2.50
Hdl Handle:
http://hdl.handle.net/10755/162904
Type:
Presentation
Title:
Neuro Critical Transfer - Faster Access to Definitive Care
Abstract:
Neuro Critical Transfer - Faster Access to Definitive Care
Conference Sponsor:Emergency Nurses Association
Conference Year:2006
Author:Gutekunst, Mark, RN, CEN
P.I. Institution Name:Lehigh Valley Hospital - Muhlenberg
Title:Registered Nurse
Contact Address:2545 Schoenersville Rd., Bethlehem, PA, 18017, USA
Contact Telephone:(484) 884-2522
Co-Authors:Claranne Mathiesen, RN, MSN, CNRN; Brian Joho, RN, BA; Sharon Hoffner, RN, BS; Kathy Herron-Buttillo, RN, BS, CEN; Julie Fulcher, RN, C, BSN; Diana Haines, RN, MSN, CEN; Georgine Fontaine, RN, BSN, CEN; Charlotte Buckenmyer, RN, MS, CEN
Clinical Topic: Facilitating rapid transfer of patients experiencing a neuro-critical emergency can make a difference in treatment options and patient outcomes. During chart reviews in preparation for certification as a primary stroke center, an opportunity to further expedite the transfer of neuro-critical patients to a network facility with neurosurgical capabilities was identified. In fiscal year 2005, this emergency department (ED) saw a 54% increase in the number of patients meeting the criteria for neuro-critical transfer. The goal was to develop a neuro-critical transfer protocol that included rapid assessment, diagnosis, stabilization, and transport of a patient requiring emergent neurosurgical intervention. Implementation: In July of 2005, the ED Practice Council (eight members, including registered nurses, and technical and administrative partners) consulted with the neurological nurse specialist and transfer center staff to define a detailed transfer plan. They identified available resources, neurological patient needs, and reviewed transfer criteria to develop an enhanced plan for providing pre-transport communication and identifying transport needs and equipment, thus helping staff to rapidly identify and initiate transfer of these patients. Resource materials were placed in a comprehensive manual that included a transfer checklist, consent forms, and references for medications commonly administered to the patient experiencing a critical neurological event. Target times from the Brain Attack Coalition served as the benchmark for process improvement. The goal was set at two hours or less from identification of need for transfer to arrival at the tertiary care facility. In September, the ED Practice Council members presented an educational program to the ED nurses that included review of focused neurological assessment, critical diagnostic criteria, identified nursing care priorities, transfer criteria, and the new neuro-critical transfer protocol. Unit-based resource materials were placed in the emergency department. Outcomes: Pre-implementation data showed turnaround times of approximately five hours (most delays were the result of waiting for bed assignment prior to making transfer arrangements and the need to stabilize the patient). The ED Practice Council and the neurological nurse specialist evaluated the program through a retrospective chart review. Preliminary data shows a 50% reduction in turnaround time with an average of 2.5 hours. The resource manual has proved a valuable tool in the implementation of this process improvement and serves as a model for future process development. Development of a systematic approach has provided ED staff with a focused approach to eliminating delays in transfer and provided an ongoing opportunity for staff to share barriers to intra-facility transports. Any issues are referred to the ED Practice Council for input and action planning. Recommendations: A nurse-driven practice council provided a forum for ED nurses to effect changes in practice and to collaborate with colleagues to improve processes. Such collaborative efforts were necessary to implement a transfer protocol for the neuro-critical patient that expedites access to definitive care. Intra- facility transport involves coordination of services and clear communication to provide for no-delay access to specialized services not available at sending site. Continued staff education will help eliminate barriers related to process pieces. Ongoing review with physician leadership is helping to increase awareness of transfer issues and ensure prompt feedback to treating team. An additional understanding of regional traffic issues has led to refining the criteria for land versus air transports. Further data is necessary to complete full evaluation of protocol impact.
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.titleNeuro Critical Transfer - Faster Access to Definitive Careen_GB
dc.identifier.urihttp://hdl.handle.net/10755/162904-
dc.description.abstract<table><tr><td colspan="2" class="item-title">Neuro Critical Transfer - Faster Access to Definitive Care</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">2006</td></tr><tr class="item-author"><td class="label">Author:</td><td class="value">Gutekunst, Mark, RN, CEN</td></tr><tr class="item-institute"><td class="label">P.I. Institution Name:</td><td class="value">Lehigh Valley Hospital - Muhlenberg</td></tr><tr class="item-author-title"><td class="label">Title:</td><td class="value">Registered Nurse</td></tr><tr class="item-address"><td class="label">Contact Address:</td><td class="value">2545 Schoenersville Rd., Bethlehem, PA, 18017, USA</td></tr><tr class="item-phone"><td class="label">Contact Telephone:</td><td class="value">(484) 884-2522</td></tr><tr class="item-email"><td class="label">Email:</td><td class="value">Mark.Gutekunst@lvh.com</td></tr><tr class="item-co-authors"><td class="label">Co-Authors:</td><td class="value">Claranne Mathiesen, RN, MSN, CNRN; Brian Joho, RN, BA; Sharon Hoffner, RN, BS; Kathy Herron-Buttillo, RN, BS, CEN; Julie Fulcher, RN, C, BSN; Diana Haines, RN, MSN, CEN; Georgine Fontaine, RN, BSN, CEN; Charlotte Buckenmyer, RN, MS, CEN</td></tr><tr><td colspan="2" class="item-abstract">Clinical Topic: Facilitating rapid transfer of patients experiencing a neuro-critical emergency can make a difference in treatment options and patient outcomes. During chart reviews in preparation for certification as a primary stroke center, an opportunity to further expedite the transfer of neuro-critical patients to a network facility with neurosurgical capabilities was identified. In fiscal year 2005, this emergency department (ED) saw a 54% increase in the number of patients meeting the criteria for neuro-critical transfer. The goal was to develop a neuro-critical transfer protocol that included rapid assessment, diagnosis, stabilization, and transport of a patient requiring emergent neurosurgical intervention. Implementation: In July of 2005, the ED Practice Council (eight members, including registered nurses, and technical and administrative partners) consulted with the neurological nurse specialist and transfer center staff to define a detailed transfer plan. They identified available resources, neurological patient needs, and reviewed transfer criteria to develop an enhanced plan for providing pre-transport communication and identifying transport needs and equipment, thus helping staff to rapidly identify and initiate transfer of these patients. Resource materials were placed in a comprehensive manual that included a transfer checklist, consent forms, and references for medications commonly administered to the patient experiencing a critical neurological event. Target times from the Brain Attack Coalition served as the benchmark for process improvement. The goal was set at two hours or less from identification of need for transfer to arrival at the tertiary care facility. In September, the ED Practice Council members presented an educational program to the ED nurses that included review of focused neurological assessment, critical diagnostic criteria, identified nursing care priorities, transfer criteria, and the new neuro-critical transfer protocol. Unit-based resource materials were placed in the emergency department. Outcomes: Pre-implementation data showed turnaround times of approximately five hours (most delays were the result of waiting for bed assignment prior to making transfer arrangements and the need to stabilize the patient). The ED Practice Council and the neurological nurse specialist evaluated the program through a retrospective chart review. Preliminary data shows a 50% reduction in turnaround time with an average of 2.5 hours. The resource manual has proved a valuable tool in the implementation of this process improvement and serves as a model for future process development. Development of a systematic approach has provided ED staff with a focused approach to eliminating delays in transfer and provided an ongoing opportunity for staff to share barriers to intra-facility transports. Any issues are referred to the ED Practice Council for input and action planning. Recommendations: A nurse-driven practice council provided a forum for ED nurses to effect changes in practice and to collaborate with colleagues to improve processes. Such collaborative efforts were necessary to implement a transfer protocol for the neuro-critical patient that expedites access to definitive care. Intra- facility transport involves coordination of services and clear communication to provide for no-delay access to specialized services not available at sending site. Continued staff education will help eliminate barriers related to process pieces. Ongoing review with physician leadership is helping to increase awareness of transfer issues and ensure prompt feedback to treating team. An additional understanding of regional traffic issues has led to refining the criteria for land versus air transports. Further data is necessary to complete full evaluation of protocol impact.</td></tr></table>en_GB
dc.date.available2011-10-27T10:36:08Z-
dc.date.issued2011-10-17en_GB
dc.date.accessioned2011-10-27T10:36:08Z-
dc.description.sponsorshipEmergency Nurses Associationen_GB
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