NSG 601 Root Causes and the Use of Evidence Discussion

NSG 601 Root Causes and the Use of Evidence Discussion

NSG 601 Root Causes and the Use of Evidence Discussion

 

Engagement Treatment Improvement by the use of Teams of Mental Health Outreach in Emergency Department

The main objective of this professional article was to explore the benefits associated with the establishment of outreach from local community regarding mental health providers to psychiatric patients in hospital emergency departments. 

According to NSG 601 Root Causes and the Use of Evidence Discussion, retrospective examination of data was used to compare the results attained when psychiatric patients received face to face services with psychiatric professionals in health services to when there are no outreach programs (Boudreaux et al., 2016).  The study established that an increase in outreach programs contributes to significant growth in selection attendance at our local health community centers.

Increasing partnership between community health services and community emergency departments can be crucial in reducing future emergency psychiatric visits and therefore significantly reduce patient boarding by these patients.

NSG 601 Root Causes and the Use of Evidence Discussion

Boarding by psychiatry patients reduces the quality of healthcare services provided to inpatients and stretches the resources of healthcare centers making it extremely costly for the hospitals. Even though psychiatric patients flock the emergency department, it is not the right place or department to help them receive the relevant mental and behavioral care required (Boudreaux et al., 2016). NSG 601 Root Causes and the Use of Evidence Discussion states that some of them may need to be admitted in hospitals, but most of them do not need to be hospitalized and a visit by experts from a mental community center can help identify the cases that need hospitalization and those that do not therefore reducing boarding.

The study was conducted in a city in Southern USA in a hospital that handled patients from both urban and rural areas and a Mental Health Emergency Room Extension was set up where psychiatric patients cleared from the hospital ED were handled. The results of the study indicated that provision of extension programs for psychiatric had immense benefits in reducing patient boarding through its effect on reducing repeated visits to the ED and instead honoring appointments by the psychiatry extension services (Boudreaux et al., 2016). according to NSG 601 Root Causes and the Use of Evidence Discussion, Patients were more likely to attend aftercare services and appointments after contact with professionals in the ED, therefore lowering the chances of them coming back to the ED in future. The study suggests that there is a significant increase in follow up for appointments for psychiatric patients who have experienced a psychiatric crisis before.

Highlighted in the study is how communication between healthcare providers and patients is currently not effective which contributes to a significant increase in boarding cases in hospital EDs.  Among the most outstanding limitations of this study is that the data was primarily observational, lack of random assignment and various other factors that may have interfered with the attainment of valid and reliable results (Boudreaux et al., 2016).  The study concluded that for improvements in continuity of psychiatric care it is imperative to ensure that patients get their first appointment with psychiatry professionals. The study also proves that outreach interventions are not only beneficial for reducing boarding but also reducing costs incurred by institutions when caring for psychiatry patients.

Reference

Boudreaux, J. G., Crapanzano, K. A., Jones, G. N., Jeider, T. A., Dodge, V. H., Hebert, M. J., &           Kasofsky, J. M. (2016). Using mental health outreach teams in the emergency department to improve engagement in treatment. Community mental health journal52(8), 1009-            1014.

Module 2 Discussion

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Root Causes and the Use of Evidence

Please review the Discussion Board Requirements in the rubric.  For the discussion boards each week, please answer the questions in light of your future role according to your program track.  For example if you are a public health student, consider answering the questions from the perspective of a public health agency employee or administrator.

 Reflect on your readings, the content in the IHI Open School courses so far, and the module content, then address the following:

  • Building on your thoughts from last week, further discuss a key quality or safety initiative you might embrace in your workplace and why.
  • Identify the quality gap, a potential benchmark and possible root causes.
  • Research and analyze one article related to your potential topic describing a quality improvement initiative. Make sure to articulate the level of evidence provided and your rationale for using the article.
  • Respond to two of your peer’s initial posts

Your initial post and your responses must be substantial and have reference citations in APA format from a variety of sources.

Initial post is due Thursday by 11:59 PM EST, and at least two peer response posts are due Sunday by 11:59 PM EST.

As observed from NSG 601 Root Causes and the Use of Evidence Discussion, the quality and safety initiative you bring up is something I encounter frequently working in the emergency department (ED). We are always boarding patients in the ED, there just is not enough beds in the hospital or not enough nurses to care for patients. The patients end up boarding in the ED. Alongside our medical boarders, we have psychiatric boarders. Patients coming in having a mental health crisis or suicidal ideations/attempts end up stuck in the emergency department with no where to go. There is a limited amount of psych hospitals and facilities in the area to take these patients out of the emergency department and in a more proper healing environment. And a lot of times these psych facilities do not accept the psych patients boarding in the ED.

We have an area in the emergency department called “the annex”. The annex is a secured locked unit under constant observation with only four beds. Two of the rooms have doors and the other two rooms do not, just a single curtain for privacy. The patients all use the same bathroom. There are no windows in the annex and it is a co-ed unit. Most of the time, we have more than four psychiatric patients in the ED. The other psych patients end up taking medical beds and require a staff member to sit and watch them one on one. By the time 7am hits, most of the emergency department beds are occupied by both medical and psychiatric boarders. This leaves us with one or two open beds for patients to be seen from the waiting room/medical emergencies coming in by ambulance.

according to NSG 601 Root Causes and the Use of Evidence Discussion, the emergency department is a chaotic environment not suitable for psychiatric patients to board in. These patients have a plethora of emotional harm that can be exacerbated by the loud unorganized environment of the ED. Most ED nurses are not psych nurses and this makes it even harder for patients to heal properly. I have witnessed psych patients boarding in the ED for over a month. That is one month of never seeing sunlight, never knowing the time of day, and never having an organized schedule.

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