Date of Degree

Spring 2026

Document Type

DNP Scholarly Project

Academic Department

School of Nursing

Degree Type

Doctoral

Degree Name

Doctor of Nursing Practice

First Advisor

Lydia Forsythe

Abstract

Problem:

Delays in computed tomography (CT) imaging contribute to prolonged emergency department (ED) length of stay and delayed clinical decision-making. At the project site, baseline data demonstrated an average ASAP CT order-to-scan time of approximately 116 minutes for non-critical ED patients, with CT readiness compliance rates of 0%. Gap analysis identified inconsistent patient preparation and fragmented communication between ED nursing and radiology as key contributors to avoidable delays. PICOT question: In non-emergent emergency department (ED) patients (P), how does the use of a CT readiness checklist by ED nurses (I), compared with no standardized readiness checklist (C), affect patient readiness and CT order-to-scan time (O) over 12 weeks (T)?

Aim of the Project:

This quality improvement project aimed to reduce CT order-to-scan turnaround time for non-critical ED patients by improving communication and standardizing CT readiness processes through a nursing-led intervention.

Review of the Evidence:

Current evidence supports standardized readiness tools, structured nurse-to-radiology communication, and audit-and-feedback strategies to reduce diagnostic imaging delays in emergency settings. The literature also highlights the effectiveness of iterative quality improvement frameworks and stakeholder engagement in sustaining workflow improvements.

Project Design:

This project used a quality improvement design guided by the Plan–Do–Study–Act (PDSA) framework and supported by the OhioHealth Change Management Model. Two complete PDSA cycles were conducted over an eight-week period to test, refine, and sustain workflow changes addressing both process and behavioral components of practice change.

Intervention:

The intervention involved implementing the Scan-Ready Passport, a standardized checklist used to verify patient readiness and to prompt direct nurse-to-radiology communication. Education, just-in-time coaching, and leadership reinforcement supported adoption across shifts.

Significant Findings/Outcomes:

Implementation of the intervention improved CT readiness compliance and reduced CT order-to-scan delays, with workflow stabilization following policy alignment and reinforcement. CT TAT from order to scan reduced from a baseline of 116 to 72.5 minutes during peak compliance.  Readiness compliance improved from 0% at baseline to a peak of 47.3% with fluctuation in some weeks.

Implications for Nursing:

This project demonstrates the impact of nursing-led communication interventions on diagnostic efficiency. It underscores the role of nurses in driving quality improvement, interdepartmental collaboration, and sustainable practice change in emergency care settings.

Rights

Copyright, all rights reserved

Included in

Nursing Commons

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