"Keep Calm and Carry On"

Publication Date

Spring 2026

Presentation Length

Poster/Gallery presentation

College

Gordon E. Inman College of Nursing

Department

Nursing, School of

Student Level

Undergraduate

Faculty Mentor

Linda Wofford

Presentation Type

Gallery

Summary

“Keep Calm and Carry On” is an initiative for psychiatric patients at a local emergency department to improve safety, quality of care, and staff preparedness for behavioral crises through de-escalation training with integrated simulation practice. Prolonged psychiatric boarding contributes to patient escalation, staff injury, and emotional distress in the emergency department. In Davidson County, 34% of individuals receiving crisis assessments required psychiatric hospitalization. Admission for these patients is delayed due to an inadequate number of available psychiatric hospital beds in middle Tennessee causing a delay in admission by an average of 2-7 days.

The unit nurse manager and nurse educators will implement this six-month initiative in three phases: baseline data collection; delivery of a hybrid training and simulation program; and post-implementation evaluation. Within 12 weeks, current staff and all newly hired nurses will complete training with a goal participation rate of 85%, followed by one 15-minute simulation practice in the unit after training completion. Expected outcomes include 80% increase in use of de-escalation strategies, 20% decrease in number of incident reports and security calls, and 70% increase in nurse confidence measured by Likert-scale surveys. Integration into annual competencies supports initiative sustainability and long-term positive outcomes for emergency department psychiatric patient boarding.

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