Communicating agitation in real time with PANSS-EC scoring on the ED track board
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Poster presentation
Session F presented Tuesday, October 1, 11:30 am-12:30 pm
Purpose: To improve visual communication and interdisciplinary collaboration to manage patient agitation in a busy emergency setting. Responding to agitated patients early contributes to safer patient care.
Design: Communicating agitation assessments in real time is a frequent challenge for behavioral emergencies. PANSS-EC scoring (Montoya et al, 2011) was implemented as an evidence based validated tool for agitation assessment in November of 2016. Nursing staff routinely completed one assessment at every triage for behavioral patients and then would repeat the scoring in the EHR for episodes of agitation to support nurse physician communication regarding the medical management of escalated patients. General feedback from staff nurses was that the scores being documented were being ignored by the interdisciplinary team. In a busy ED the electronic EHR trackboard did not have an indicator of agitation assessments which were dynamically changing throughout a shift. In January of 2018 the PANSS-EC scores that nurses were documenting were moved prominently to show the most recent score to the trackboard and would highlight yellow if significant.
Setting: Large level 1 academic teaching hospital. The Adult and Children's Psychiatric Emergency Services unit is adjacent to the adult medical emergency services unit main entrance. The unit has an unlocked waiting area that is also used for treatment of low acuity patients and a locked secure core area with 3 rooms for agitated or violent patients.
Participants/Subjects: All PES staff participated in this project including nurses, social workers, physicians, medical assistants, and clerical staff.
Methods: An electronic survey and several staff were interviewed.
Results/Outcomes: The majority of staff indicated that the track board information assisted with flagging agitated patients to the attention of the team for further intervention.
Implications: Flagging significant PANSS-EC scores does not provide a clear indicator of what interventions should be implemented or the time frame for response. Failing to update the score on the trackboard can lead to fatigue with significant scores.
Type | Poster |
Format | Text-based Document |
Evidence Level | N/A |
Research Approach | N/A |
Keywords | Agitation; Behavioral; Communication |
Name | Emergency Nursing 2019 |
Host | Emergency Nurses Association |
Location | Austin, Texas, USA |
Date | 2019 |
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