2.50
Hdl Handle:
http://hdl.handle.net/10755/324168
Category:
Abstract
Type:
Presentation
Title:
Implementation of a Modified Emergency Department Overcrowding Measure
Author(s):
Barishman, David
Author Details:
David Barishman, MHA, BSN, RN, email: dbaris1@uic.edu
Abstract:
Evidence-based Practice Abstract
Keywords:
Overcrowding
Repository Posting Date:
4-Aug-2014
Date of Publication:
4-Aug-2014
Conference Date:
2014
Conference Name:
2014 ENA Leadership Conference
Conference Host:
Emergency Nurses Association
Conference Location:
Phoenix, Arizona USA
Description:
2014 ENA Leadership Conference Theme: Safe Practice, Safe Care. Held at the Phoenix Convention Center
Note:
This is an abstract-only submission. If the author has submitted a full-text item based on this abstract, you may find it by browsing the Virginia Henderson Global Nursing e-Repository by author. If author contact information is available in this abstract, please feel free to contact him or her with your queries regarding this submission. Alternatively, please contact the conference host, journal, or publisher (according to the circumstance) for further details regarding this item. If a citation is listed in this record, the item has been published and is available via open-access avenues or a journal/database subscription. Contact your library for assistance in obtaining the as-published article.

Full metadata record

DC FieldValue Language
dc.language.isoen_USen_GB
dc.type.categoryAbstracten_GB
dc.typePresentationen_GB
dc.titleImplementation of a Modified Emergency Department Overcrowding Measureen_GB
dc.contributor.authorBarishman, Daviden_GB
dc.author.detailsDavid Barishman, MHA, BSN, RN, email: dbaris1@uic.eduen_GB
dc.identifier.urihttp://hdl.handle.net/10755/324168-
dc.description.abstractEvidence-based Practice Abstract<Purpose: Overcrowding within emergency departments (ED) contributes to clinically significant delays in care and increased mortality. The purpose of this project was to implement an overcrowding measure within the department to objectively assess and better communicate departmental condition to stakeholders, including the adequacy of care resources for meeting patient care demands. Design: This project was an operational implementation assessment and modification to an existing overcrowding measure identified through literature review. Setting: The setting for this project was an ED within a 495-bed urban academic medical center. Subjects: This project was approved by the Associate Director of Nursing for Emergency Services and the Chair of Emergency Medicine. De-identified data and feedback was provided by charge nurses while they worked in the ED. Methods: The overcrowding measure selected for evaluation was the National Emergency Department Overcrowding Scale (NEDOCS). Project goals were reviewed with staff and faculty. Education was provided for charge nurses including variable clarification, online computational tool use, expectations for data entry and explanation of the nursing workload perception score. During a 10 month period, charge nurses recorded data every four hours. This generated a computed score representing the level of overcrowding and provided a score from one to ten representing the perceived level of nursing workload within the department. The relationships between the NEDOCS scoring and perception scores were analyzed using correlation and simple linear regression. A modification to the NEDOCS equation was made to represent a coverage factor for nursing care over a given number of patients. The original NEDOCS measure determines overcrowding based on the size of an ED regardless of the care resources available for patients. By adding a staffing modification, the overcrowding measure became sensitive to nurse staffing fluctuations. This coverage factor was determined through data analysis, identifying the point of highest correlation between NEDOCS scoring and nursing workload perception scoring. The modified NEDOCS equation was then applied to the historical data to determine if the staffing modification resulted in a statistically significant change. Results: Relationship between NEDOCS scoring and perception scoring demonstrated a strong correlation r(1839)=.79, p<.001 and strong statistical relationship t(1839)=54.7, R2=.62 F(1,1837)=2986, p<.001. Relationship between modified NEDOCS scoring and perception scoring demonstrated a strong correlation r(1839)=.80, p<.001 and strong statistical relationship t(1839)=57.8, R2=.65 F(1,1837)=3342, p<.001. A T-Test for paired sample means was performed between NEDOCS and Modified NEDOCS scoring, demonstrating a statistically significant change NEDOCS Mean 57.2 SD 42.0 Modified NEDOCS Mean 65.1 SD 40.5, T-score 25.8 p<.001. Implications: By integrating nurse staffing within the NEDOCS model, resources required for patient care are better represented. Scoring can be used to drive responses to overcrowding within the ED. Patient outcomes improve through facilitation of patient throughput. The Modified NEDOCS scoring can be used to assess the adequacy of current nursing resources and develop shorter term planning for staffing. The model may aide in projecting longer term nurse staffing needs with further development. The Modified NEDOCS model may be suitable for use in other EDs.en_GB
dc.subjectOvercrowdingen_GB
dc.date.available2014-08-04T13:28:44Z-
dc.date.issued2014-08-04-
dc.date.accessioned2014-08-04T13:28:44Z-
dc.conference.date2014en_GB
dc.conference.name2014 ENA Leadership Conferenceen_GB
dc.conference.hostEmergency Nurses Associationen_GB
dc.conference.locationPhoenix, Arizona USAen_GB
dc.description2014 ENA Leadership Conference Theme: Safe Practice, Safe Care. Held at the Phoenix Convention Centeren_GB
dc.description.noteThis is an abstract-only submission. If the author has submitted a full-text item based on this abstract, you may find it by browsing the Virginia Henderson Global Nursing e-Repository by author. If author contact information is available in this abstract, please feel free to contact him or her with your queries regarding this submission. Alternatively, please contact the conference host, journal, or publisher (according to the circumstance) for further details regarding this item. If a citation is listed in this record, the item has been published and is available via open-access avenues or a journal/database subscription. Contact your library for assistance in obtaining the as-published article.en_GB
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