Document Type

Report

Publication Date

Spring 2021

Date of Final Presentation

3-11-2021

Committee Chair

Teresa Serratt, PhD, RN

Committee Member

Cara Gallegos, PhD, RN

Coordinator/ Chair of DNP Program

Pamela Gehrke, EdD, RN

Abstract/ Executive Summary

Pediatric patients (17 years and younger) in mental health crisis are arriving in the emergency department in increasing numbers because there is a lack of mental health crisis care in the community setting. The emergency department is crowded, lacks a dedicated area for psychiatric patients that is quiet and safe, and staff are inadequately trained in psychiatric competencies. A quality improvement project was approved by Boise State IRB to train RNs in psychiatric competencies. Telepsychiatry provided timely evaluation by a qualified psychiatric provider. Patients’ perceived meaning of the ED visit was evaluated using the Patient Evaluation of Emotional Comfort Experienced tool. Patients were evaluated by a psychiatric provider via telemedicine to determine the need for involuntary detainment. Pre- and Post-education survey of 8 registered nurse volunteers demonstrated an increase in self-efficacy in caring for pediatric psychiatric patients. Patients attributed positive meaning to their emergency department visit, reporting they felt “cared for”, “safe”, and “thankful” for the care received. Impact: Telepsychiatric evaluation meets the least-restrictive means of providing care for pediatric psychiatric patients in the emergency department. Registered nurses were more comfortable providing mental health care in the emergency department after psychiatric-specific education. Patients perceive brief interventions as meaningful when applied by trained RNs. Future plans should include training all ED RNs in pediatric psychiatric competencies and providing dedicated safe space for psychiatric patients.

Comments

With gratitude and thanks, I would like to recognize Dr. Teresa Serratt, my faculty mentor. Dustin and Sarah were inspirations in continuing my education, and I will always remember their contribution to this endeavor. My wife and best friend, Joanne, who gave up her time with me so I could complete this part of our journey. My son, Zach, who always inspires me with the wonderful man he has become.

And most of all, I dedicate this to my mom, Dorothy L. Greene, RN, Philadelphia General Hospital class of 1959.

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