Safe/unsafe ER Transfer times to Inpatient Units

[Sashat3]

Hi everyone!

Taking a Nursing Research course, and we developed a research question using PICO(T) for an assignment in which we are asked to review studies (journals) based on our research questions that we developed.

Here is mine, because it interested me a lot and when I was creating it I assumed there would be lots of research on this seeing as how safe handover affects the overall quality of the care being delivered. I am a practising RPN, and have been for 5 years now, and working on my degree. I work on an Inpatient acute general medicine floor, and so we a lot of times have ER calling to give report during the time when day shift nurses are giving report to night shift nurses, and often, patients are brought up onto the floor and are waiting in the hallway until nurses are done giving report.

Anyway, below is my research question, feel free to guide me in any direction, at this point after searching various terms on journal websites I am coming up with nothing:

Are newly admitted patients that are being transferred to an inpatient medicine unit from the emergency department at risk of worsening admitted symptoms during shift change between nurses, as opposed to patients admitted during regular working hours?

Thanks for reading!

Robert

[dudette10, MSN, RN]

You may need to speak to a librarian to help you with your selection of databases and search terms. I just plugged the very long search phrase "emergency room transfer to inpatient safety shift change," and I received a bunch of hits that seem to be on this very topic. One of those hits was this thread, too!

[sandyfeet]

This is always a hot topic. It would be interesting to include in your research the acuity of patients waiting in the ER lobby for an open room...also at risk of worsening symptoms. When we have over a 2 hour wait in the ER lobby, the entire hospital hears an announcement about it.

[Guest03/15/15, BSN, RN]

At our hospital - the floor nurses come to the ER and retrieve their patients and bedside report. The exception of the "no fly zone" respectively at 0700-0730 and 1900-1930.

[HouTx, BSN, MSN, EdD]

As a researcher, you need to be wary of interjecting bias into your investigation. So, your hypothesis should not contain words like "worse"... a better statement would be "is there a difference in ________ (dependent variables of interest) among patients transferred to inpatient units during change of shift?" You don't want to give the impression that your mind is already made up and you're just searching for evidence to support your position - LOL.

You will also have to structure your data collection in a way that allows you to control for events that may confound your premise. For instance, you may want to ensure that you also have data on the inpatient unit census &/or staff ratio as well as the acuity of the patient that is being transferred. You don't want your findings to be skewed by times when those "train wreck" complex patients transferred during 'safe times' or shifts where the inpatient unit is desperately short of staff.

Have fun with your research! Do a terrific job, and you could use it (and the lit search) as the basis for advanced projects as you progress in your educational journey. I know quite a few nurses whose doctoral dissertations originated from their undergrad work.

[terri2622]

hello, I am currently doing research about "no fly zones" for facility. is it possible for you to send me a copy of your facilities policy on this topic? thanks in advance.