| Course | NUR 453 Integration Concepts in the Health Care |
|---|---|
| Module | Module 1 |
| Paper type | Group presentation slides with speaker notes |
| Length | About 549 words, 4 pages |
| Format | APA 7 slide deck with speaker notes |
| School | Arizona State University |
| Program | BSN in Nursing |
| Updated | October 2026 |
Free sample paper for NUR 453 Module 1
Waiting in Room 12: Youth Mental Health Boarding in American Emergency Departments
Student Name
Edson College of Nursing and Health Innovation, Arizona State University
NUR 453: Integration Concepts in the Health Care
Instructor Name
Month Day, Year
Slide 1: Waiting in Room 12
Title slide with a photo description: an emergency department room with the bed stripped of cords and a sitter's chair by the door.
Speaker notes: Room 12 in many pediatric emergency departments is the room set aside for a child at risk of self-harm. Tonight we will talk about the children who stay in that room for days.
Slide 2: What Boarding Means
Definition: a patient who needs admission or transfer but remains in the emergency department because no bed is available.
Speaker notes: For youth with mental health emergencies, boarding means waiting for an inpatient psychiatric bed in a space built for short stays and medical emergencies, often with no therapy and little activity.
Slide 3: A Rising Tide
Mental health visits rose from 4.8 million to 7.5 million a year among U.S. youth between 2011 and 2020; suicide-related visits grew from 0.9% to 4.2% of all pediatric visits.
Speaker notes: These national figures come from emergency department survey data analyzed by Bommersbach et al. (2023). The share of pediatric visits that were for mental health nearly doubled in a decade.
Slide 4: Who Waits Longest
In one children's hospital, 22% of mental health visits lasted 24 hours or longer. Longer stays were linked to psychosis or mania, aggression, prior psychiatric admission, autism or developmental delay, restraint use and visits during school months.
Speaker notes: Hoffmann et al. (2019) found that the children with the most complex needs waited longest, and that insurance type also mattered, which tells us beds are not the only barrier.
Slide 5: Harms of Boarding
For youth: delayed treatment, worsening symptoms, restraint, missed school. For families: lost work, uncertainty. For staff: moral distress, crowding.
Speaker notes: A psychiatric association resource document describes boarding as harmful to patients and the departments that hold them, delaying care and using scarce emergency space (Nordstrom et al., 2019).
Slide 6: What Families and Clinicians Say
Interviews with parents and clinicians: unclear roles, poor communication with families, unsuitable rooms and clinician moral distress.
Speaker notes: McCarty et al. (2022) interviewed 11 parents and 19 clinicians. Parents described long stretches with no plan; clinicians described feeling unprepared to give mental health care in an emergency setting.
Slide 7: Why It Happens
Too few pediatric psychiatric beds; workforce shortages; slow transfers; payment rules that favor short stays; limited community crisis services.
Speaker notes: Boarding is a system problem. The emergency department is the place where gaps in the rest of the mental health system become visible.
Slide 8: What Has Been Tried
Telepsychiatry in emergency departments, crisis stabilization units, mobile crisis teams, payment changes for psychiatric beds.
Speaker notes: In South Carolina, a statewide emergency telepsychiatry program was associated with fewer inpatient admissions and more outpatient follow-up (Narasimhan et al., 2015), one example of a solution aimed at the emergency department itself.
Slide 9: Questions for Our Individual Innovations
How might nurses shorten the wait? How might nurses make the wait therapeutic? How might nurses keep families informed? How might nurses prevent the visit in the first place?
Speaker notes: Each of us will take one of these questions into our individual innovation papers.
Slide 10: References and Discussion
Questions for the class.
Speaker notes: Thank you. We welcome questions, especially from anyone who has cared for a boarding patient in clinical.
References
Bommersbach, T. J., McKean, A. J., Olfson, M., & Rhee, T. G. (2023). National trends in mental health-related emergency department visits among youth, 2011-2020. JAMA, 329(17), 1469-1477. https://doi.org/10.1001/jama.2023.4809
Hoffmann, J. A., Stack, A. M., Monuteaux, M. C., Levin, R., & Lee, L. K. (2019). Factors associated with boarding and length of stay for pediatric mental health emergency visits. The American Journal of Emergency Medicine, 37(10), 1829-1835. https://doi.org/10.1016/j.ajem.2018.12.041
McCarty, E. J., Nagarajan, M. K., Halloran, S. R., Brady, R. E., House, S. A., & Leyenaar, J. K. (2022). Healthcare quality during pediatric mental health boarding: A qualitative analysis. Journal of Hospital Medicine, 17(10), 783-792. https://doi.org/10.1002/jhm.12906
Narasimhan, M., Druss, B. G., Hockenberry, J. M., Royer, J., Weiss, P., Glick, G., Marcus, S. C., & Magill, J. (2015). Impact of a telepsychiatry program at emergency departments statewide on the quality, utilization, and costs of mental health services. Psychiatric Services, 66(11), 1167-1172. https://doi.org/10.1176/appi.ps.201400122
Nordstrom, K., Berlin, J. S., Nash, S. S., Shah, S. B., Schmelzer, N. A., & Worley, L. L. M. (2019). Boarding of mentally ill patients in emergency departments: American Psychiatric Association resource document. Western Journal of Emergency Medicine, 20(5), 690-695. https://doi.org/10.5811/westjem.2019.6.42422
Reading the NUR 453 Module 1 assignment instructions
The posted syllabus grades the Group Health Care in America presentation at 25 of the course's 200 points, and it starts the main project of NUR 453. A team chooses a current issue in American health care and presents it to the class; each member then develops an individual innovation that responds to the issue through a logic model with SMART goals, an evidence table, an outline, a full paper and a poster. The rubric and presentation length are in Canvas. Expect the presentation to define the issue, show its scale with current data, explain who is affected and why it persists, and point toward possible solutions. Because your individual work builds on it, choose an issue broad enough that each teammate can find a distinct innovation within it, and agree early on who presents which slides.
Inside the NUR 453 Module 1 example
The ten slides follow a simple arc: a concrete opening image, a definition, the national trend, who waits longest, the harms, what families and clinicians say, why the problem exists, what has been tried and four questions for individual innovations. Each slide pairs a brief on-screen line with speaker notes, and every figure is attributed to a source in the notes. The harms slide combines patient, family and staff perspectives, and the qualitative slide brings parents' and clinicians' voices into a presentation otherwise built on numbers. The final content slide hands each team member a question to develop. Five peer-reviewed sources support the presentation.
Where the marks sit in the NUR 453 Module 1 rubric
Group presentations in this course are likely scored on a clear definition of the issue, current and accurate data, analysis of causes and affected populations, evidence that the team researched solutions, organization, delivery, teamwork and APA citation on the slides. Data earn credit when they are recent and attributed. Analysis of why an issue persists shows systems thinking beyond describing the problem. Including perspectives from patients or families adds depth. A closing slide that sets up individual work shows the team understands how the presentation fits the course. Even speaking time across members and smooth transitions affect the delivery score.
NUR 453 Module 1 help from the desk
A common weakness in group presentations is a stack of statistics with no explanation of causes. Add a slide on why the problem persists. Another is too much text on slides; keep short phrases on screen and put detail in your notes. Check that every number has a source and a year. Practice handoffs between speakers so the presentation feels like one talk. If your team would like a draft deck on the issue it chose, describe the issue and the rubric to the desk and slides can be outlined. Agree on one citation style for all slides before you merge them. Leave time at the end for the class's questions.
Write yours, or have the desk draft it
This paper is an original model document written by our desk, not a submitted student paper and not an official Arizona State University document. Read it for the moves, then write your own to the instructions in your classroom. If you want one built to your exact prompt and rubric, the first custom sample is free and arrives in 24 to 48 hours.
More NUR 453 and BSN in Nursing sample papers
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- NUR 453 Module 7: Paper 3: Individual HCA Innovation Paper Outline
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- NUR 350 Module 3: Evidence-Based Feasibility Table and Synthesis
- NUR 405 Module 1: AI Prioritization Activity
NUR 453 Module 1 questions, answered
Where can I find a free NUR 453 Module 1 sample paper?
The slides above are a complete NUR 453 Group Health Care in America presentation sample on youth mental health boarding, with speaker notes and five sources.
What is the Health Care in America presentation in NUR 453?
A group presentation on a current issue in American health care that each student then develops into an individual innovation paper and poster.
How many points is the NUR 453 group presentation worth?
The posted syllabus lists it at 25 of the course's 200 points.
What is emergency department boarding?
Keeping a patient who needs admission or transfer in the emergency department because no inpatient or psychiatric bed is available.
How do I choose an HCA issue for NUR 453?
Pick a current, well-documented issue broad enough that each team member can design a distinct nursing innovation within it.