Development and Implementation of a Pediatric Nursing Emergency Behavioral Health Assessment Tool.

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  • Additional Information
    • Source:
      Publisher: Mosby-Year Book Country of Publication: United States NLM ID: 7605913 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1527-2966 (Electronic) Linking ISSN: 00991767 NLM ISO Abbreviation: J Emerg Nurs Subsets: MEDLINE
    • Publication Information:
      Publication: St. Louis Mo : Mosby-Year Book
      Original Publication: East Lansing, Mich. : The Association, [1975-
    • Subject Terms:
      Emergency Nursing*/methods ; Emergency Service, Hospital* ; Pediatric Nursing*/methods ; Quality Improvement*; Humans ; Child ; Mental Disorders/nursing ; Mental Disorders/diagnosis ; Nursing Assessment/methods ; Patient Acuity ; Female ; Male
    • Abstract:
      Introduction: The national pediatric mental and behavioral health crisis dramatically increased emergency department mental and behavioral health visits and changed emergency nursing practice. Acuity assessment determines patient severity level and supports appropriate resources and interventions. There are no established nursing tools that assess pediatric mental or behavioral health acuity in the emergency department setting. Our goal was to develop and implement the novel pediatric emergency nurse Emergency Behavioral Health Acuity Assessment Tool.
      Methods: This quality-improvement project used the plan, do, study, act model to design/refine the Emergency Behavioral Health Acuity Assessment Tool and a non-experimental descriptive design to assess outcomes. The setting was a 47-bed urban level 1 pediatric trauma center with more than 60,000 annual visits. The team designed the tool using published evidence, emergency nurse feedback, and expert opinion. The tool objectively captured patient acuity and suggested acuity-specific nursing interventions. Project outcomes included acuity, length-of-stay, restraint use, and patient/staff injuries. Analyses included descriptive statistics and correlations.
      Results: With over 3000 annual mental/behavioral-related visits, the emergency department had an average daily census of 23 mental and behavioral health patients. Implementation occurred in August 2021. The Emergency Behavioral Health Acuity Assessment Tool dashboard provided the number of patients, patient location, and acuity. Length-of-stay did not change; however, patient restraint use and patient/staff injuries declined. Number of restraints positively correlated with moderate acuity levels (r = 0.472, P = 0.036).
      Discussion: For emergency nurses, the Emergency Behavioral Health Acuity Assessment Tool provided an objective measure of patient acuity. Targeted interventions can improve the care of this population.
      (Copyright © 2024 Emergency Nurses Association. Published by Elsevier Inc. All rights reserved.)
    • Contributed Indexing:
      Keywords: Behavioral medicine; Emergency department; Emergency nursing; Mental health; Patient acuity; Pediatrics
    • Publication Date:
      Date Created: 20240410 Date Completed: 20240505 Latest Revision: 20240505
    • Publication Date:
      20240506
    • Accession Number:
      10.1016/j.jen.2024.02.005
    • Accession Number:
      38597852