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Capstone Advisor: Dr. Matthew Wintersteen


Mental and behavioral health problems are on the rise among adolescents, and healthcare professionals are uniquely placed in Emergency Departments (ED) to intervene. The Behavioral Health Screen-Emergency Department (BHS-ED) was designed to assist pediatric emergency department (PED) providers in analyzing patients for these problems. An evaluation of the BHS-ED was conducted to identify the key perceived barriers and facilitators to PED staff nurses in administration of the screening tool. The nurses were asked to think about new guidelines and protocols associated with the BHS-ED. A semi-structured interview was conducted utilizing questions created from an iterative process of experts, with nurses (n=21) at The Children’s Hospital of Philadelphia (CHOP) in the summer of 2013. The interviews were audio recorded, transcribed, and coded to identify themes. The ED nurses all demonstrated a clear understanding of what mental and behavioral health means for a teenager, edifying the importance of this screening tool. The nurses stated that the largest barrier to utilization of the BHS-ED was the availability of time for this task. Another important barrier is patient acuity, where sometimes the teenagers are too sick to complete the screening tool. On the other hand, the most agreed upon facilitator to the ACASI tool was the adoption of a portable computer with the screening tool. These findings suggest that the BHS-ED has moved in the correct direction towards ubiquity in the CHOP ED. PED staff accepts the BHS-ED as a necessary and important part of adolescent emergency care, yet challenges do exist. The PED nurses highlighted BHS-ED advantages and disadvantages and have made apt suggestions for future planning for BHS-ED use.

Presentation: 25 minutes