Date of Graduation

Spring 5-17-2018

Document Access

Project/Capstone - Global access

Degree Name

Master of Science in Nursing (MSN)


School of Nursing and Health Professions

First Advisor




The primary objective as outlined in this prospectus is to develop pediatric admission criteria to reduce length of stay (LOS) in the emergency department for patients being admitted to the pediatric acute care unit. The pediatric acute care unit is a 25-bed licensed bed at a tertiary hospital in San Francisco serving patients from 1 day to 21 years of age. Methods included both qualitative and quantitative data to determine relevance of quality improvement project related to LOS, patient safety, patient satisfaction, and nurse to physician communication. Data collected indicated that average LOS in the ED was significantly higher than organizational goal of 220 minutes.

Implementation of admission criteria was disseminated among charge RNs on the acute care unit. Evaluation of criteria will be based on surveys distributed biweekly for 6 months (starting April 21) to both RN and physicians in the emergency department and acute care unit to determine efficacy. Additional data to be collected will include average LOS for admitted pediatric patients and patients who left without being seen (LWBS). Additional opportunities identified by an intense analysis is the utilization of a pediatric early warning system (PEWS) and advanced respiratory support skills among RNs. The project supports the utilization of a Clinical Nurse Leader that is specifically trained and educated to develop, implement, and evaluate quality improvement initiatives that have a high impact potential for patient safety and cost savings.