All aboard: Improving the admission and boarding procedures in the acute care setting

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dc.contributor.advisorBoller, Janen_US
dc.contributor.authorLehn-Anderson, Cindyen_US
dc.contributor.authorFischer, Jamieen_US
dc.contributor.authorKing, Amberen_US
dc.contributor.authorRowell, Jessen_US
dc.contributor.authorVan, Hangen_US
dc.date.accessioned2019-05-12T17:30:03Z
dc.date.available2020-05-18T08:40:23Z
dc.date.issued2019-05-18
dc.degree.disciplineMaster of Science in Nursing (MSN) Degree Programen_US
dc.degree.levelMSNen_US
dc.degree.nameMaster of Science in Nursingen_US
dc.description.abstractIncreased admission rates and lack of bed capacity affects patient flow through the hospital, which results in care delays. Delayed admissions lead to increased length of stay, rise in hospital costs, and emergency department (ED) boarding, which puts patients at a higher risk for adverse medical events and mortality. In response to an acute delay identified by Centers for Medicare & Medicaid Services (CMS), a group of Clinical Nurse Leader (CNL) students were utilized in the admission nurse role to aid in improving timeliness of care. The purpose of this evidence-based quality improvement project was to enhance patient outcomes by reducing delays in care. Data were collected over a thirteen-month period, including pre and post implementation, for the admission nurse role from January 2018 through January 2019. A total of 240 charts were reviewed to investigate time difference of order entry, ED boarding, and admission assessment times. Additionally, hospital data for quality and safety measures were also reviewed during the evaluated period. Furthermore, 82 staff members were surveyed concerning the admission nurse role via SurveyMonkey®. The results revealed significant improvements in timeliness of order entry and admission assessment. Patient safety and quality metrics improved, and nurses experienced more efficient workflows leading to increased nurse satisfaction. Recommendations from this study include continued systems improvement and innovations, such as implementation of the admission nurse role, formation of interdisciplinary teams to address ED boarders, and utilization of the Clinical Nurse Leader in the ED.|Keywords: Emergency Department throughput; admission nurse role; admission, discharge, transfer nurse; missed care; delayed admission; ED boarding, Clinical Nurse Leader; quality care; and patient outcomes.en_US
dc.description.noteManuscripten_US
dc.embargo.terms2020-05-18
dc.identifier.urihttp://hdl.handle.net/10504/122625
dc.program.unitSchool of Nursing (1971 - July 2013)en_US
dc.program.unitCollege of Nursingen_US
dc.rightsCopyright is retained by the Author. A non-exclusive distribution right is granted to Creighton Universityen_US
dc.rights.holderJan Bolleren_US
dc.rights.holderCindy Lehn-Andersonen_US
dc.rights.holderJamie Fischeren_US
dc.rights.holderAmber Kingen_US
dc.rights.holderJess Rowellen_US
dc.rights.holderHang Vanen_US
dc.subject.meshNursing Careen_US
dc.subject.meshPatient Admissionen_US
dc.subject.meshEmergency Service, Hospitalen_US
dc.subject.meshDelivery of Health Careen_US
dc.titleAll aboard: Improving the admission and boarding procedures in the acute care settingen_US
dc.typeManuscripten_US
dc.typePosteren_US
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