Using SBAR to Decrease Transfers from the Long-term Care to the Emergency Room

Using SBAR to Decrease Transfers from the Long-term Care to the Emergency Room By Phyllis M. Bowers Garrett Project Submitted in Fulfillment of the Requirements for the Degree of Doctor of Nursing Practice Walden University May, 2016 Abstract Care of the elderly, long-term care resident in the emergency department is an issue of importance because of the overall impact on healthcare costs, potential for negative outcomes for the resident, and the loss of revenue. The purpose of this project was to decrease avoidable transfer of residents to the Emergency Department. Using the Antecedent, Target, Measurement logic model, poor quality assessment data was deemed the antecedent of the avoidable transfer. The goal of the project was the implementationCare of the elderly, long-term care resident in the emergency department is an issue of importance because of the overall impact on healthcare costs, potential for negative outcomes for the resident, and the loss of revenue. The purpose of this project was to decrease avoidable transfer of residents to the Emergency Department. Using the Antecedent, Target, Measurement logic model, poor quality assessment data was deemed the antecedent of the avoidable transfer. The goal of the project was the implementation of a standardized process of assessment that would have decreased avoidable transfer of the resident. The project would have involved training of the nursing staff in the use of the Situation Background Assessment and Recommendation tool for collecting and communicating pertinent data. The tool would have been completed at each acute complaint and would have indicated disposition. Data would have been collected by the Education Coordinator and organized for review and comparison with preintervention data. Social change implications would have included enhanced communication, potential for increased nurse and physician satisfaction which could have potentially increased job satisfaction, and improved recruitment and retention. Autonomy and selfpertinence empowers the nurse to be a stronger advocate. Positive outcomes increase when care is provided by those familiar with the patient norms and the setting. Financial savings can have an impact on the cost of healthcare. This project would also have allowed for and encouraged internal review of process and practices. This project was not implemented and so remains inconclusive. Using SBAR to Decrease Transfers from the Long-term Care to the Emergency Room by Phyllis M. Bowers Garrett Project Submitted in Fulfillment of the Requirements for the Degree of Doctor of Nursing Practice Walden University May 2016 Dedication This work is dedicated to all the teachers, mentors, and educators who have always encouraged me to be the very best that I can be. This work is also dedicated to the memory of my parents, who while possessing only a third grade education recognized the benefit of higher education and to my beautiful sister Linda Bowers who engaged me in learning the basics of education. Acknowledgments I would like to acknowledge first and foremost my Lord and Savior Jesus the Christ, who loves me before, beyond, and past myself. I thank my parents who gave me life and taught me the basics of life; love and respect for the differences that exist in us all. I would like to acknowledge all of the key educators in my student life from early childhood until now; with a special acknowledgement of Aaron A. Granberry, Peggy Ranew Durden, and Gene Walton; all who recognized potential in me before I saw any in myself. Lastly but certainly never least I acknowledge my beautiful mother who taught me more about nursing during her illness and death than I learned during my previous 30 years of nursing.