED created the policy, "Backboard Removal for Emergency Department Patients" which outlined criteria for evaluation and safe and timely removal of the backboard. The policy was approved by administration and implemented.

Results/Outcomes: Since implementation of the new policy for backboard removal, patients' average time on the backboard has been reduced to 35 minutes. Reduction in backboard time has subsequently increased patient throughput and comfort levels. Additionally, less backboard time results in a decreased risk for device-related pressure ulcers.

Implications: Managers can directly influence patient throughput and comfort levels related to backboard removal. By exploring reasons for delay, creating specific policies, and implementing those policies, a positive impact upon patient care and satisfaction can be achieved.
Repository Posting Date:
27-Oct-2011
Date of Publication:
17-Oct-2011
Sponsors:
Emergency Nurses Association

Full metadata record

DC FieldValue Language
dc.typePresentationen_GB
dc.titleHow Long is Enough? Decreasing Time Patients Spend on Backboardsen_GB
dc.identifier.urihttp://hdl.handle.net/10755/162355-
dc.description.abstract<table><tr><td colspan="2" class="item-title">How Long is Enough? Decreasing Time Patients Spend on Backboards</td></tr><tr class="item-sponsor"><td class="label">Conference Sponsor:</td><td class="value">Emergency Nurses Association</td></tr><tr class="item-year"><td class="label">Conference Year:</td><td class="value">2010</td></tr><tr class="item-author"><td class="label">Author:</td><td class="value">Wolfe, Barbara, RN</td></tr><tr class="item-institute"><td class="label">P.I. Institution Name:</td><td class="value">MetroHealth Medical Center - Emergency Dept.</td></tr><tr class="item-author-title"><td class="label">Title:</td><td class="value">Clinical Nurse</td></tr><tr class="item-address"><td class="label">Contact Address:</td><td class="value">2500 MetroHealth Drive, Cleveland, OH, 44109, USA</td></tr><tr class="item-email"><td class="label">Email:</td><td class="value">bwolfe1@metrohealth.org</td></tr><tr class="item-co-authors"><td class="label">Co-Authors:</td><td class="value">Carol Klekota, RN, MSN, ACNS-BC; Laura Bobrowski, RN, MSN, ACNS-BC</td></tr><tr><td colspan="2" class="item-abstract">Leadership Conference - Evidence-Based Practice Abstract: How Long is Enough? Decreasing Time Patients Spend on Backboards<br/><br/><br/>Purpose: Backboard immobilization is commonly used for transport and stabilization of the trauma patient en route to emergency departments. Upon arrival in the emergency department (ED), patients remain on the backboard until the physician determines that spinal integrity will not be compromised. The length of time a patient remains on the backboard varies among facilities. This situation provides a challenge to ED management, as a delay in backboard removal results in increased waiting times for treatments and admissions, decreased patient throughput, potential adverse effects to the patient --specifically, comfort levels (Cross &amp; Baskerville, 2001; Hauswald, Hsu &amp; Stockoff, 2000; Lerner, Billittier &amp; Moscati, 1998) skin breakdown (Cordell, et al 1995) and decrease in patient satisfaction (Brown et al, 2005; Cook et al, 2006; Sun et al, 2005).<br/><br/>Design: An evidence-based, quality improvement project was created to address this concern.<br/><br/>Setting: A mid-west urban teaching hospital, level 1 trauma center.<br/><br/>Participants/Subjects: All adult patients ages 18 years and over who are conscious, able to communicate, and were brought in to the ED on a backboard were asked about their pain and comfort levels related to backboard immobilization. During a 2-week time period, nurses assessed the back boarded patients on randomly selected days and included all 3 shifts.<br/><br/>Methods: Real time assessment of patients&AElig; level of comfort on and off backboard was done, using a 1 to 10 scale: 1= no comfort; 10= great comfort. Patients were asked to differentiate between discomfort from injuries and discomfort caused from backboard. Data shows a 4-point increase in comfort after backboard removal. A retrospective chart review showed an average time of 90 minutes on the backboard. Reasons for delay in removal of backboards were explored by the ED staff. The reasons were: nurses lack of knowledge of when to remove patient from backboard; physician&AElig;s lack of communication that backboard can be removed; influx of high acuity patients leading to lack of available staff to remove backboard; lack of staff to transport patient to radiology; patient's impaired cognition. Staff from the ED created the policy, &quot;Backboard Removal for Emergency Department Patients&quot; which outlined criteria for evaluation and safe and timely removal of the backboard. The policy was approved by administration and implemented.<br/><br/>Results/Outcomes: Since implementation of the new policy for backboard removal, patients' average time on the backboard has been reduced to 35 minutes. Reduction in backboard time has subsequently increased patient throughput and comfort levels. Additionally, less backboard time results in a decreased risk for device-related pressure ulcers.<br/><br/>Implications: Managers can directly influence patient throughput and comfort levels related to backboard removal. By exploring reasons for delay, creating specific policies, and implementing those policies, a positive impact upon patient care and satisfaction can be achieved. <br/></td></tr></table>en_GB
dc.date.available2011-10-27T10:26:43Z-
dc.date.issued2011-10-17en_GB
dc.date.accessioned2011-10-27T10:26:43Z-
dc.description.sponsorshipEmergency Nurses Associationen_GB
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