2.50
Hdl Handle:
http://hdl.handle.net/10755/157437
Type:
Presentation
Title:
USE OF NURSE PRACTITIONERS TO IMPROVE ACCESS TO EMERGENCY CARE
Abstract:
USE OF NURSE PRACTITIONERS TO IMPROVE ACCESS TO EMERGENCY CARE
Conference Sponsor:Western Institute of Nursing
Conference Year:2010
Author:Abbott, Patricia D., PhD, RN, FNPc
P.I. Institution Name:University of Washington
Title:Post Doc
Contact Address:1959 NE Pacific, Box 356123, Seattle, WA, 98195, USA
Co-Authors:Brenda K. Zierler; Debbie Ward; Karen G. Schepp
BACKGROUND:
Emergency departments (EDs) have evolved into the "safety net" for the health care system in the United States. With increasing numbers of patients presenting to fewer and overcrowded EDs, the safety of this net is at risk unless changes are made. Despite over 35 years of working in EDs there is a paucity of data on how to effectively utilize NPs in this setting. Use of NPs in EDs may be a cost-effective approach to increase access to care and ease overcrowding which is known to compromise the safety of care in EDs.
PURPOSE:
The purpose of this descriptive research was to ascertain existing staffing patterns and utilization of NPs and physician assistants (PAs) in ED practice in Washington (WA) and Oregon (OR). With further clarity of how NPs/PAs were currently utilized, future models of care could be developed to inform practice and drive policy to ensure consistent, effective and safe utilization of these providers.
METHODS:
The descriptive study utilized a web-based survey developed by the researcher to meet aims of research. The 37 item survey asked questions on operational and organizational characteristics and ED managerÆs understanding of NP/PA roles. Surveys were sent to managers in all EDs in WA and OR (n=158) in March 2009. Data analyses to obtain descriptive and chi-square statistics were completed using SPSS version 17.0. The study was approved by the institutional internal review board.
RESULTS:
Ninety-three hospitals (59 WA/ 34 OR) responded to the survey, a 59% response rate. 58% of the respondents used NPs and or PAs. Larger, urban hospitals who reported overcrowding employed these providers more often than smaller, rural hospitals in both States. Chi-square statistics showed a significant interaction between size (p < .05), location (p < .05) and the use of NP/PAs. Nurse practitioners/ PAs were used in a variety of staffing models: 59% in ED seeing non-emergent patients only, 50% in ED seeing both emergent and non-emergent patients and 46% in a designated non-emergent area. 17% of mangers employing and supervising NPs & PAs were unclear on the differences between the roles. 89% of managers indicated that the use of these providers improved timeliness of ED care by decreasing wait times and lengths of stay in the ED. 48% of the mangers that employed NPs/PAs indicated a willingness to be further interviewed.
IMPLICATIONS:
The findings of this study provided data on how this workforce delivered care in ED systems. These data will help ED managers understand the dynamics of the NP/PA roles to ensure that billing, supervision and management of these providers is optimal. The findings of this research will inform current practice and may help to drive policy at the micro and macro levels for the optimal staffing model in EDs. Future studies to evaluate models of care that include NPs/PAs to improve access to acute and urgent care, patient safety, and clinical outcomes while decreasing overcrowding need to be completed.
Repository Posting Date:
26-Oct-2011
Date of Publication:
17-Oct-2011
Sponsors:
Western Institute of Nursing

Full metadata record

DC FieldValue Language
dc.typePresentationen_GB
dc.titleUSE OF NURSE PRACTITIONERS TO IMPROVE ACCESS TO EMERGENCY CAREen_GB
dc.identifier.urihttp://hdl.handle.net/10755/157437-
dc.description.abstract<table><tr><td colspan="2" class="item-title">USE OF NURSE PRACTITIONERS TO IMPROVE ACCESS TO EMERGENCY CARE</td></tr><tr class="item-sponsor"><td class="label">Conference Sponsor:</td><td class="value">Western Institute of Nursing</td></tr><tr class="item-year"><td class="label">Conference Year:</td><td class="value">2010</td></tr><tr class="item-author"><td class="label">Author:</td><td class="value">Abbott, Patricia D., PhD, RN, FNPc</td></tr><tr class="item-institute"><td class="label">P.I. Institution Name:</td><td class="value">University of Washington</td></tr><tr class="item-author-title"><td class="label">Title:</td><td class="value">Post Doc</td></tr><tr class="item-address"><td class="label">Contact Address:</td><td class="value">1959 NE Pacific, Box 356123, Seattle, WA, 98195, USA</td></tr><tr class="item-email"><td class="label">Email:</td><td class="value">pda@uw.edu</td></tr><tr class="item-co-authors"><td class="label">Co-Authors:</td><td class="value">Brenda K. Zierler; Debbie Ward; Karen G. Schepp</td></tr><tr><td colspan="2" class="item-abstract">BACKGROUND: <br/>Emergency departments (EDs) have evolved into the &quot;safety net&quot; for the health care system in the United States. With increasing numbers of patients presenting to fewer and overcrowded EDs, the safety of this net is at risk unless changes are made. Despite over 35 years of working in EDs there is a paucity of data on how to effectively utilize NPs in this setting. Use of NPs in EDs may be a cost-effective approach to increase access to care and ease overcrowding which is known to compromise the safety of care in EDs. <br/>PURPOSE: <br/>The purpose of this descriptive research was to ascertain existing staffing patterns and utilization of NPs and physician assistants (PAs) in ED practice in Washington (WA) and Oregon (OR). With further clarity of how NPs/PAs were currently utilized, future models of care could be developed to inform practice and drive policy to ensure consistent, effective and safe utilization of these providers. <br/>METHODS: <br/>The descriptive study utilized a web-based survey developed by the researcher to meet aims of research. The 37 item survey asked questions on operational and organizational characteristics and ED manager&AElig;s understanding of NP/PA roles. Surveys were sent to managers in all EDs in WA and OR (n=158) in March 2009. Data analyses to obtain descriptive and chi-square statistics were completed using SPSS version 17.0. The study was approved by the institutional internal review board. <br/>RESULTS: <br/>Ninety-three hospitals (59 WA/ 34 OR) responded to the survey, a 59% response rate. 58% of the respondents used NPs and or PAs. Larger, urban hospitals who reported overcrowding employed these providers more often than smaller, rural hospitals in both States. Chi-square statistics showed a significant interaction between size (p &lt; .05), location (p &lt; .05) and the use of NP/PAs. Nurse practitioners/ PAs were used in a variety of staffing models: 59% in ED seeing non-emergent patients only, 50% in ED seeing both emergent and non-emergent patients and 46% in a designated non-emergent area. 17% of mangers employing and supervising NPs &amp; PAs were unclear on the differences between the roles. 89% of managers indicated that the use of these providers improved timeliness of ED care by decreasing wait times and lengths of stay in the ED. 48% of the mangers that employed NPs/PAs indicated a willingness to be further interviewed. <br/>IMPLICATIONS: <br/>The findings of this study provided data on how this workforce delivered care in ED systems. These data will help ED managers understand the dynamics of the NP/PA roles to ensure that billing, supervision and management of these providers is optimal. The findings of this research will inform current practice and may help to drive policy at the micro and macro levels for the optimal staffing model in EDs. Future studies to evaluate models of care that include NPs/PAs to improve access to acute and urgent care, patient safety, and clinical outcomes while decreasing overcrowding need to be completed.<br/></td></tr></table>en_GB
dc.date.available2011-10-26T19:52:21Z-
dc.date.issued2011-10-17en_GB
dc.date.accessioned2011-10-26T19:52:21Z-
dc.description.sponsorshipWestern Institute of Nursingen_GB
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