nursing research topics in emergency department

Emergency Nursing Research Paper Topics

Emergency nursing research paper topics are incredibly diverse and important to the evolution of healthcare. This field involves dealing with patients in emergency situations to provide them with the best possible care. Research in this area can lead to not only improved patient care but also to significant advancements in emergency medical procedures. This article will outline a range of topics, from triage and trauma care to mental health emergencies and disaster response, providing a comprehensive list for students and researchers interested in this crucial aspect of healthcare.

100 Emergency Nursing Research Paper Topics

Emergency nursing is a critical and dynamic specialty within the nursing profession, making the study of emergency nursing research paper topics highly relevant and essential for the ongoing improvement of patient care and outcomes. This field encompasses a wide range of urgent care situations, from initial assessment and stabilization to dealing with acute illnesses and traumatic injuries. It is a role that demands not only technical skills but also the ability to make quick decisions, manage multiple patients at once, and communicate effectively with other members of the healthcare team.

Academic Writing, Editing, Proofreading, And Problem Solving Services

Get 10% off with 24start discount code.

• The effectiveness of triage systems in emergency departments
• Triage protocols for mass casualty incidents
• Triage nurse decision-making: A qualitative study
• The role of tele-triage in emergency care
• Pediatric triage: A systematic review
• Triage accuracy and patient outcomes
• The impact of overcrowding on triage effectiveness
• Training and education for triage nurses
• Triage for mental health emergencies
• The use of mobile apps in triage decision-making
• Management of pediatric asthma in the emergency department
• The role of emergency nurses in child abuse cases
• Pediatric sepsis: Early recognition and management
• The effectiveness of pain management for pediatric patients
• Emergency care for pediatric trauma patients
• The use of simulation training in pediatric emergency care
• Pediatric mental health emergencies: Best practices
• The impact of parental involvement in pediatric emergency care
• Emergency nursing interventions for children with special needs
• The challenges of pediatric medication administration in the emergency department
• The role of emergency nurses in trauma care
• Best practices for initial assessment and stabilization of trauma patients
• The impact of trauma team dynamics on patient outcomes
• The role of simulation training in trauma care education
• The effectiveness of fast track systems in trauma care
• The challenges of managing multiple trauma patients
• The impact of pre-hospital care on trauma outcomes
• The role of emergency nurses in mass casualty incidents
• The use of point-of-care ultrasound in trauma care
• The effectiveness of trauma protocols and guidelines
• The impact of electronic health records on emergency nursing practice
• The role of telemedicine in emergency care
• The use of mobile apps for emergency response
• The effectiveness of wearable technology in monitoring patients in the emergency department
• The use of simulation training in emergency nursing education
• The impact of artificial intelligence on emergency nursing practice
• The use of social media in emergency response and recovery
• The role of drones in emergency medical services
• The use of virtual reality in emergency nursing training
• The effectiveness of computerized physician order entry in reducing medication errors in the emergency department
• Managing suicidal patients in the emergency department
• The role of emergency nurses in managing acute psychosis
• Best practices for managing agitation and aggression in the emergency department
• The impact of substance abuse on mental health emergencies
• The effectiveness of brief interventions for alcohol and drug use in the emergency department
• The role of emergency departments in the management of opioid overdose
• The challenges of managing patients with dementia in the emergency department
• The effectiveness of mental health screening in the emergency department
• The role of emergency nurses in the management of patients with eating disorders
• The impact of mental health training on emergency nursing practice
• The role of emergency nurses in disaster response
• The effectiveness of disaster preparedness training for emergency nurses
• The impact of disaster simulation exercises on emergency nursing practice
• The challenges of managing mass casualty incidents in the emergency department
• The role of emergency departments in the management of infectious disease outbreaks
• The effectiveness of triage systems in mass casualty incidents
• The impact of communication systems on disaster response
• The role of inter-professional collaboration in disaster response
• The use of mobile apps in disaster response and recovery
• The challenges of providing mental health support in disaster situations
• The impact of overcrowding on emergency department operations
• The effectiveness of fast track systems in the emergency department
• The challenges of managing patient flow in the emergency department
• The impact of nurse staffing levels on emergency department operations
• The role of leadership in managing emergency department operations
• The use of lean principles in improving emergency department operations
• The impact of electronic health records on emergency department operations
• The role of inter-professional collaboration in emergency department operations
• The challenges of managing violence and aggression in the emergency department
• The effectiveness of emergency department protocols and guidelines
• The effectiveness of pain assessment tools in the emergency department
• The role of emergency nurses in acute pain management
• The challenges of managing acute pain in opioid-tolerant patients
• The effectiveness of non-pharmacological interventions for acute pain management
• The impact of patient education on acute pain management
• The role of opioids in acute pain management in the emergency department
• The impact of acute pain management on patient satisfaction
• The use of regional anesthesia in acute pain management in the emergency department
• The effectiveness of acute pain management protocols and guidelines
• The challenges of managing acute pain in special populations (e.g. pediatrics, elderly)
• The most common medication errors in the emergency department and how to prevent them
• The role of computerized physician order entry systems in reducing medication errors
• The impact of medication reconciliation on reducing medication errors
• The role of emergency nurses in preventing medication errors
• The challenges of medication administration in the emergency department
• The impact of medication errors on patient outcomes
• The role of pharmacists in reducing medication errors in the emergency department
• The effectiveness of medication error reporting systems
• The role of drug-drug interaction checking systems in preventing medication errors
• The impact of medication storage and labeling on medication errors
• The challenges of ethical decision-making in the emergency department
• The role of informed consent in emergency nursing practice
• The ethical considerations in triage decision-making
• The challenges of providing care to patients who refuse treatment
• The ethical considerations in providing care to vulnerable populations
• The role of advance directives in emergency nursing practice
• The ethical considerations in managing patients with substance abuse disorders
• The challenges of providing culturally competent care in the emergency department
• The role of ethics committees in addressing ethical dilemmas in the emergency department
• The ethical considerations in end-of-life care in the emergency department

In conclusion, the vast range of emergency nursing research paper topics reflects the complexity and diversity of this specialty. It is a field that is constantly evolving and adapting to new challenges, from the increased use of technology to the growing recognition of mental health emergencies. Research in this area is not only essential for the ongoing development and refinement of best practices but also for the preparation and training of future generations of emergency nurses. It is our hope that this list of topics will inspire and guide researchers and students in their efforts to contribute to this vital field of study.

The Range of Emergency Nursing Research Paper Topics

Emergency nursing is a critical and specialized field within the healthcare system that involves caring for patients in emergency situations. These patients may be experiencing acute illnesses, injuries, or other medical emergencies that require immediate attention. Emergency nurses are often the first healthcare professionals that a patient interacts with in the emergency department (ED), making their role vital in the initial assessment, stabilization, and treatment of patients. The field of emergency nursing covers a wide array of topics, including but not limited to triage, trauma care, disaster response, pediatric emergency care, mental health emergencies, and many others. This article will explore the significance of emergency nursing and the diverse range of research paper topics it offers.

Significance of Emergency Nursing

Emergency nurses play a crucial role in the healthcare system. They work in fast-paced and often chaotic environments where patients present with a variety of symptoms and conditions, ranging from minor injuries to life-threatening emergencies. The work of emergency nurses involves quickly assessing a patient’s condition, providing immediate care, and stabilizing the patient until they can be transferred to the appropriate department for further treatment. Emergency nurses also play a critical role in coordinating care with other healthcare professionals, such as physicians, paramedics, and other specialized nurses.

The role of emergency nurses is particularly important because the care they provide can often be the difference between life and death for a patient. Timely and appropriate care can significantly improve a patient’s outcome, while delays or mistakes can have severe consequences. Therefore, emergency nurses need to have a high level of skill, knowledge, and the ability to make quick decisions in high-pressure situations.

The scope of emergency nursing goes beyond just providing immediate care to patients in the ED. Emergency nurses are also involved in public health initiatives, disaster response, and education of the public and other healthcare professionals. For example, emergency nurses may be involved in community education programs to teach the public about preventing injuries, recognizing signs of a medical emergency, and when to seek medical help. In the event of a natural disaster or mass casualty event, emergency nurses play a critical role in the response and management of the situation.

Various Aspects of Emergency Nursing

• Triage: Triage is one of the most important aspects of emergency nursing. It involves the initial assessment of a patient’s condition to determine the severity of their illness or injury and prioritize their treatment accordingly. The triage process involves assigning a category or level of urgency to each patient based on their signs and symptoms, vital signs, and other relevant information. This process helps ensure that the most critically ill or injured patients receive care first, while those with less severe conditions may have to wait. Triage is a dynamic process, and a patient’s condition may change, requiring reevaluation and reprioritization.
• Trauma Care: Trauma care is another critical aspect of emergency nursing. Trauma patients are those who have sustained physical injuries, often as a result of accidents, falls, violence, or other traumatic events. Emergency nurses involved in trauma care are responsible for the initial assessment, stabilization, and ongoing care of trauma patients. They must be skilled in recognizing and managing a wide variety of injuries, from minor wounds to life-threatening injuries such as head trauma, internal bleeding, or multiple fractures.
• Disaster Response: Disaster response is another important area within emergency nursing. Disasters, whether natural or man-made, can result in a large number of casualties and overwhelm the healthcare system. Emergency nurses play a crucial role in the response to such events. They may be involved in the initial response, providing care to those injured at the scene, or in the ongoing care of patients in the emergency department or other healthcare facilities. Emergency nurses involved in disaster response must be skilled in mass casualty triage, coordinating care with other emergency services, and providing care in often challenging and resource-limited environments.

The field of emergency nursing is broad and diverse, offering a wide range of research paper topics. Some potential topics for research in emergency nursing include:

• The effectiveness of different triage systems in the emergency department.
• The impact of overcrowding in the emergency department on patient outcomes.
• Strategies to improve communication and coordination of care in the emergency department.
• The role of emergency nurses in disaster response and preparedness.
• The effectiveness of different pain management strategies in the emergency department.
• The impact of violence in the emergency department on healthcare professionals.
• Strategies to improve the mental health and well-being of emergency nurses.
• The effectiveness of simulation training in improving the skills and knowledge of emergency nurses.
• The role of emergency nurses in the management of patients with mental health emergencies.
• The impact of new technologies, such as telemedicine or mobile apps, on emergency nursing practice.

These are just a few of the many potential topics for research in emergency nursing. The field is continuously evolving, with new challenges and opportunities arising all the time. Research in emergency nursing is critical to improving patient care, enhancing the skills and knowledge of emergency nurses, and addressing the challenges faced by emergency nurses and the healthcare system as a whole.

Emergency nursing is a critical and specialized field within the healthcare system that plays a vital role in the care of patients in emergency situations. The work of emergency nurses involves quickly assessing a patient’s condition, providing immediate care, and stabilizing the patient until they can be transferred to the appropriate department for further treatment. The field of emergency nursing covers a wide array of topics, including but not limited to triage, trauma care, disaster response, and many others. Research in emergency nursing is essential to improve patient care, enhance the skills and knowledge of emergency nurses, and address the challenges faced by emergency nurses and the healthcare system as a whole. Therefore, exploring emergency nursing research paper topics is crucial for the continuous development and improvement of this vital field.

iResearchNet’s Custom Writing Services

In the academic world, writing research papers is a common and crucial task for students, especially for those pursuing a career in nursing. Understanding and conducting research on various aspects of emergency nursing is pivotal for the betterment of healthcare services. However, research paper writing can be a daunting task for many students, as it involves in-depth research, critical thinking, and excellent writing skills. This is where iResearchNet steps in. We are a professional writing service dedicated to helping students succeed in their academic pursuits by providing top-notch custom written works on a wide range of topics, including emergency nursing research paper topics.

• Expert Degree-Holding Writers : Our team consists of professional writers who hold advanced degrees in nursing and other related fields. They have a deep understanding of the subject matter and are well-versed in the latest research and trends in emergency nursing.
• Custom Written Works : We provide custom written research papers tailored to your specific requirements. Our writers will conduct in-depth research on your chosen topic and create a well-organized and thoroughly researched paper.
• In-Depth Research : Our writers are skilled in conducting comprehensive research from reliable sources, ensuring that your paper is well-grounded in the latest and most relevant literature in the field of emergency nursing.
• Custom Formatting : We provide custom formatting according to your preferred style, whether it is APA, MLA, Chicago/Turabian, or Harvard. Our writers are well-versed in all major citation styles and will ensure that your paper is correctly formatted.
• Top Quality : We are committed to delivering top-quality work. All our papers go through a rigorous quality check process to ensure that they meet the highest academic standards.
• Customized Solutions : We understand that every student has unique needs and requirements. Therefore, we offer customized solutions to meet your specific needs, whether you need help with selecting a topic, conducting research, or writing the entire paper.
• Flexible Pricing : We offer flexible pricing options to suit your budget. Our pricing is transparent and straightforward, with no hidden charges.
• Short Deadlines : We understand that sometimes you may have tight deadlines. Our writers are capable of delivering high-quality work within short deadlines, even as short as 3 hours.
• Timely Delivery : We are committed to delivering your paper on time, every time. You can rest assured that your paper will be completed within the specified deadline.
• 24/7 Support : Our customer support team is available 24/7 to assist you with any questions or concerns you may have. You can reach us via email, phone, or live chat.
• Absolute Privacy : We respect your privacy and confidentiality. All your personal information and order details are kept secure and will never be shared with third parties.
• Easy Order Tracking : Our user-friendly online platform allows you to easily track the progress of your order and communicate with your writer directly.
• Money-Back Guarantee : We are confident in the quality of our work. However, if you are not satisfied with the final paper, we offer a money-back guarantee.

At iResearchNet, we are committed to helping you succeed in your academic pursuits. With our expert team of degree-holding writers, custom written works, in-depth research, and a wide range of other features, we provide a reliable and professional writing service that you can trust. Whether you need help with selecting emergency nursing research paper topics, conducting research, or writing the entire paper, we are here to assist you. Order a custom emergency nursing research paper today and experience the benefits of our top-quality writing services.

Unlock Your Potential with Our Custom Research Papers!

Are you struggling to choose the right emergency nursing research paper topic? Feeling overwhelmed with the amount of research required? Worried about meeting your deadline? iResearchNet is here to help! Our expert team of degree-holding writers is ready to assist you at every step of your research paper writing journey. From selecting a compelling topic to conducting in-depth research, and crafting a well-structured paper, we’ve got you covered.

Don’t miss out on the opportunity to excel in your academic career. Order a custom emergency nursing research paper from iResearchNet today and unlock your potential for success. Your path to academic excellence starts here!

ORDER HIGH QUALITY CUSTOM PAPER

Emergency Department Nursing Burnout and Resilience

Affiliation.

• 1 School of Nursing, Western Carolina University, Cullowhee, North Carolina.
• PMID: 35089283
• DOI: 10.1097/TME.0000000000000391

Burnout is a significant problem in emergency nursing, and it is associated with higher turnover rates than other disciplines of health care. Emergency nurses are highly susceptible to burnout due to continual exposure to traumatic events, varying work schedules, violence directed at staff, and, in recent times, due to the stressors of the COVID-19 pandemic. This literature review will (1) expose the causes of emergency department (ED) nurse burnout and (2) discuss strategies to build resilience in ED nurses. A systematic review of studies published in academic journals discussing burnout and resilience, specifically related to ED nurses, published in English between 2015 and 2019. The databases MEDLINE, Cumulative Index to Nursing and Allied Health Literature (CINAHL), Education Source, Health Source: Nursing/Academic Edition, APA PsycArticles, Military and Government Collection, Gender Studies Database, SocINDEX, and PsycINFO were searched. Sixteen studies were included in this review. Work schedules and shift work, violence toward staff, and lack of management support were factors linked to burnout. Self-discipline, optimism, and goal-oriented behaviors evolved as characteristics of resilient ED nurses. Burnout rates among ED nurses are steep. Shift work, traumatic events, violence, and management support are determinants of burnout. Specialized actions can combat burnout and increase resilience. Nursing management can provide specific education to nurses to assist in this effort.

Copyright © 2022 Wolters Kluwer Health, Inc. All rights reserved.

Publication types

• Systematic Review
• Burnout, Professional* / epidemiology
• Emergency Nursing*
• Emergency Service, Hospital

40+ Emergency Nursing Research Topics

• Carla Johnson
• August 24, 2023
• Nursing Topics and Ideas

Emergency nursing is a dynamic and vital branch of healthcare that requires nurses to provide rapid and skilled care to patients facing critical situations. As nursing students embark on their journey to become healthcare professionals, understanding the intricacies of emergency nursing is essential. This article delves into emergency nursing research topics, offering insights into PICOT questions, evidence-based practice (EBP) projects, nursing capstone projects, research questions, and essay ideas.

Introduction to Emergency Nursing

Emergency nursing is a specialized field that focuses on caring for patients in urgent and critical situations. Emergency nurses are crucial in assessing, stabilizing, and providing immediate care to patients with various medical conditions, from life-threatening injuries to acute illnesses . Their ability to make rapid and informed decisions often means the difference between life and death. Emergency nurses work collaboratively with other healthcare professionals in this demanding role to ensure timely and effective interventions.

PICOT Questions in Emergency Nursing

• P: Adult population in psychiatric care; I: Implementation of daily RS questionnaire; C: Units without the daily survey; O: Reduced utilization of restraints and seclusion; T: 6 months. In psychiatric care settings, how does implementing a daily RS (Restraint and Seclusion) questionnaire compared to units without the questionnaire affect the utilization of restraints and seclusion over 6 months?
• P: Pediatric patients in emergency departments; I: Use of distraction techniques during procedures; C: Standard care without distraction; O: Reduction in procedural pain and distress; T: Per procedure. For pediatric patients in emergency departments, how does the use of distraction techniques during procedures compared to standard care without distraction influence the reduction of procedural pain and distress, measured on a per procedure basis?
• P: Geriatric patients with fall risk; I: Implementation of multifactorial fall prevention strategies ; C: Standard fall prevention protocols; O: Decreased fall incidence; T: 1 year. Among geriatric patients with fall risk, how does the implementation of multifactorial fall prevention strategies versus standard fall prevention protocols impact the incidence of falls over the course of 1 year?
• P: Trauma patients admitted to the emergency department; I: Early administration of antibiotics; C: Delayed antibiotic administration; O: Reduction in sepsis development; T: During hospital stay. For trauma patients admitted to the emergency department, how does the early administration of antibiotics compared to delayed administration influence the reduction in sepsis development during the hospital stay?
• P: Patients with suspected myocardial infarction; I: High-sensitivity troponin testing; C: Conventional troponin testing; O: Improved accuracy of diagnosing myocardial infarction; T: Within 1 hour. Among patients with suspected myocardial infarction, how does high-sensitivity troponin testing compared to conventional troponin testing impact the accuracy of diagnosing myocardial infarction within 1 hour?
• P: Post-surgical patients; I: Use of early mobilization protocols; C: Standard post-operative care ; O: Faster recovery of ambulatory function; T: Post-operative period. For post-surgical patients, how does the use of early mobilization protocols compared to standard post-operative care contribute to the faster recovery of ambulatory function during the post-operative period?
• P: Patients with diabetic emergencies; I: Implementation of standardized insulin infusion protocols; C: Non-standardized insulin administration; O: Better glycemic control; T: 48 hours. Among patients with diabetic emergencies, how does the implementation of standardized insulin infusion protocols compared to non-standardized insulin administration affect glycemic control within a 48-hour timeframe?
• P: Stroke patients in the emergency department; I: Use of telemedicine for remote neurologist consultation; C: No telemedicine use; O: Decreased door-to-treatment time; T: Per patient. For stroke patients in the emergency department, how does the use of telemedicine for remote neurologist consultation compared to no telemedicine use impact the reduction in door-to-treatment time on a per-patient basis?
• P: Patients with suspected sepsis; I: Procalcitonin-guided antibiotic therapy ; C: Empiric antibiotic therapy; O: Decreased antibiotic overuse; T: During hospital stay. Among patients with suspected sepsis, how does procalcitonin-guided antibiotic therapy compared to empiric antibiotic therapy contribute to the decreased overuse of antibiotics during the hospital stay?
• P: Obstetric patients in emergency care; I: Implementation of obstetric early warning systems; C: No obstetric early warning systems; O: Improved recognition of maternal complications ; T: Per admission. For obstetric patients in emergency care, how does the implementation of obstetric early warning systems compared to no use of such systems enhance the recognition of maternal complications on a per-admission basis?

Evidence-Based Practice Projects Ideas on Emergency Nursing

• Assessment of Pain Management Strategies in Emergency Department Settings: A Comparative Study.
• Effectiveness of Rapid Response Teams in Reducing Adverse Events in Critical Care Patients.
• Implementation of Evidence-Based Triage Protocols to Improve Patient Flow in the Emergency Department.
• Evaluation of the Impact of Simulation Training on Nurses’ Preparedness for Handling Pediatric Emergencies.
• Exploring the Use of Ultrasound-Guided Peripheral Intravenous Catheter Insertion in Emergency Nursing Practice.

Capstone Projects Ideas on Emergency Nursing

• Developing a Comprehensive Disaster Preparedness Plan for a Local Emergency Department.
• Analyzing the Effectiveness of Communication Strategies During Code Blue Situations in a Hospital Setting.
• Creating Educational Modules for Nurses on Recognizing and Responding to Sepsis in the Emergency Department.
• Assessment of Nurse Fatigue and its Impact on Decision-Making in High-Stress Emergency Environments.
• Implementing a Standardized Handover Process to Enhance Continuity of Care for Critical Patients in the Emergency Department.

Research Topics on Emergency Nursing

• Ethical Dilemmas in Emergency Nursing: Balancing Autonomy and Beneficence.
• Cultural Competence in Emergency Nursing: Providing Culturally Sensitive Care in Critical Moments.
• The Role of Advanced Practice Nurses in Leading and Innovating Emergency Care Delivery.
• Impact of Nurse-to-Patient Ratios on Patient Outcomes in Emergency Departments.
• Emergency Nursing Education and Training: Bridging the Gap Between Classroom Knowledge and Clinical Practice.

Emergency Nursing Research Questions

• How does the implementation of standardized protocols influence the efficiency and effectiveness of triage in the emergency department?
• What are the challenges and strategies for maintaining patient safety during high-stress emergency situations?
• How do emergency nurses manage their emotional well-being while dealing with traumatic and high-pressure scenarios?
• What role does interprofessional collaboration play in improving patient outcomes in emergency care settings?
• What are the barriers and facilitators to implementing evidence-based practices in emergency nursing?

Essay Topic Ideas & Examples on Emergency Nursing

• The Role of Emotional Intelligence in Emergency Nursing: Navigating High-Stress Situations with Empathy. Explore how emotional intelligence impacts the ability of emergency nurses to provide compassionate care in critical moments.
• Emergency Nursing: Beyond Medical Skills. Discuss the non-technical skills, such as communication and teamwork, essential for emergency nursing success.
• Ethical Dilemmas in Emergency Nursing: Making Tough Decisions Under Pressure. Analyze the ethical challenges that emergency nurses face and how they navigate morally complex situations.
• The Evolution of Triage: From Triage Tags to Triage Protocols. Trace the historical development of triage methods and their role in modern emergency nursing practice.
• Emergency Nursing in a Global Context: Varied Challenges, Universal Dedication. Compare and contrast the unique challenges emergency nurses face worldwide and their shared commitment to patient care.

As nursing students embark on their journey to become proficient and compassionate healthcare providers, exploring the realm of emergency nursing can be enlightening and inspiring. The challenges and rewards of this specialized field are immense, and delving into the topics of PICOT questions, evidence-based practice projects, capstone project ideas, research paper topics, research questions, and essay ideas related to emergency nursing can set the foundation for a fulfilling career. Remember, you don’t have to journey alone as you navigate your studies. If you ever need guidance or assistance crafting impactful essays or research papers, don’t hesitate to seek our reliable writing services that cater to nursing students. Your academic success and future contributions to the field of nursing are worth every effort you invest. Contact us today and take the first step toward academic excellence and a successful nursing career.

FAQs About Emergency Nursing

Q1: What is emergency nursing care?

Emergency nursing care involves providing rapid and skilled medical attention to patients facing critical medical conditions or injuries in urgent care settings, such as emergency departments.

Q2: What is the role of the emergency nurse?

The role of an emergency nurse encompasses assessing patients’ conditions, prioritizing care, administering treatments, collaborating with healthcare teams, and making crucial decisions in high-stress situations.

Q3: What is the difference between an emergency nurse and a critical care nurse?

While both roles involve handling critical patients, an emergency nurse primarily deals with immediate assessment and initial treatment in urgent situations, while a critical care nurse provides ongoing, intensive care for patients in unstable conditions, often in specialized intensive care units.

Q4: What are the priorities of emergency nurses?

Emergency nurses prioritize patient stabilization, rapid assessment, timely intervention, and effective communication with other healthcare professionals to ensure the best possible patient outcomes in critical situations.

Working On an Assignment With Similar Concepts Or Instructions? ​

A Page will cost you $12, however, this varies with your deadline. 

We have a team of expert nursing writers ready to help with your nursing assignments. They will save you time, and improve your grades. 

Whatever your goals are, expect plagiarism-free works, on-time delivery, and 24/7 support from us.  

Here is your 15% off to get started.  Simply:

• Place your order ( Place Order ) 
• Click on Enter Promo Code after adding your instructions  
• Insert your code –  Get20

All the Best, 

Get A 100% Plagiarism-Free Nursing Paper

Related samples.

• PICOT QUESTION GENERATOR
• NRS 493 Benchmark – Capstone Project Change Proposal – BSN Capstone Project Example
• Capstone Project Change Proposal Presentation GCU
• 105 Nursing Informatics topics for MSN
• Literature Review Definition in MSN Nursing, What to Include?

Nursing Topics

• Academic Writing Guides
• Advanced Cardiac Care Nursing
• Advanced Community Health Nursing
• Advanced Critical Care Nursing
• Advanced Health Assessment
• Advanced Mental Health Nursing
• Advanced Nursing Ethics
• Advanced Nursing Informatics
• Advanced Occupational Health Nursing
• Advanced Pathophysiology
• Advanced Pediatric Nursing
• Advanced Pharmacology
• Gerontological Nursing
• Healthcare Policy and Advocacy
• Healthcare Quality Improvement
• Nurse Practitioner
• Nursing Education and Curriculum Development
• Nursing Leadership and Management
• Nursing Research and Evidence-Based Practice
• Nursing Theories
• Population Health and Epidemiology
• Assignment Help
• Chamberlain University
• Grand Canyon University (GCU)
• MSN Nursing Papers Examples
• APA NURSING PAPER EXAMPLE
• capstone project
• community health nursing assignments
• comprehensive assessment
• graphic organizer
• Nursing Care Plan
• Nursing Case study
• nursing informatics assignments
• Nursing Leadership Essay
• Shadow Health
• tina jones shadow health
• Windshield Survey Examples
• Nursing Essays
• PICOT Paper Examples
• Walden University
• Women's Health Nursing

Important Links

Knowledge base, utilize our guides & services for flawless nursing papers: custom samples available.

MSNSTUDY.com helps students cope with college assignments and write papers on various topics. We deal with academic writing, creative writing, and non-word assignments.

All the materials from our website should be used with proper references. All the work should be used per the appropriate policies and applicable laws.

Our samples and other types of content are meant for research and reference purposes only. We are strongly against plagiarism and academic dishonesty.

We Accept: 

Emergency Nursing Capstone Project Ideas

If you are interested in emergency nursing, here are some critical topics and research project ideas you can use in your emergency nursing capstone project.

• Trauma-informed care for people presenting to the ED with mental issues
• Impacts of educating ED nurses about trauma-informed care for people presenting with mental health issues
• How to prevent overcrowding in the emergency departments
• Impacts of overcrowding in the hospital emergency departments
• Healthcare quality in the ED of hospitals
• Factors affecting patient flow in the ED
• Use of mobile applications to improve emergency response procedures
• How to reduce the emergency department stays for patients
• Emergency departments as the primary points of entry into healthcare
• Role of Emergency Departments in the care continuum management
• Addressing COVID-19 in the emergency departments during the pandemic
• Reorganizing Emergency Departments to address disasters and pandemics
• Trends in Emergency Department Visits and Hospital admissions during the Covid-19 pandemic
• Responsibilities of an Emergency room Nurse
• Patient classification systems in the Emergency Department settings
• Role of Emergency Nurses in Emergency Preparedness
• Role of emergency nurses in the management of chemotherapy-related complications
• Medication knowledge and willingness to nurse-initiate medications in an emergency department
• Addressing the Nurse Shortage to Improve the Quality of Patient Care in Emergency Departments
• Factors leading to the length of stay and boarding inpatients
• Infection control in the emergency departments
• Education to improve staff competence in the ED
• Interdisciplinary collaboration and open communication among ED nurses
• Incentive programs for the ED nurses
• Ergonomics and facility design of Eds
• Implementation of technology to improve patient care in ED
• Nursing Workforce Issues and Trends Affecting Emergency Departments
• Assessment and risk classification protocol for patients in emergency units
• Attitudes of emergency nurses in caring for older patients at an emergency department
• Use of Pediatric Telemedicine in the Emergency Departments
• Pediatric medication safety in the Emergency departments
• Use of MRI and CT in Paediatric emergency departments
• The efficacy of enema solutions in Paediatric Emergency Departments
• How student nurses view the emergency departments
• Utilizing six sigma in the emergency departments
• Lean thinking in the emergency departments
• Assessment tools for nursing workload in the emergency departments
• Violence in the Emergency Departments
• Role of ED nurses in patient advocacy and policy formulation
• Factors leading to frequent use of Emergency departments
• Incidence and Prevalence of burnout among emergency nurses
• Role of freestanding emergency departments in healthcare
• Do freestanding emergency departments alleviate congestion in hospital-based Eds?
• Freestanding Emergency departments and Medicare Costs

Published by laura

View all posts by laura

Quality and Safety Resources

Evidence-based emergency nursing resources to support your commitment to care..

• ENA's evidence-based resources.

• Workplace violence, opioid crisis, & more

• Health, Safety, & more

• Guidelines and Resources

Draft Position Statements

The position statement Trauma Nursing Education is now available for public review and comments. Please submit evidence-based feedback by May 30.

ENA has compiled resources on hot topics in emergency nursing in one place - check out the categories below:

• Workplace Violence
• Opioid Crisis
• Behavioral Health
• Human Trafficking
• COVID-19 (previously 2019 Novel Coronavirus)

related resources

69 Emergency Department Essay Topics

🏆 best essay topics on emergency department, ✍️ emergency department essay topics for college, 🎓 most interesting emergency department research titles, 💡 simple emergency department essay ideas.

• Emergency Nursing Journal Conclusion
• Emergency Room Treatment for Patients With Stroke
• Key Issues of the Emergency Nurses Association
• Emergency Room Wait Time: Literature Review
• Quality Improvement Plan of the Emergency Department
• Healing a Hospital’s Struggling Emergency Department
• Emergency Departments and Balanced Scorecard Assignment
• Emergency Room Triage in America A conceptual analysis of ER triage, defining its meaning and characteristics, and explaining how a particular ER triage system can work under a number of circumstances.
• Using Information Technology and Artificial Intelligence in Critical Care Medicine Artificial Intelligence in critical care is helping to care for patients faster, supervise more patients, calculate the exact dosage for patients, and collect more detailed data.
• The American Association of Critical-Care Nurses The American Association of Critical-Care Nurses (AACN) work is vital for the healthcare sector. AACN was created following the specific mission.
• Violence and Safety Concerns in the Emergency Department The present project was aimed at the location of an evidence-based solution to a problem of violence and safety issues faced by nurses working in the emergency department.
• Nurse Staffing Ratios in the Emergency Department The study investigates the relationship between nurse staffing ratios to patient outcomes in emergency departments and provides an indicator to assess nursing care.
• Emergency Nurses Association: Interest Group Presentation The selected group for this discussion is the Emergency Nurses Association. The interest group conducts research to inform or guide existing policies on emergency nursing.
• Stress Influence in Emergency Nursing Working as a nurse in emergency departments is particularly stressful, as patients who are there need urgent medical assistance or they can die.
• Cutting Unnecessary Usage of Emergency Rooms Most emergency rooms in the U.S. are currently experiencing a surge in patients which explains why the issue of delays and diversions has become common.
• Increased Suicide in Emergency Departments The paper attempts to acknowledge the causes of high suicide attempts resulting in the death of patients and staff in EDs and provide preventative solutions.
• Practicing Nurses in Emergency Departments Falls, traumas, and advanced-degree pressure injuries are common causes of emergency department visits that still require increased attention from registered nurses.
• Unnecessary Emergency Department Admissions The main goal of a nurse leader is to reduce the number of unnecessary Emergency Department admissions with the help of improving staffing levels at the nursing home.
• The COVID-19 Section on the Federal Emergency Management Agency Website for Nurses While the main focus of the coronavirus section on the FEMA website is supporting patients with vaccines, finances, and guidance, it is also relevant for public health nurses.
• Healthcare Database for Reducing Patient Stay in the Emergency Department A database is an efficient tool for reducing the patient’s length of stay to increase the efficacy of the emerging department’s operations and resource usage.
• Emergency Department Staff Hourly Rounding Effects on Clients’ Satisfaction in a Pediatric Facility The purpose of this study is to evaluate the effect of emergency department staff hourly rounding on clients’ satisfaction in a pediatric facility by holding an interview.
• Strategies for Performance Improvements in Operating Rooms and Emergency Rooms Medical chart review is an extremely important tool used to collect performance information in operating rooms (OR) and emergency rooms (ER).
• Reduce Emergency Room Wait Times The paper discusses wait time in the emergency unit is reduced. An emergency room is special medical treatment care that usually specializes in emergency cases such as accidents.
• Emergency Department Discharge Instructions and Patients’ Understanding of Them This paper is an article critique for “Patient understanding of emergency department discharge instructions: where are knowledge deficits greatest?”
• Ethical and Justice Considerations of Triage of Critical Care Resources The rising scale of the pandemic causes problems with resource allocation when providing health care to the continuously increasing number of patients impacted by the coronavirus.
• Violence Against Nurses in the Emergency Room In the present-day situations of the health care sector, among the highly complicated as well as perilous risks faced in the workplace is violence.
• Upper Airway Obstruction and Gunshot Wound in the Emergency Room Airway obstruction is a hindrance in any part of the air passage. It may partially or fully block the air from reaching the lungs.
• Nurses Liability Issues in the Emergency Room The research paper set out to give a detailed description of the various kinds of liability issues that nurses in the emergency room are prone to.
• American Association of Critical-Care Nurses Master’s Essentials The paper shows that each Master’s essential proposed by the AACN allows nurses to achieve better results in one or more areas of clinical practice.
• The Use of Protocols for Pressure Ulcers in Emergency Departments This project aims at summarizing the existing knowledge on pressure ulcers protocols to design an intervention that can be successfully implemented in emergency departments.
• National Patient Safety Goals: Critical Care Access Limited access to healthcare services has been on the agenda of the modern healthcare system for quite a long, warranting the status of critical concern.
• Dry Eye in Critical Care: Evidence-Based Practice A common problem for ICU patients is dry eye due to their conditions or medications that block physical mechanisms of maintaining moisture in the eyes.
• “Factors That Influence the Development of Compassion Fatigue, Burnout, and Compassion Satisfaction in Emergency Department Nurses” the Article by Hunsaker, S., et al Taking into account the overall tendency of the nursing profession to become a demanding and intensive occupation, nurses face a significant problem of workplace burnout.
• Safety and Violence Policies in Emergency Departments Ensuring safety in the workplace for emergency workers is accompanied by strong necessity since frequent stresses inevitably entail conflicts and quarrels.
• Emergency Room Wait Time Reduction The research focuses on the emergency room setting and addresses the problem of emergency room wait time as a major barrier to the delivery of quality care.
• Nursing Philosophy in Emergency Trauma Care The purpose of this paper is to analyze how the nursing metaparadigm and the personal nursing philosophy can be applied to serving patients from a trauma and emergency unit.
• Pressure Ulcer Protocol in the Emergency Department The study explores whether the implementation of a pressure ulcer protocol initiated in the emergency department reduces the incidence of hospital-acquired pressure ulcers.
• Pressure Ulcer Treatment in Emergency Department The risk of developing pressure ulcers both in intensive care units and in usual hospital settings predetermined the need to find solutions to this nursing problem.
• Moral Distress and Effects on Critical Care Nurses Wiegand and Funk explore the moral distress experiences of nurses, the causes of such experiences, and the effects they had on nurses’ practice, attitude, and future decisions.
• Building Cyclic Schedules for Emergency Department Physicians
• Hospital Emergency Department and Supply Chain Management
• Emergency Department for Treatment of Unexplained Fever
• Teamwork and Moral Hazard: Evidence From the Emergency Department
• The Emergency Department Trauma Team
• Treatment Speed and High Load in the Emergency Department—Does Staff Quality Matter?
• Reducing Primary Care Utilization of the Emergency Department
• Pain Management for the Pediatric Emergency Department
• How Have Stroke Patients Been Affected by Emergency Department Overcrowd?
• Inadequate Staffing and Emergency Department Capacity
• Collaboration Meeting for Process Excellence in the Emergency Department
• Geriatric Emergency Department Care
• Emergency Department Overload: Creating Positive Changes Under Conflicting
• Aggressive Behaviors and Assault in the Emergency Department
• Impact Of Interruptions In Emergency Nursing Department
• Anaphylaxis and the Emergency Department
• Emergency Department Nursing Informatics
• Emergency Department Nurse’s Ethical Dilemma
• The Emergency Department and Its Effects on Health Care
• Delivering Safe and High-Quality Healthcare in the Emergency Department
• Demographic Factors Influencing Nonurgent Emergency Department Utilization Among a Medicaid Population
• Suspected Ischemic Cardiac Chest Pain in Emergency Department
• Burnout Among Emergency Department Nurses
• Emergency Department Patient Satisfaction
• Copayments and Emergency Department Use Among Adult Medicaid Enrollees
• Associated Factors With Sexual Assaults in a Gynaecology Emergency Department
• Urgent and Unscheduled Care in Accident And Emergency Departments
• The Problems In The Emergency Department Of Services
• Waiting Times in Emergency Department
• Essay on Triage Nursing in the Emergency Department

Cite this post

• Chicago (N-B)
• Chicago (A-D)

StudyCorgi. (2022, May 10). 69 Emergency Department Essay Topics. https://studycorgi.com/ideas/emergency-department-essay-topics/

"69 Emergency Department Essay Topics." StudyCorgi , 10 May 2022, studycorgi.com/ideas/emergency-department-essay-topics/.

StudyCorgi . (2022) '69 Emergency Department Essay Topics'. 10 May.

1. StudyCorgi . "69 Emergency Department Essay Topics." May 10, 2022. https://studycorgi.com/ideas/emergency-department-essay-topics/.

Bibliography

StudyCorgi . "69 Emergency Department Essay Topics." May 10, 2022. https://studycorgi.com/ideas/emergency-department-essay-topics/.

StudyCorgi . 2022. "69 Emergency Department Essay Topics." May 10, 2022. https://studycorgi.com/ideas/emergency-department-essay-topics/.

These essay examples and topics on Emergency Department were carefully selected by the StudyCorgi editorial team. They meet our highest standards in terms of grammar, punctuation, style, and fact accuracy. Please ensure you properly reference the materials if you’re using them to write your assignment.

This essay topic collection was updated on January 8, 2024 .

An official website of the United States government

The .gov means it’s official. Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

The site is secure. The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

• Publications
• Account settings

Preview improvements coming to the PMC website in October 2024. Learn More or Try it out now .

• Advanced Search
• Journal List
• HHS Author Manuscripts

Implementing Clinical Research in the High Acuity Setting of the Emergency Department

Holli a. devon.

Biobehavioral Health Science, College of Nursing, University of Illinois at Chicago, Chicago, IL.

Frances L. Patmon

Betty Irene Moore School of Nursing, University of California–Davis, Sacramento, CA.

Anne G. Rosenfeld

College of Nursing, University of Arizona, Tucson, AZ.

Michelle M. Fennessy

Daphene francis, introduction.

Clinical research in the emergency department provides supporting evidence needed for the development of practice guidelines, such as door-to-needle and door-to-balloon times for treatment of acute coronary syndromes, and is vital to improvements in patient outcomes. The purpose of this article is to describe barriers and lessons learned in launching a multisite clinical research study of symptoms of acute coronary syndromes in the emergency department.

Participants included ED and research staff in 4 busy emergency departments in 3 states. At each step of the study launch, the principal investigator at the clinical site identified barriers that either were anticipated or experienced and discussed them with the site staff and study principal investigator to validate the issue as a barrier. Orientation sessions and ongoing communication between clinicians, research staff, and the research study team provided opportunity for adjustment of study protocols.

Barriers were lack of staff engagement in research, difficulty identifying eligible patients, perception of interference in clinical care, variability in research staff education and training, patient refusals, nurses’ perceptions of lack of time, undifferentiated patients, and time-sensitive quality improvement indicators necessitating acceleration in care.

Important strategies to overcome barriers were developed, including identification and support of unit champions in emergency nursing and medicine; minor protocol modifications to improve enrollment goals; development of specific written expectations, roles, research protocols, and algorithms; and sharing successes among sites.

Clinical research in the emergency department provides the supporting evidence needed for the development of practice guidelines such as door-to-needle and door-to-balloon times and is vital to improvements in patient outcomes. 1 Examples of other advancements in clinical care through ED research include refinement of cardiopulmonary resuscitation, pharmacologic guidelines for resuscitation, appropriate ECG analysis of ventricular fibrillation, and ST-elevation myocardial infarction (STEMI). 2 , 3 Patient ED visits categorized as emergent have doubled from 8% to 16.6%, and those considered urgent have increased from 40.2% to 50.3% thus increasing acuity levels and increasing the challenge of conducting research. 4 For instance, current standards call for rapid evaluation of patients with chest pain, with an ECG required within the first 10 minutes of arrival. 2

Conducting research in the high-acuity setting of the emergency department is challenging for many reasons, including overcrowding, boarding of patients, mental health visits, provision of nonemergent care, and the need to meet quality indicators such as time to ECG for suspected myocardial infarction. 3 Additionally, many quality improvement measures are publicly reported and linked to reimbursement rates, adding additional responsibilities for ED staff. Despite these obstacles, research has been recognized as providing the foundation for providing optimal patient care in the emergency department 5 and is an expectation of the ENA. 6 While nursing research is vital to advancing health care in the ED setting, 7 lack of administrative and structural support has been cited as a common barrier to conducting nursing research in the emergency department. 8 Engagement in research also is affected by lack of knowledge of the research process, lack of opportunity to participate in research, and lack of understanding of statistical analyses. 9 , 10 No prior studies have documented the challenges encountered in implementing a multicenter nursing research study in the high-acuity setting of the emergency department. Therefore the purpose of this article is to describe barriers and lessons learned in launching such a study. The research being conducted is the Think Symptoms study. The main aim of the study is to examine the influence of gender on symptom characteristics during acute coronary syndromes (ACS). A novel prospective design in which symptoms are assessed on presentation to the emergency department is being used.

SAMPLE AND SETTING

Participants included ED and research staff in 4 busy emergency departments in 3 states—3 urban academic medical centers and one large referral hospital located in a rural area. Participants predominantly were female, registered nurses, and well educated. Each emergency department has a site principal investigator (PI), including 2 physicians and 2 doctorally prepared nurse researchers. Three sites have fulltime research staff employed in the emergency department who are involved in the study.

Identification of Barriers

At each step of the study launch, including preparatory work, the PI at the site identified barriers that were either anticipated or experienced and discussed them with the site staff and the study PI to validate the issue as a barrier. The initial plan was to have the Symptom Checklist completed by triage nurses, but this plan was modified early in the process because of the challenge of identifying who should be screened. In the first 6 months of data collection, we recruited many more patients who had ACS ruled out than was anticipated. To more accurately identify who was likely to be ruled in, we chose to delay the enrollment process until evidence of ischemia was available. Therefore at 2 locations the Symptom Checklist is completed by research staff who are alerted to patients who have received orders for a troponin level check and an ECG. At another site, the Symptom Checklist is being completed by registration staff trained by the site coordinator. Research staff then determine if the patient is eligible for the study.

Think Symptoms Study

A brief background of the Think Symptoms study design and methods are presented to provide context for the methods for identification of barriers to conducting research in the emergency department. A prospective approach in which symptoms are recorded as soon after presentation to the emergency department as possible is being used in the study. The target enrollment is 800 patients admitted to the emergency department with symptoms suggestive of ACS. Participants are being recruited from 4 emergency departments in Illinois, California, and Oregon with annual visits in excess of 300,000. The primary measure is a 13-item ACS Symptom Checklist completed upon presentation to the emergency department ( Figure 1 ). Measures of physical function, comorbidities, and clinical data are collected once the patient has provided written consent and has been admitted to a room.

Preconsent symptom checklist.

Human Subjects Protection

Approval for the study was received from the sponsoring institution and the 3 other clinical sites before the study launch. A waiver of consent for the Symptom Checklist only was obtained from all 4 institutional review boards in order to record symptoms before the patients’ enrollment in the study. The rationale for the waiver was that the research could not practicably be carried out without the waiver. The primary study aim of collecting prospective symptom data would not be possible without a waiver to assess symptoms while they are occurring and before providing written informed consent. Patients are approached for consent when they are stabilized. Once enrolled, participants complete a short survey and provide contact information for follow-up calls.

Presentation of Study Protocol to Triage Nurses and Research Staff

The study initially was launched at 2 sites, and an additional 2 sites were added during the following year. A formal presentation, including PowerPoint slides and handouts, was provided to all interested staff in orientation sessions. The researchers were flexible and attentive to the requests of staff in each emergency department. The type of orientation program was determined by the individual emergency departments because cultures vary by institution. The formal orientation with a PowerPoint presentation was conducted at 2 locations by the PI and co-investigator. A study protocol algorithm was developed and distributed ( Figure 2 ). Staff had an opportunity to ask questions and provide feedback to the researchers. In one location, the PI met with the site coordinator, director of emergency medicine, and research assistant to review protocols. The site team then conducted orientation with ED staff. At the final site, the PI, clinical education nurse, and research nurse conducted a 12-hour-long informal orientation session in the ED break room. Staff attended when they were available, viewed slides, reviewed handouts, and asked questions of the research team. Booster orientation sessions were conducted on the day the study was launched.

Study protocol. ACS, Acute coronary syndromes.

Conducting a multisite study is an arduous process. Meetings with site PIs and research staff were conducted before patient recruitment in an effort to launch successfully with as little delay as possible. Regularly scheduled monthly meetings, in person or via phone conference, were held to discuss barriers to the study and possible solutions. Phone conferences were conducted as needed. Site coordinators and research staff can reach the PI by cell phone 7 days a week, and they call whenever questions arise. Barriers to the research were identified by all ED and research staff and have been categorized in the following sections.

STAFF ENGAGEMENT IN RESEARCH

Some staff have been extremely enthusiastic about participating in the study and have self-selected to assume the role of unit champions, whereas some staff are disinterested. Support for research varies according to the culture of the institution. Despite the fact that one site is pursuing Magnet status from the American Nurses’ Credentialing Center, 11 participation in research is not yet a priority. One site has a strong labor union, and nurses expressed resistance to participating in research. During an orientation session during change of shift, one nurse commented that research was not part of the job description. The PI and co-investigator stressed the importance of nursing research contributing to the evidence on which best practices are based. Two sites have instituted policies to encourage staff participation in the study. One site offers emergency nurses credit toward progression up the clinical ladder, and another offers release time to participate in research committees and journal clubs. These and other strategies demonstrate administrations’ commitment to clinical research and aid staff in adopting the same values.

IDENTIFYING ELIGIBLE PATIENTS

The study was designed with the expectation that eligible patients would be identified by triage nurses. This process worked well in pilot testing in another institution; however, identification of eligible patients was supervised by the PI, who was present in the emergency department and collected all pilot data. When it became evident that this process would not occur in the emergency departments participating in this large study, the research team met to develop a new plan for identifying patients. Concomitantly, we tracked enrollment figures. During the first 6 months of the study, more than 300 patients were enrolled. More than 200 of these patients had ACS ruled out, exceeding our original goal of 108. The challenges associated with identifying patients at high risk for ACS accounted for the high number of patients enrolled who subsequently were ruled out. Consequently, we decided to take advantage of the fact that patients were receiving ECGs and having blood drawn to determine troponin levels within 10 minutes of arrival. Subsequently, only patients whose troponin level exceeded norm-referenced values for the institution or had ECG changes consistent with ischemia were approached for enrollment. The Symptom Checklist has been completed before an ECG has been performed and blood has been drawn for a troponin level in most cases. One site asked registration staff to complete the Symptom Checklist for stable patients because they are sent immediately to registration after evaluation in triage. Registration staff were trained by research staff in administration of the tool. This process worked well because symptoms are recorded immediately on admission and research staff then could enroll patients when they had been placed in an examining room and are comfortable.

PERCEPTION OF INTERFERENCE IN CLINICAL CARE

Some emergency nurses expressed concerns that conducting research interfered with or had the potential to interfere with the provision of patient care. This concern was particularly evident in triages nurses’ resistance to completing the Symptom Checklist, even though it contained items commonly assessed during the triage and admission process. Several triage nurses in one location noted that many patients often were waiting to be evaluated and that using even a short Symptom Checklist would take time away from patient care. We could find no evidence to support the notion of interference with care in the literature. The main concern expressed by staff was that participating in the research would take them away from other patients. We emphasized to staff that compromising patient care in favor of collecting data for a research study is unethical. 1 This feedback reassured some staff that the priority of clinical care would not be compromised, but others were not convinced and declined to participate.

VARIABILITY IN RESEARCH STAFF EDUCATION AND TRAINING

Although all research staff completed mandatory ethics and Health Insurance Portability and Accountability Act training, they vary in educational preparation and experience. We received feedback that research assistants, who were not nurses, could not determine whether patients were eligible for the study based on unfamiliar items in the screening tool. Use of the tool requires clinical judgment and familiarity with the terms and concepts of heart failure, dysrhythmia, STEMI, and ACS. Some research assistants required additional training in these terms and where to find this information in the record if patients did not know their health history. Refinement of enrollment algorithms and scheduled training at monthly research meetings has helped overcome these barriers.

PATIENT REFUSAL TO PARTICIPATE

Refusal to participate in the study was a concern initially. In the first 9 months, rates were 50.4% at one site (66/131) and 30.9% (93/301) at a second site. These sites were the home institutions of the PI and co-investigator, who had frequent interactions with the study team. Data were not yet available from the other sites. Patients who refused expressed feelings of fatigue, anxiety, uncertainty, and discomfort. This issue was addressed by focusing on timing and approach to potential participants. Research assistants were trained to use a calm and friendly approach when patients were stable, more relaxed, and pain free. Every attempt was made to discuss the study when the patient was alone in his or her room with little chance of interruption. A small number of patients expressed resistance to blood draws and were enrolled without a blood sample being collected. Often patient fears were addressed successfully during quiet and empathetic discussion in private. The overall refusal rate is currently 24.8%, indicating that the strategies have been effective. Additionally, the 2 sites that launched the study later benefited from lessons learned at sites 1 and 2.

NURSES’ PERCEPTIONS OF LACK OF TIME

A number of nurses responded that that they did not have time to complete the Symptom Checklist or identify eligible patients because of high census, overcrowding, and/or boarding of patients. They stated that patient care in the emergency department required all of their time. In some cases, inadequate staffing was noted to be a problem. Other time constraints reported were required training, continuing education, and committee responsibilities. These barriers were beyond the control of the researchers, so we focused on assisting the research staff in enrollment activities.

UNDIFFERENTIATED PATIENTS

Enrolling patients with suspected ACS necessitates the evaluation of patients whose diagnoses remain undifferentiated and complex. For example, a sprained ankle is fairly easy to diagnose and treat based on history and physical examination, but vague symptoms such as weakness, fatigue, or indigestion make it extremely difficult to determine the problem without diagnostic testing. Identification of patients with STEMI usually is straightforward based on ECG findings, but identification of patients without STEMI and patients with unstable angina requires further diagnostic work-up, risk stratification, and clinical judgment, all of which are challenging in the ED setting. To overcome some of the initial diagnostic uncertainty and capture patients likely to rule-in for ACS early, we obtained a waiver of consent from the institutional review boards to complete the Symptom Checklist before obtaining informed consent, waited until after evidence of ischemia was available either from an ECG and/or troponin levels, gained assistance in identifying patients from unit champions, and enlisted the help of the rapid response team in one location.

QUALITY IMPROVEMENT INDICATORS

The need to meet quality indicators of care, particularly the practices that are time dependent, presents another barrier to research in the emergency department. Guideline-based care requires that patients be seen and treated more quickly for conditions such as STEMI, stroke, pneumonia, sepsis, and trauma. At the same time, fewer human and financial resources are available to accelerate triage, assessment, and diagnostic testing. For example, guidelines for the treatment of STEMI recommend a goal of 90 minutes or less for door-to-balloon time. 12 Meeting these guidelines requires many resources in order to triage, admit, and transfer patients to the cardiac catheterization laboratory as quickly as possible. Clinical care is the priority; however, once patients are seen and stabilized, they can be enrolled in research studies. It is evidence from prior studies that have resulted in the professional guidelines used in practice.

Four strategies to address each of the barriers identified were successfully undertaken and can aid other investigators conducting research in high-acuity settings. First, unit champions in nursing and medicine were identified, supported, and incentivized through promotion and release time. Second, minor modifications that did not change study aims but could improve enrollment goals, such as enlisting the cooperation of registration staff, were made based on clinician and research staff input. Third, specific written expectations, roles, research protocols, and algorithms were developed, shared with all research personnel, and reviewed periodically. Fourth, successes were shared between sites via E-mail, phone calls, and regularly scheduled meetings. Dissemination of findings within the departments also may positively affect research interest in the future. Finally, we shared collective study milestones among each site. Milestones included the number of patients screened, the number enrolled, and diagnoses. These data were graphed and shared with the entire research team via E-mail. Successful strategies to overcome barriers also were shared among sites at monthly phone conferences.

Numerous barriers to research were noted in the launch of the Think Symptoms study. Acceleration of care such as rapid determination of troponin levels and ECGs add pressure to already busy clinicians and impedes participation in the research process. Of these barriers, lack of staff engagement and difficulty identifying eligible patients were the most critical and the most challenging. Our research team designed new approaches to identifying eligible patients by monitoring the ED admissions on the computer, arranging to be paged when patients with STEMI arrived by ambulance, and enlisting the help of unit champions to receive notice of admissions. We are supporting change in institutional policy to change role expectations and facilitate engagement of nursing staff in research. Our findings were similar to prior research, which found evidence to support the participation of nurses in clinical research when they are empowered to do so. In a study designed to describe barriers and attitudes toward safe patient handling, staff nurses willingly conducted research to improve safe patient outcomes. 13

Many emergency nurses reported being too busy caring for patients in an overcrowded department and boarding of patients as barriers to participation in research. 14 These findings also have been reported previously. Olshaker 15 found that the inability to transfer patients from the emergency department to inpatient beds is the most important factor leading to overcrowding. In another study of overcrowding, patients with ACS experienced more adverse outcomes during the time of highest waiting room census (odds ratio, 3.7; 95% confidence interval, 1.3-11.0). 15 , 16 Both overcrowding in the waiting room and boarding are factors that impede enrollment of patients in research studies. 16 Our findings indicate that a comprehensive model of practice, including a research committee, facilitated staff participation at one site. Larkin et al 17 found that the adoption of a collaborative model of practice, including a research committee structure, improved the use of research findings in practice. Finally, the use of electronic health records (EHRs) may facilitate the conduct of clinical research in the emergency department if tools such as the ACS Symptom Checklist can be imbedded in the record. One of the benefits of the use of EHRs is use for research and standardization of documentation. 18 The EHR also could be programmed to trigger an alert for the symptom checklist when a patient is triaged. There would be little redundancy because the Symptom Checklist contains symptoms already included in the nursing assessment.

Limitations

This analysis of barriers to conducting clinical research in the emergency department is limited to the implementation of one ongoing study. Although it was not an original purpose of the Think Symptoms study, it quickly became clear that evaluation of these barriers would be key to the success of the study. Therefore we added a descriptive aim to chronicle the barriers and related strategies to address them. The fact that these barriers data were not collected using formal or standardized staff surveys was a limitation. In addition, many of the barriers to conducting research described here varied across institutions and may have been the result of administrative or clinical policies and processes unrelated to this study.

Implications for Emergency Nurses

Evidence-based practice is the goal for emergency nurses. Emergency nurses can have an active role in the design, implementation, and dissemination of clinical research. Participation in clinical research has been recognized as an important area in the ED setting as part of a unit-based research team. 9 Nurses have recognized the importance of involvement in research in improving their clinical practice and for identifying evidence-based outcomes to improve the care of their patients.

Conclusions

Initiating rigorous clinical studies in the ED setting presents unique challenges, but they can be overcome through development of clear study algorithms and communication between research personnel and ED staff. Important strategies to overcome barriers were developed, including identification and support of unit champions in emergency nursing and medicine; minor protocol modifications to improve enrollment goals; development of specific written expectations, roles, research protocols, and algorithms; and sharing successes among sites.

Acknowledgments

This study is funded by National Institute of Nursing Research grant 5R01NR012012-03.

Contributor Information

Holli A. DeVon, Biobehavioral Health Science, College of Nursing, University of Illinois at Chicago, Chicago, IL.

Frances L. Patmon, Betty Irene Moore School of Nursing, University of California–Davis, Sacramento, CA.

Anne G. Rosenfeld, College of Nursing, University of Arizona, Tucson, AZ.

Michelle M. Fennessy, Betty Irene Moore School of Nursing, University of California–Davis, Sacramento, CA.

Daphene Francis, Betty Irene Moore School of Nursing, University of California–Davis, Sacramento, CA.

A .gov website belongs to an official government organization in the United States.

A lock ( ) or https:// means you've safely connected to the .gov website. Share sensitive information only on official, secure websites.

• Managing Substance Use Disorders
• Health Equity
• Data Resources
• Additional HHS Resources
• Overdose Prevention Resources
• Management and Treatment of Pain
• Clinical Practice Guideline at a Glance
• Clinical Care and Treatment
• Health Care Provider Toolkits
• Electronic CDS Tools for Opioids
• Strategies and Partnerships
• Resources for Public Health Professionals
• Journal Articles
• MMWR Articles
• Guides and Meeting Reports
• Related Publications
• Overdose Data to Action
• Drug-Free Communities (DFC)

DOSE Dashboard: Nonfatal Overdose Emergency Department and Inpatient Hospitalization Discharge Data

What to know.

• The nonfatal drug overdose data on this dashboard come from CDC’s Drug Overdose Surveillance and Epidemiology (DOSE) system. DOSE captures both emergency department and inpatient hospitalization discharge data.
• Currently, 25 states share discharge data with DOSE - 18 states share both emergency department and inpatient hospitalization discharge data, 4 states submit only emergency department discharge data, and 3 states submit only inpatient hospitalization discharge data.

About this dashboard

The nonfatal drug overdose data on this dashboard come from CDC's Drug Overdose Surveillance and Epidemiology (DOSE) system, which captures both emergency department (ED) and inpatient hospitalization discharge data from jurisdictions. Currently, 25 states share discharge data with DOSE. This dashboard represents the most up-to-date data that CDC's DOSE system has available and is updated annually with an expected eight-month lag to account for data submission and review timelines.

States participating in CDC's DOSE System that report ED and/or inpatient hospitalization discharge data, 2018-2022 †

• Download a dataset with all available ED and inpatient hospitalization discharge data.
• Read more About DOSE and discharge data captured through DOSE.

Quick start for using this dashboard

• Select Data Source : Click on the box to select the desired data source (emergency department visit or inpatient hospitalization discharge data) from the drop-down.
• Select a Drug : Click on the box to select from a drop-down list of options, including all drug, all opioid, heroin, and all stimulant overdoses.
• Select a State : Click on the box to select and highlight overdose data by a specific state or overall. Note only states that submitted the selected data source during the selected time period will be displayed in the drop-down list.
• Select Time Frame : Click on the box to select the desired time frame (monthly or annual); if monthly data are selected, an option to Select a Month will be displayed.
• Select a Year : Click on the box to select the desired year.
• All visualizations will responsively adjust to your selections , including the summary data points; barbell chart; line graph; sex by age pyramid; and county-level heat map. Use the reset button below the selection boxes to clear all selections and return to the default settings.

Data dashboard

Suggested citation.

Centers for Disease Control and Prevention. Drug Overdose Surveillance and Epidemiology (DOSE) System: Nonfatal Overdose Emergency Department and Inpatient Hospitalization Discharge Data. Atlanta, GA: US Department of Health and Human Services, CDC; [INSERT YEAR, MONTH, DAY]. Access at: https://www.cdc.gov/overdose-prevention/data-research/facts-stats/dose-dashboard-nonfatal-discharge-data.html

Overdose Prevention

Overdose prevention is a CDC priority that impacts families and communities. Drug overdose is a leading cause of preventable death in the U.S.

For Everyone

Health care providers, public health.