8.00
Hdl Handle:
http://hdl.handle.net/10755/162357
Type:
Presentation
Title:
"Please Get Me Off of This Thing!" Nurse Initiated Spinal Board Removal
Abstract:
"Please Get Me Off of This Thing!" Nurse Initiated Spinal Board Removal
Conference Sponsor:Emergency Nurses Association
Conference Year:2010
Author:Abbott, Darcy, RN, MS, CEN
P.I. Institution Name:The Miriam Hospital
Title:Director of Emergency Nursing
Contact Address:164 Summit Avenue, Providence, RI, 02906, USA
Contact Telephone:401-793-3395
Co-Authors:Nancy M. Robin RN, M. Ed. CEN; Denise Brennan RN, MSN
[ENA Annual Conference - Evidence-based Practice Presentation]

Purpose: Explore the notion of nurses removing spinal boards for patients meeting defined criteria to decrease pain experience, and prevent tissue injury from unnecessary, prolonged immobilization

Design: Quality Improvement Project

Setting: Non-designated trauma center, acute care, 50,000 visit Emergency Department

Participants: ED Nursing Director, ED Nurse Manager, ED Nurse Educator and ED Staff Nurses

Methods: Staff nurses brought forward that many patients present to the ED on spinal boards for solely transport purposes. Spinal boards could only be removed after the physician assessed the patient and ordered its removal. Patient's expressed that lying on a spinal board was very uncomfortable. Delays in spinal board removal increased pain and discomfort. The review of literature was limited in terms of pressure ulcer and length of spinal board immobilization; however there was clear evidence that patients' pain experience was increased in direct correlation to immobilization on a rigid spinal board. Lying on a rigid, hard surface without being able to move or shift position is notably very uncomfortable. Some studies suggested that immobilization on rigid spine boards could result in pain in some patients who were otherwise free of pain. Members of this ED nursing leadership team developed a policy which was fully supported by its physician group. The new ED policy for nurse initiated spinal board removal was reviewed by staff in October 2009. It included ED nurses attended competency training with return demonstration. Nurses needed to verbalize criteria for spinal board removal and demonstrate an assessment of patients who arrived on a spinal board. Nurses also need to demonstrate correct spinal board removal procedure. Nurse initiated spinal board removal began in November 2009.

Results/Outcomes: Staff are now empowered to remove spinal boards. Removal of spinal boards for those patients who met the defined criteria, has resulted in improved patient comfort and decreased prolonged exposure to immobilization. Not only have these patients been more comfortable, it is provided one ED opportunity to improve pressure ulcer prevention.

Implications: Pressure ulcer reduction and pain management are high priority issues for Emergency Nursing. This new nurse initiated protocol advances nursing autonomy at the bedside and has the potential to impact patient outcomes.

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.title"Please Get Me Off of This Thing!" Nurse Initiated Spinal Board Removalen_GB
dc.identifier.urihttp://hdl.handle.net/10755/162357-
dc.description.abstract<table><tr><td colspan="2" class="item-title"> &quot;Please Get Me Off of This Thing!&quot; Nurse Initiated Spinal Board Removal</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">Abbott, Darcy, RN, MS, CEN</td></tr><tr class="item-institute"><td class="label">P.I. Institution Name:</td><td class="value">The Miriam Hospital</td></tr><tr class="item-author-title"><td class="label">Title:</td><td class="value">Director of Emergency Nursing</td></tr><tr class="item-address"><td class="label">Contact Address:</td><td class="value">164 Summit Avenue, Providence, RI, 02906, USA</td></tr><tr class="item-phone"><td class="label">Contact Telephone:</td><td class="value">401-793-3395</td></tr><tr class="item-email"><td class="label">Email:</td><td class="value">dabbott@lifespan.org</td></tr><tr class="item-co-authors"><td class="label">Co-Authors:</td><td class="value">Nancy M. Robin RN, M. Ed. CEN; Denise Brennan RN, MSN</td></tr><tr><td colspan="2" class="item-abstract">[ENA Annual Conference - Evidence-based Practice Presentation] <br/><br/>Purpose: Explore the notion of nurses removing spinal boards for patients meeting defined criteria to decrease pain experience, and prevent tissue injury from unnecessary, prolonged immobilization<br/><br/>Design: Quality Improvement Project<br/><br/>Setting: Non-designated trauma center, acute care, 50,000 visit Emergency Department<br/><br/>Participants: ED Nursing Director, ED Nurse Manager, ED Nurse Educator and ED Staff Nurses<br/><br/>Methods: Staff nurses brought forward that many patients present to the ED on spinal boards for solely transport purposes. Spinal boards could only be removed after the physician assessed the patient and ordered its removal. Patient's expressed that lying on a spinal board was very uncomfortable. Delays in spinal board removal increased pain and discomfort. The review of literature was limited in terms of pressure ulcer and length of spinal board immobilization; however there was clear evidence that patients' pain experience was increased in direct correlation to immobilization on a rigid spinal board. Lying on a rigid, hard surface without being able to move or shift position is notably very uncomfortable. Some studies suggested that immobilization on rigid spine boards could result in pain in some patients who were otherwise free of pain. Members of this ED nursing leadership team developed a policy which was fully supported by its physician group. The new ED policy for nurse initiated spinal board removal was reviewed by staff in October 2009. It included ED nurses attended competency training with return demonstration. Nurses needed to verbalize criteria for spinal board removal and demonstrate an assessment of patients who arrived on a spinal board. Nurses also need to demonstrate correct spinal board removal procedure. Nurse initiated spinal board removal began in November 2009.<br/><br/>Results/Outcomes: Staff are now empowered to remove spinal boards. Removal of spinal boards for those patients who met the defined criteria, has resulted in improved patient comfort and decreased prolonged exposure to immobilization. Not only have these patients been more comfortable, it is provided one ED opportunity to improve pressure ulcer prevention. <br/><br/>Implications: Pressure ulcer reduction and pain management are high priority issues for Emergency Nursing. This new nurse initiated protocol advances nursing autonomy at the bedside and has the potential to impact patient outcomes.<br/><br/></td></tr></table>en_GB
dc.date.available2011-10-27T10:26:46Z-
dc.date.issued2011-10-17en_GB
dc.date.accessioned2011-10-27T10:26:46Z-
dc.description.sponsorshipEmergency Nurses Associationen_GB
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