2.50
Hdl Handle:
http://hdl.handle.net/10755/163006
Type:
Presentation
Title:
Guesting Area: An Innovative Approach to Holding the Psychiatric ED Patient
Abstract:
Guesting Area: An Innovative Approach to Holding the Psychiatric ED Patient
Conference Sponsor:Emergency Nurses Association
Conference Year:2005
Author:Winokur, Beth, RN, MSN, CEN
P.I. Institution Name:St. Joseph Hospital
Title:Clinical Educator Emergency Department, Behavioral Health Services, Cardiology
Contact Address:1100 West Stewart Drive, Orange, CA, 92868, USA
Contact Telephone:(714) 771-8250
Co-Authors: Amy Waunch, RN, MSN, FNP, CEN
Clinical Topic: With emergency department (ED) volume increasing, the number of patients presenting to the emergency department with psychiatric problems is growing. Concurrently, the quantity of available inpatient psychiatric beds is decreasing, which is contributing to an increased length of stay in the emergency department. These issues lead to expanded utilization of staff and resources and delays in the initiation of definitive psychiatric care. The purpose of this project was to relocate psychiatric patients from the emergency department to a safe, therapeutic area, while freeing ED services for other patients. Implementation: A temporary holding area located within the behavioral health services department of a suburban community hospital in Orange County, CA, was created to house psychiatric patients awaiting admission or transfer. The concept, which was named the Guesting Area, was developed by a multidisciplinary team of nurses and physicians from the behavioral health services and emergency departments, security personnel, and individuals from hospital administration. The team sought consultation and approval from the Orange County Departments of Health and Mental Health. Implementation began after locating and furnishing an appropriate area within the behavioral health services department. Policy and procedures, documentation forms, and tracking methods were developed, and education was provided to staff of both the behavioral health services and emergency departments. Although housed temporarily in the behavioral health department, the patients remained assigned to the emergency department. Evaluation of the Guesting Area is ongoing and involves staff feedback, chart reviews, and tracking of staffing needs, as well as risk issues, including violence and elopement. Outcomes: The Guesting Area opened March 2003. Outcome tracking included the number of hours security personnel were needed in the emergency department to watch over psychiatric patients, which decreased from 347 hours per month prior to implementation of the Guesting Area to an average of 65 hours per month after the program was established. At this time, attempted or actual elopements from the Guesting Area have been nonexistent, which compares to an average of five attempted or actual elopements that occurred each year prior to the program. In addition, feedback from ED staff regarding the Guesting Area has been very positive. Recommendations: This project provides an innovative solution to a problem that confronts many emergency departments. In the current state of ED overcrowding and increasing numbers of psychiatric patients, the Guesting Area decreased the length of stay for psychiatric patients in the emergency department and freed resources for other patients seeking emergency care. Future research activities involve obtaining additional outcome measures, such as patient and staff satisfaction and resource utilization.
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.titleGuesting Area: An Innovative Approach to Holding the Psychiatric ED Patienten_GB
dc.identifier.urihttp://hdl.handle.net/10755/163006-
dc.description.abstract<table><tr><td colspan="2" class="item-title">Guesting Area: An Innovative Approach to Holding the Psychiatric ED Patient</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">2005</td></tr><tr class="item-author"><td class="label">Author:</td><td class="value">Winokur, Beth, RN, MSN, CEN</td></tr><tr class="item-institute"><td class="label">P.I. Institution Name:</td><td class="value">St. Joseph Hospital</td></tr><tr class="item-author-title"><td class="label">Title:</td><td class="value">Clinical Educator Emergency Department, Behavioral Health Services, Cardiology</td></tr><tr class="item-address"><td class="label">Contact Address:</td><td class="value">1100 West Stewart Drive, Orange, CA, 92868, USA</td></tr><tr class="item-phone"><td class="label">Contact Telephone:</td><td class="value">(714) 771-8250</td></tr><tr class="item-email"><td class="label">Email:</td><td class="value">bwinokur@sjo.stjoe.org</td></tr><tr class="item-co-authors"><td class="label">Co-Authors:</td><td class="value"> Amy Waunch, RN, MSN, FNP, CEN</td></tr><tr><td colspan="2" class="item-abstract">Clinical Topic: With emergency department (ED) volume increasing, the number of patients presenting to the emergency department with psychiatric problems is growing. Concurrently, the quantity of available inpatient psychiatric beds is decreasing, which is contributing to an increased length of stay in the emergency department. These issues lead to expanded utilization of staff and resources and delays in the initiation of definitive psychiatric care. The purpose of this project was to relocate psychiatric patients from the emergency department to a safe, therapeutic area, while freeing ED services for other patients. Implementation: A temporary holding area located within the behavioral health services department of a suburban community hospital in Orange County, CA, was created to house psychiatric patients awaiting admission or transfer. The concept, which was named the Guesting Area, was developed by a multidisciplinary team of nurses and physicians from the behavioral health services and emergency departments, security personnel, and individuals from hospital administration. The team sought consultation and approval from the Orange County Departments of Health and Mental Health. Implementation began after locating and furnishing an appropriate area within the behavioral health services department. Policy and procedures, documentation forms, and tracking methods were developed, and education was provided to staff of both the behavioral health services and emergency departments. Although housed temporarily in the behavioral health department, the patients remained assigned to the emergency department. Evaluation of the Guesting Area is ongoing and involves staff feedback, chart reviews, and tracking of staffing needs, as well as risk issues, including violence and elopement. Outcomes: The Guesting Area opened March 2003. Outcome tracking included the number of hours security personnel were needed in the emergency department to watch over psychiatric patients, which decreased from 347 hours per month prior to implementation of the Guesting Area to an average of 65 hours per month after the program was established. At this time, attempted or actual elopements from the Guesting Area have been nonexistent, which compares to an average of five attempted or actual elopements that occurred each year prior to the program. In addition, feedback from ED staff regarding the Guesting Area has been very positive. Recommendations: This project provides an innovative solution to a problem that confronts many emergency departments. In the current state of ED overcrowding and increasing numbers of psychiatric patients, the Guesting Area decreased the length of stay for psychiatric patients in the emergency department and freed resources for other patients seeking emergency care. Future research activities involve obtaining additional outcome measures, such as patient and staff satisfaction and resource utilization.</td></tr></table>en_GB
dc.date.available2011-10-27T10:37:55Z-
dc.date.issued2011-10-17en_GB
dc.date.accessioned2011-10-27T10:37:55Z-
dc.description.sponsorshipEmergency Nurses Associationen_GB
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