Improving Nursing Confidence in the Management of Behavioral Health Patients in the Emergency Department

Abstract

Purpose: Improve nursing confidence in providing care to behavioral health behavioral healthpatients in the emergency department through education and implementation of the Safe Structure template, which addresses identified nursing barriers. Background and Significance: There is substantial growth in the number of behavioral health patients presenting to the emergency department. Evidence shows there are four primary barriers to nursing care of behavioral health patients in the emergency department: physical environment, time constraints, resources, and the overall impact on the process of triage within their role. Nursing learned behaviors, stigma, and attitudes contribute to frustration and fear of caring for the behavioral health population. Nurses report lack of confidence and education in their ability to care for the behavioral health population. Methods: Descriptive quantitative study design using a retrospective post then pre-surveys to measuring nursing confidence levels post education on nursing barriers to care for behavioral health patients and the use of the safe structure template using a five-point Likert scale. Results: Post-the-pre surveys (n=28) were completed. Although findings were not clinically significant (p >.05), there was a slight overall increase in mean confidence levels post education. Pre-education, the nurses who completed the survey reported on average most confident in their ability to provide safe limitations consistent with environment and policies for behavioral health patients (M = 3.21±1.287) and least confident in their ability to create a daily routine for behavioral health patients (M=2.93 ±1.303) Confidence scores from nurses post-education were similar to the pre-confidence results with a slight rise in confidence their ability to provide safe limitations consistent with environment and policies for behavioral health patients 11 (M=3.71±0.854). Paired t test of nursing confidence levels did not reveal statistically significant findings in confidence levels (p >.05). Conclusion: Nurses continue to experience gaps and lack confidence in their ability to care for behavioral health patients in the emergency department. The limited findings of this project support the need for ongoing education, training, and support. The need for streamline education and time to complete is education based on nursing feedback.