At the end of a patient’s visit to an emergency department, there may be questions they hadn’t previously felt comfortable asking, or they might not fully understand what they need to know for their care.

In the five minutes taking their vital signs before discharge, the nurse can reconnect with the patient to address these needs, said Mandy Adkins, BSN, RN, CEN, TCRN, perioperative services nurse with UCHealth Medical Center of the Rockies.

“You’re one-on-one with the patient, and it slows you down enough to really address their concerns, recognize gaps in education and set them up for success,” she said.

In her previous role as a charge nurse with the UCHealth Emergency Room – Harmony Campus, Adkins developed her UEXCEL Level III project to improve quality, safety and patient satisfaction in freestanding emergency departments (ED) in the UCHealth Northern Colorado Region.

The project implemented a requirement for patients’ vital signs to be entered into the electronic health record within 30 minutes of discharge, before the after-visit summary is printed. The change was rolled out across all UCHealth freestanding EDs.

“In the emergency department, things move so quickly,” Adkins said. “If you don’t have vital signs before they leave, you can’t prove that they’re safe.”

The change led to a 22% increase in vital signs being recorded within the 30-minute window at the Harmony Campus location, and a 16% increase at the UCHealth Emergency Room – West Greeley, improving compliance with UCHealth’s Standards of Nursing Practice. Recording vital signs at the end of a visit can help avoid repeat visits and ensure the patient is indeed ready to go home.

 

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The visual companion to our 2026 Nursing Year in Review showcases the print edition’s visual storytelling with connections to all of the articles.