Date of Award

Fall 2014

Document Type

Dissertation

Degree Name

Doctor of Nursing Practice (DNP)

First Advisor

Culpa-Bondal, Flor

Second Advisor

Moore, Leslie

Third Advisor

Shapiro, Susan

Abstract

Psychiatric patients have been “deinstitutionalized” over recent decades with their care shifting from the inpatient to outpatient setting. As a result of the closing of more than 13,500 in-patient psychiatric beds between 2005 and 2010, emergency departments (ED) across the nation have become both safe havens and holding areas for psychiatric patients seeking care in the ED. The boarding of psychiatric patients in the ED impacts the timeliness of care provide to psychiatric and non-psychiatric patients alike lengthening door to discharge time for all patients. The purpose of this study is to assess the nursing staff’s compliance with departmental standards for the assessment and re-assessment of psychiatric patients boarded in the ED and to assess the impact of compliance with the standards on patient outcomes. Using a retrospective randomized chart audit, this study examined nursing compliance with the established department standard for the assessment and re-assessment of Level 2 psychiatric and non-psychiatric patients presenting to the ED between May 1, 2013 and April 30, 2014. Descriptive statistics was used to analyze the data. The study revealed that there was no impact on the length of stay of the patient when compliance with standards for assessment and reassessment was met. The study revealed an unexpected finding in that patient who were not reassessed based on the standard had shorter lengths of stay.

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