Phoebe Girgis

Date on Paper


Document Type

Doctoral Paper

Degree Name




Committee Chair

Coty, Mary Beth

Committee Member

Adelstein, Kate

Author's Keywords

TeamSTEPPS; improving communication; teamwork; Huddle; Nursing staff; ED


Background: Emergency Department (ED) nurses are experiencing a rise in patient visits, staffing shortages, lower levels of job satisfaction, higher nurse to patient ratios, increased acuity for trauma patients, and increased psychiatric admissions. Tension, frustration, and breakdowns in communication are among reasons for lateral violence among emergency nursing staff.

Setting: This evidence-based practice project took place at a level one trauma academic medical center in the Southeastern region of the United States. Emergency Psychiatric Services (EPS) is a subunit within the ED which has a capacity of 24 patients for psychiatric services. The main ED, Medical ED (MED), or the Medical Emergency Room (MER) is the part of the ED that treats physical trauma and any medical condition. The MER has a capacity of 31 treatment beds.

Purpose: The purpose of this evidence-based practice (EBP) scholarly project was to improve communication and professional relationships/teamwork among nurses working in the ED, specifically between the MER and EPS.

Procedures: This project consisted of two phases: 1) an educational content session focused on professional communication and teamwork and 2) implementation of a safety huddle between MER and EPS nurses (RNs). The education and safety huddle were based on Team Strategies and Tools to Enhance Performance and Patient Safety (TeamSTEPPS).

Method: Nurses in the MER and EPS completed a pre-test prior to the educational session and a post-test at the completion of the TeamSTEPPS educational content and implementation of the Huddle. Improvement in communication and teamwork among the RNs were measured by the TeamSTEPPS Teamwork Perceptions Questionnaire (TTPQ) and TeamSTEPPS Teamwork Attitudes Questionnaire (TTAQ). Data collected from the TTPQ and TTAQ were analyzed by descriptive analysis and an independent t-test.

Results: The results of this study showed that there was an increase in TeamSTEPPS knowledge rom pre-test to post-test. The independent t-test revealed that there was no statistically significant difference between the pre- and post-tests using the TTPQ (P=.988 & .904) and TTAQ (P=.779 & .898). There was a measurable decrease in the number of patients who needed to be transferred back to the MED from EPS during the huddle intervention implementation.

Included in

Nursing Commons