Sign Here Please: Nurses and Physicians Working Cohesively for Proper Patient Placement

2.50
Hdl Handle:
http://hdl.handle.net/10755/162380
Type:
Presentation
Title:
Sign Here Please: Nurses and Physicians Working Cohesively for Proper Patient Placement
Abstract:
Sign Here Please: Nurses and Physicians Working Cohesively for Proper Patient Placement
Conference Sponsor:Emergency Nurses Association
Conference Year:2010
Author:Garee, Stephanie L., RN, MSN, CEN
P.I. Institution Name:The Methodist Hospital
Title:Registered Nurse; Clinical Colleague
Contact Address:6565 Fannin Street, Houston, TX, 77030, USA
Contact Telephone:713-441-4467
[ENA Annual Conference - Evidence-based Practice Presentation]

Purpose: Patients were being transferred out of the Emergency Department to acute care and shortly after arriving required transfer to a higher level of care. In order to improve quality of care and patient safety a system to improve patient placement in a unit with the appropriate level of care was developed.

Design: This is an evidence based project developed by the staff. The project began in the Emergency Departments Shared Governance Committee.

Setting: An urban, teaching hospital, seeing approximately 42,000 patients in the Emergency Department annually. The admission rate of this Emergency Department is approximately 42% of all visits.

Participants/Subjects: Participants included all patients that were admitted to the hospital and all nurses and physicians within the Emergency Department.

Methods: A new process was created, called "Sign-Out". The process branched off of the "Time Out" process that is used frequently for surgeries and other procedures in which all participants are in agreement before proceeding. Once a patient is assigned a room and is nearing their departure from the ED the treating nurse and physician go to the patientÆs bedside and decide together that the patient is being admitted to the appropriate level of care. Once the decision is agreed upon, the nurse and physician "Sign Out" on a sheet indicating that the care level is appropriate. If not, the patient is then either upgraded or downgraded depending on their condition at that time.

Results/Outcomes: In the last five months since the processes inception there has been a decrease in the number of patients admitted to units inappropriately.

Implications: The condition of a patient can change frequently throughout their stay in the ED. Having the treating physician and nurse decide together whether the patient requires a change in care level is beneficial for all involved. First, the physician and nurse are working together cohesively to make a decision that is going to benefit the patient. Second, the patient is benefitting by being admitted to the appropriate care level in the first place. Patients are often downgraded after the Sign Out thus reducing patients overall length of stay by eliminating an ICU admission. This indicates that the development of the "Sign Out" process leads to decreased inappropriate admissions and potentially improved patient care.

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.titleSign Here Please: Nurses and Physicians Working Cohesively for Proper Patient Placementen_GB
dc.identifier.urihttp://hdl.handle.net/10755/162380-
dc.description.abstract<table><tr><td colspan="2" class="item-title">Sign Here Please: Nurses and Physicians Working Cohesively for Proper Patient Placement</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">Garee, Stephanie L., RN, MSN, CEN</td></tr><tr class="item-institute"><td class="label">P.I. Institution Name:</td><td class="value">The Methodist Hospital</td></tr><tr class="item-author-title"><td class="label">Title:</td><td class="value">Registered Nurse; Clinical Colleague</td></tr><tr class="item-address"><td class="label">Contact Address:</td><td class="value">6565 Fannin Street, Houston, TX, 77030, USA</td></tr><tr class="item-phone"><td class="label">Contact Telephone:</td><td class="value">713-441-4467</td></tr><tr class="item-email"><td class="label">Email:</td><td class="value">sgaree@tmhs.org</td></tr><tr><td colspan="2" class="item-abstract">[ENA Annual Conference - Evidence-based Practice Presentation]<br/><br/>Purpose: Patients were being transferred out of the Emergency Department to acute care and shortly after arriving required transfer to a higher level of care. In order to improve quality of care and patient safety a system to improve patient placement in a unit with the appropriate level of care was developed. <br/><br/>Design: This is an evidence based project developed by the staff. The project began in the Emergency Departments Shared Governance Committee. <br/> <br/>Setting: An urban, teaching hospital, seeing approximately 42,000 patients in the Emergency Department annually. The admission rate of this Emergency Department is approximately 42% of all visits. <br/> <br/>Participants/Subjects: Participants included all patients that were admitted to the hospital and all nurses and physicians within the Emergency Department. <br/> <br/>Methods: A new process was created, called &quot;Sign-Out&quot;. The process branched off of the &quot;Time Out&quot; process that is used frequently for surgeries and other procedures in which all participants are in agreement before proceeding. Once a patient is assigned a room and is nearing their departure from the ED the treating nurse and physician go to the patient&AElig;s bedside and decide together that the patient is being admitted to the appropriate level of care. Once the decision is agreed upon, the nurse and physician &quot;Sign Out&quot; on a sheet indicating that the care level is appropriate. If not, the patient is then either upgraded or downgraded depending on their condition at that time. <br/> <br/>Results/Outcomes: In the last five months since the processes inception there has been a decrease in the number of patients admitted to units inappropriately. <br/> <br/>Implications: The condition of a patient can change frequently throughout their stay in the ED. Having the treating physician and nurse decide together whether the patient requires a change in care level is beneficial for all involved. First, the physician and nurse are working together cohesively to make a decision that is going to benefit the patient. Second, the patient is benefitting by being admitted to the appropriate care level in the first place. Patients are often downgraded after the Sign Out thus reducing patients overall length of stay by eliminating an ICU admission. This indicates that the development of the &quot;Sign Out&quot; process leads to decreased inappropriate admissions and potentially improved patient care. <br/><br/></td></tr></table>en_GB
dc.date.available2011-10-27T10:27:12Z-
dc.date.issued2011-10-17en_GB
dc.date.accessioned2011-10-27T10:27:12Z-
dc.description.sponsorshipEmergency Nurses Associationen_GB
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