2025 Missouri ENA Poster Fair

Time is treatment! The ability to locate the area of concern quickly can help get diagnostics and treatment started sooner. Understanding a patient’s complaint and quickly getting the relevant information for diagnosis can be challenging. Patients often have difficulty giving details about mouth/throat dysfunction because the parts and mechanism of swallowing are not commonly understood and globus descriptions are common. The connected systems results in an overlap of professional expertise, which can impede efficient appropriate referral.

Kerry Winget

SSM Health St. Agnes Hospital

Recent literature supports that virtual learning was adequate during the COVID pandemic, but there have been limitations since in regards to hospital-based learners needing hands-on skills. This poster reviews the perception of self-confidence in learners that have done RQI PALS only versus previously had an in-person PALS course

Julie Scovronski & Kelly Riedel

SSM Health - St. Louis

Blood culture contamination (BCC) in emergency departments (EDs) is a persistent issue, often exceeding the recommended 3% threshold. Elevated BCC rates can lead to diagnostic inaccuracies, unnecessary antibiotic use, prolonged hospital stays, and increased healthcare costs. This quality improvement project aimed to reduce BCC rates in a high-volume ED through a series of phased interventions targeting collection practices and staff competency

Jesse Godec

Boone Health

Patient aggression and violence is a problem in multiple areas of healthcare, but especially in emergency departments around the world. A poll of emergency physicians reported 47% had been physically assaulted while at work, with 51% reporting their patients had also been physically injured in the process (American College of Emergency Physicians, 2024). The use of physical restraints is correlated to prolonged hospitalizations, increased mortality, increased hospital acquired infections, and patients being less likely to be discharged home. In emergency department patients experiencing aggressive behaviors does verbal de-escalation compared with physical restraint reduce patient injuries within their hospital stay. Verbal de-escalation is a tool that could potentially decrease the use and frequency of physical restraints. By reducing physical restraint usage, it would in turn reduce patient injuries and deaths caused by physical restraints. The final studies used include four level II studies (Bowers et al., 2015; Celofiga et al., 2022; Putkoren et al., 2014; Ye et al., 2021). All level II studies were random control studies (RCT). Levels of evidence were determined using the description provided by Evidence-Based Practice in Nursing & Healthcare Fifth Edition (Melnyk & Fineout-Overholt, 2023). The intervention assessed for in all four studies was the use of de-escalation therapies in patients experiencing aggressive behaviors. All studies demonstrated that the use of verbal de-escalation techniques reduced physical restraint usage in patients. Additional benefits of verbal de-escalation were reduced patient seclusion episodes and the reduction of patient and staff injuries. The Iowa Model will be used for implementation of this project. It is used for implementation of evidence-based practice at the organizational level. The model is represented as an algorithm with defined decision points and feedback loops (Schaffer et al., 2012). The model uses input from multiple disciplines from the entire organization and involves nurses in each of the steps. Verbal de-escalation addresses the National Action Plan to Eliminate Seclusion and Restraint that was developed by Substance Abuse and Mental Health Services Administration (SAMHSA) in 2005 as well as safer care for patients and less risk for staff providing care.

Lesley Jackson

Bothwell Regional Health Center