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Objective: Pediatric patients with asthma are frequently cared for in the emergency department (ED). Many studies show early administration of corticosteroids (CS) can improve outcomes for children experiencing an asthma exacerbation. Despite the evidence, delays in care remain. The purpose of this study is to streamline the process for nurse-initiated,

Objective: Pediatric patients with asthma are frequently cared for in the emergency department (ED). Many studies show early administration of corticosteroids (CS) can improve outcomes for children experiencing an asthma exacerbation. Despite the evidence, delays in care remain. The purpose of this study is to streamline the process for nurse-initiated, triage-based CS administration and determine the effect on overall length of stay (LOS). Methods: For this quality improvement initiative, ED nurses at a large, freestanding, children’s emergency department in the southwestern United States were given education on inclusion and exclusion criteria for nurse-initiated CS in ED triage. Time to CS administration, LOS, and whether the ED nurse or provider ordered the CS were evaluated through chart reviews of patients presenting with a chief complaint of difficulty breathing. These metrics were compared to charts from the previous year during the same timeframe to evaluate for improved timeliness of CS delivery. Results: Time to CS administration decreased from a mean of 98.6 minutes to 57.6 minutes. LOS decreased from an average of 259.3 minutes to 169.6 minutes. The effect of timely CS on LOS was significant for December p =.003, January p =.002, and February p = <.001. Conclusion: A streamlined process for CS delivery to pediatric patients experiencing an asthma exacerbation can enable providers to achieve efficient and effective care in the ED and decrease a patient’s overall LOS.
Created2021-04-23
Description
In the emergency department of a hospital, providers are responsible for diagnosing and treating multiple critical patients at a time. Their ability to make quick and careful decisions often will determine whether their patient lives or dies. Because of this, emergency department (ED) providers experience significant amounts of stress during

In the emergency department of a hospital, providers are responsible for diagnosing and treating multiple critical patients at a time. Their ability to make quick and careful decisions often will determine whether their patient lives or dies. Because of this, emergency department (ED) providers experience significant amounts of stress during each shift which consequently may lead to burnout (Lall et al., 2019). It is crucial to investigate strategies to help control burnout among ED providers, as their own well-being directly affects the physical health of their patients. Furthermore, female providers are subject to increased stress from unique challenges within the workplace due to their gender. The purpose of this study was to determine which strategies are the most effective in the mitigation of burnout among female emergency department providers. A survey was administered to emergency department providers (M.D., D.O., P.A., and N.P.) from three hospitals in Arizona. It was found that spending time with family, maintaining good nutrition, and exercising were the most effective strategies in the mitigation of female provider burnout. These results should be considered by providers who work in the ED, female providers working in other medical specialties, other ED staff, hospital administration, and ED patients. With the implementation of these three strategies into their daily life, female ED providers may find a decrease in burnout and, consequently, an improvement in patient care.
ContributorsZurbriggen, Hannah (Author) / Kappes, Janelle (Thesis director) / Lewis, Stephen (Committee member) / Barrett, The Honors College (Contributor) / School of Life Sciences (Contributor) / Department of Psychology (Contributor) / Sanford School of Social and Family Dynamics (Contributor)
Created2024-05