2.50
Hdl Handle:
http://hdl.handle.net/10755/162374
Type:
Presentation
Title:
ED Triage - Putting the Nurse First
Abstract:
ED Triage - Putting the Nurse First
Conference Sponsor:Emergency Nurses Association
Conference Year:2010
Author:Delpais, Paul A., RN BSN CEN
P.I. Institution Name:Lehigh Valley Health Network-Cedar Crest
Title:Director, Emergency Services
Contact Address:1200 South Cedar Crest Blvd, Allentown, PA, 18105, USA
Contact Telephone:610-402-8112
Co-Authors:Neil Kocher RN, CEN
[ENA Annual Conference - Evidence-based Practice Presentation]

Purpose: As a Level I Trauma Center and regional referral center, it was not uncommon to have multiple "sick" patients present to the ED waiting room simultaneously. Quickly and accurately triaging these patients was difficult in the current system. A retrospective review of door to RN times and anecdotal stories of near misses led to a need for a change in process.

Design: ED nurses and physicians realized that volume growth combined with lack of physical treatment space, there was a great potential for a bad outcome in the ED waiting room. A change in processes and patient flow would need to happen to improve patient safety and patient satisfaction.

Setting: The presenting organization is a Level I Trauma Center, ABA Verified Regional Burn Center, Certified Chest Pain Center, and Primary Stroke Center. The ED has a current annual visit volume of 72,000 per year.

Participants/Subjects: Participants included Registered Nurses, Emergency Providers, Unlicensed Assistive Personnel, and Registrars.

Methods: Door to Triage, or Door to RN times were captured pre and post interventions. PressGaney data was collected pre and post interventions. A multidisciplinary team was formed to design and implement a process change that would result in a goal of 95% of patients being seen by an RN in under ten minutes from arrival. The process was changed from the patient being greeted by a non-clinical registrar to an RN. The RN gathers name, DOB, and chief complaint. The RN assigns an ESI score and the patient is either fast-bedded or placed in the appropriate queue for full triage or nurse protocol diagnostic studies.

Results/Outcomes: Door to Triage average decreased from 14 minutes to 4 minutes. Percentage of patients seen by an RN in under 10 minutes of arrival increased from 63% to 96%. PressGaney scores increased from 86.4 to 91.3.

Implications: By having a RN as the patient's first point of contact, the patient is efficiently and appropriately triaged to an ED treatment room versus spending up to 30-60 minutes in a queue waiting for evaluation by clinical staff.


Repository Posting Date:
27-Oct-2011
Date of Publication:
17-Oct-2011
Sponsors:
Emergency Nurses Association

Full metadata record

DC FieldValue Language
dc.typePresentationen_GB
dc.titleED Triage - Putting the Nurse Firsten_GB
dc.identifier.urihttp://hdl.handle.net/10755/162374-
dc.description.abstract<table><tr><td colspan="2" class="item-title">ED Triage - Putting the Nurse First</td></tr><tr class="item-sponsor"><td class="label">Conference Sponsor:</td><td class="value">Emergency Nurses Association</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">Delpais, Paul A., RN BSN CEN</td></tr><tr class="item-institute"><td class="label">P.I. Institution Name:</td><td class="value">Lehigh Valley Health Network-Cedar Crest</td></tr><tr class="item-author-title"><td class="label">Title:</td><td class="value">Director, Emergency Services</td></tr><tr class="item-address"><td class="label">Contact Address:</td><td class="value">1200 South Cedar Crest Blvd, Allentown, PA, 18105, USA</td></tr><tr class="item-phone"><td class="label">Contact Telephone:</td><td class="value">610-402-8112</td></tr><tr class="item-email"><td class="label">Email:</td><td class="value">Paul_A.Delpais@lvh.com</td></tr><tr class="item-co-authors"><td class="label">Co-Authors:</td><td class="value">Neil Kocher RN, CEN</td></tr><tr><td colspan="2" class="item-abstract">[ENA Annual Conference - Evidence-based Practice Presentation]<br/><br/>Purpose: As a Level I Trauma Center and regional referral center, it was not uncommon to have multiple &quot;sick&quot; patients present to the ED waiting room simultaneously. Quickly and accurately triaging these patients was difficult in the current system. A retrospective review of door to RN times and anecdotal stories of near misses led to a need for a change in process.<br/><br/>Design: ED nurses and physicians realized that volume growth combined with lack of physical treatment space, there was a great potential for a bad outcome in the ED waiting room. A change in processes and patient flow would need to happen to improve patient safety and patient satisfaction.<br/><br/>Setting: The presenting organization is a Level I Trauma Center, ABA Verified Regional Burn Center, Certified Chest Pain Center, and Primary Stroke Center. The ED has a current annual visit volume of 72,000 per year.<br/><br/>Participants/Subjects: Participants included Registered Nurses, Emergency Providers, Unlicensed Assistive Personnel, and Registrars.<br/><br/>Methods: Door to Triage, or Door to RN times were captured pre and post interventions. PressGaney data was collected pre and post interventions. A multidisciplinary team was formed to design and implement a process change that would result in a goal of 95% of patients being seen by an RN in under ten minutes from arrival. The process was changed from the patient being greeted by a non-clinical registrar to an RN. The RN gathers name, DOB, and chief complaint. The RN assigns an ESI score and the patient is either fast-bedded or placed in the appropriate queue for full triage or nurse protocol diagnostic studies. <br/><br/>Results/Outcomes: Door to Triage average decreased from 14 minutes to 4 minutes. Percentage of patients seen by an RN in under 10 minutes of arrival increased from 63% to 96%. PressGaney scores increased from 86.4 to 91.3.<br/><br/>Implications: By having a RN as the patient's first point of contact, the patient is efficiently and appropriately triaged to an ED treatment room versus spending up to 30-60 minutes in a queue waiting for evaluation by clinical staff. <br/><br/><br/></td></tr></table>en_GB
dc.date.available2011-10-27T10:27:06Z-
dc.date.issued2011-10-17en_GB
dc.date.accessioned2011-10-27T10:27:06Z-
dc.description.sponsorshipEmergency Nurses Associationen_GB
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