10.00
Hdl Handle:
http://hdl.handle.net/10755/344169
Category:
Abstract
Type:
Poster
Title:
Nurse-Mediated Early Backboard Removal for Low-Risk Trauma Patients
Author(s):
Dooley, Kerriann; Smith, Julia
Lead Author STTI Affiliation:
Non-member
Author Details:
Kerriann Dooley, BSN, RN, kd7er@virginia.edu; Julia Smith, BSN, RN
Abstract:
Evidence-based Practice Abstract Purpose: To improve patient outcomes and determine the effectiveness of early backboard removal by the Registered Nurse (RN) among adult conscious patients who arrive in the Emergency Department (ED) with full spinal immobilization without compromising spinal integrity. To relate the importance of early trauma assessment by the RN to patient safety and other nurse sensitive quality indicators including maintaining skin integrity, increased patient comfort, decreased iatrogenic pain, and improved patient satisfaction by being attended to promptly. Design: Quality improvement project to illustrate the need for a policy on backboard removal in the ED. After analyzing current practice and the evidence for RN backboard removal, a policy and procedure was created as an initiative for ED quality and education. Setting: Policy examined and created for the emergency department of a level one trauma, academic medical center. Participants/Subjects: Policy applies to conscious, non-intoxicated, low acuity patients who arrive in full spinal immobilization, ages 18-65, without distracting painful injury or high-risk mechanism of injury. Methods: A review of the literature included eight peer-reviewed studies including level I, III, IV, V, VI and VII evidence. After analyzing current practice, policy, and literature, three RNs created a policy proposal and presented to Nurse Manager, Nurse Educator, Nursing Director of ED, Medical Director of ED, and both day shift and night shift ED staff meeting to lead an interdisciplinary team effort for practice change. Results/Outcomes: Literature concluded low acuity trauma patients who arrive to a level one trauma center ED in full spinal immobilization often have to wait an average of 29 to 67 minutes before a physician assessment and physician removal of backboard. Complications of long wait times on backboards include skin breakdown, respiratory compromise, decreased patient satisfaction, iatrogenic pain and aspiration. Hospital leadership, including ED nursing and medical directors, approved the new hospital policy for nurse driven removal of backboards which outlined an evidence-based procedure for proper removal of backboard by RN. This encourages RN to complete early trauma assessment of patients who experience long wait times for physician assessment. The Emergency Nurses Association’s Trauma Nursing Core Curriculum (TNCC) supports early nursing trauma assessment. Barriers identified for successful use of new policy include educating and supporting RNs to change practice. Implications: An interdisciplinary and multi-media approach to educate and support ED staff on new policy is currently underway. A computer based learning presentation, including a video of the process of backboard removal and exam for all ED RNs is the method to effectively educate and encourage confidence among staff RNs on new protocol and nursing assessment skills. After all staff are educated on new policy and procedure, the ED anticipates improved patient satisfaction, decreased iatrogenic pain and skin breakdown due to decreased time patients spend on backboards.
Keywords:
Backboard Removal; Backboards and Low-risk Patients
Repository Posting Date:
4-Feb-2015
Date of Publication:
4-Feb-2015
Conference Date:
2014
Conference Name:
2014 ENA Annual Conference
Conference Host:
Emergency Nurses Association
Conference Location:
Indianapolis, Indiana, U.S.A.
Description:
2014 ENA Annual Conference Theme: Safe Practice, Safe Care. Held at the Indiana 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.typePosteren_GB
dc.titleNurse-Mediated Early Backboard Removal for Low-Risk Trauma Patientsen_GB
dc.contributor.authorDooley, Kerriannen_GB
dc.contributor.authorSmith, Juliaen_GB
dc.contributor.departmentNon-memberen_GB
dc.author.detailsKerriann Dooley, BSN, RN, kd7er@virginia.edu; Julia Smith, BSN, RNen_GB
dc.identifier.urihttp://hdl.handle.net/10755/344169-
dc.description.abstractEvidence-based Practice Abstract Purpose: To improve patient outcomes and determine the effectiveness of early backboard removal by the Registered Nurse (RN) among adult conscious patients who arrive in the Emergency Department (ED) with full spinal immobilization without compromising spinal integrity. To relate the importance of early trauma assessment by the RN to patient safety and other nurse sensitive quality indicators including maintaining skin integrity, increased patient comfort, decreased iatrogenic pain, and improved patient satisfaction by being attended to promptly. Design: Quality improvement project to illustrate the need for a policy on backboard removal in the ED. After analyzing current practice and the evidence for RN backboard removal, a policy and procedure was created as an initiative for ED quality and education. Setting: Policy examined and created for the emergency department of a level one trauma, academic medical center. Participants/Subjects: Policy applies to conscious, non-intoxicated, low acuity patients who arrive in full spinal immobilization, ages 18-65, without distracting painful injury or high-risk mechanism of injury. Methods: A review of the literature included eight peer-reviewed studies including level I, III, IV, V, VI and VII evidence. After analyzing current practice, policy, and literature, three RNs created a policy proposal and presented to Nurse Manager, Nurse Educator, Nursing Director of ED, Medical Director of ED, and both day shift and night shift ED staff meeting to lead an interdisciplinary team effort for practice change. Results/Outcomes: Literature concluded low acuity trauma patients who arrive to a level one trauma center ED in full spinal immobilization often have to wait an average of 29 to 67 minutes before a physician assessment and physician removal of backboard. Complications of long wait times on backboards include skin breakdown, respiratory compromise, decreased patient satisfaction, iatrogenic pain and aspiration. Hospital leadership, including ED nursing and medical directors, approved the new hospital policy for nurse driven removal of backboards which outlined an evidence-based procedure for proper removal of backboard by RN. This encourages RN to complete early trauma assessment of patients who experience long wait times for physician assessment. The Emergency Nurses Association’s Trauma Nursing Core Curriculum (TNCC) supports early nursing trauma assessment. Barriers identified for successful use of new policy include educating and supporting RNs to change practice. Implications: An interdisciplinary and multi-media approach to educate and support ED staff on new policy is currently underway. A computer based learning presentation, including a video of the process of backboard removal and exam for all ED RNs is the method to effectively educate and encourage confidence among staff RNs on new protocol and nursing assessment skills. After all staff are educated on new policy and procedure, the ED anticipates improved patient satisfaction, decreased iatrogenic pain and skin breakdown due to decreased time patients spend on backboards.en_GB
dc.subjectBackboard Removalen_GB
dc.subjectBackboards and Low-risk Patientsen_GB
dc.date.available2015-02-04T11:27:43Z-
dc.date.issued2015-02-04-
dc.date.accessioned2015-02-04T11:27:43Z-
dc.conference.date2014en_GB
dc.conference.name2014 ENA Annual Conferenceen_GB
dc.conference.hostEmergency Nurses Associationen_GB
dc.conference.locationIndianapolis, Indiana, U.S.A.en_GB
dc.description2014 ENA Annual Conference Theme: Safe Practice, Safe Care. Held at the Indiana 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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