Date of Graduation

Fall 12-16-2022

Document Access

Project/Capstone - Global access

Degree Name

Master of Science in Nursing (MSN)

College/School

School of Nursing and Health Professions

Program

MSN project

First Advisor

Francine Serafin-Dickson

Abstract

Problem: Staff knowledge of effective management of confusion in geriatric patients (>65yo) may be limited and inconsistent with the current goal of establishing a geriatric-friendly Emergency Department (ED) Model of Care. Suboptimal management of this patient population can result in prolonged ED stays, which increases the cost to the hospital and the patient (Han & Wilber, 2013).

Context: An Emergency Department at a large Bay Area urban hospital hopes to obtain Geriatric Emergency Department Accreditation (GEDA) through the American College of Emergency Physicians (ACEP).

Interventions: Create a simplified checklist for nursing staff using mnemonic devices to focus staff on appropriate management strategies for geriatric patients exhibiting confusion that are consistent with the core principles of the GEDA ED Model of Care and Accreditation Criteria. Conduct brief, educational in-services with individual staff that introduce them to the checklist in an “elevator speech” style. Provide a checklist as an ongoing resource for review and consultation in easily accessible areas of the department. Develop and conduct a pre- and post-knowledge quiz.

Measures: Staff self-reported knowledge assessment, pre- and post-educational in-service.

Results: Staff self-reported knowledge showed minor increases from pre- to post-knowledge quiz scores. A larger increase in scoring from pre- to post-quiz was associated with fewer years of bedside nursing experience.

Conclusions: Development and implementation of a mnemonic checklist as an educational tool for ED nursing staff showed some improvement in staff knowledge, as indicated by increased self-reported post-knowledge ratings in a small sample size of six. Further implementation beyond this small test of change is necessary to make broader generalizations surrounding the overall usefulness and practicality of such a tool in a wider clinical setting. If able to duplicate these findings in a larger cohort of staff, this checklist has the potential to affect patient care metrics positively. Reductions in length of stay (LOS) and the occurrence of adverse outcomes through enhanced nursing staff management of geriatric patients exhibiting alterations in cognitive function would be a reasonable expectation.

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