Street Nursing 101: Caring for the Homeless Population

Homelessness presents significant public health challenges, contributing to higher rates of chronic illness, mental health conditions, and overutilization of emergency departments. This project implemented the Street Nursing 101 educational program to enhance nurses' competence and improve care for homeless patients in the emergency department.

A quantitative approach, guided by the Iowa Model of Evidence-Based Practice, supported the implementation of an online training program centered on homelessness care. Nurse competence was assessed using the PROFFNurse SAS II, modified HCAHPS surveys for patient experience, and hospital data for emergency department visit trends.

Nurse competence mean scores improved from 5 to 8.0, reflecting increased confidence. Perceived training needs dropped from a mean of 8.25 to 4, indicating nurses felt more prepared without requiring immediate additional training. Patient feedback showed a slight decline in reports of "Always" courteous and respectful care, but a significant reduction in "Never" listened-to complaints. Ratings for communication, discharge planning, and aftercare education improved, while non-emergent emergency department visits by homeless patients decreased by 4.6% (from 304 to 290).

This initiative successfully improved nurse competence, patient feedback experience, and non-emergent visits. By addressing communication gaps, discharge support, and nurse preparedness, Street Nursing 101 provides a replicable model to reduce health care disparities and enhance care delivery for homeless populations in emergency department settings.