2.50
Hdl Handle:
http://hdl.handle.net/10755/162384
Type:
Presentation
Title:
Nurse Practitioner Accelerated Triage
Abstract:
Nurse Practitioner Accelerated Triage
Conference Sponsor:Emergency Nurses Association
Conference Year:2010
Author:Kamienski, Mary, PhD, APRN, FAEN, CEN
P.I. Institution Name:University of Medicine and Dentistry of New Jersey University Hospital
Title:Assistant Dean Graduate Program/Associate Professor
Contact Address:65 Bergen Street, Newark, NJ, 07101, USA
Contact Telephone:973-972-7451
Co-Authors:Barbara Carroll, MSN, DNPc ; Deborah Kanobel, MSN, DNPc
[ENA Annual Conference - Research Presentation]
Nurse Practitioners are in a pivotal position to help fill gaps in health care. Prolonged waiting times (WT) and subsequent left without being seen(LWBS) by a qualified healthcare provider are significant emergency department problems across the country (Levsky, Young, Masullo, Miller, Herold, 2008, Chan, Kileen, Kelly, Guss, 2005) and around the world (Grant, Spain, Green, 1999, Travers, & Lee, 2006, Terris, Leman, OÆConnor, Wood, 2004). Internationally, triage has been recognized as the domain of the emergency nurse (Choi, Wong, & Lau, 2006, Richardson, Braitberg, Yeoh, 2004, Spaite et al., 2002, Travers, & Lee, 2006, Terris, Leman, OÆConnor, Wood, 2004). Typically, triage and medical screening exams are two independent processes and in some institutions, both steps are handled separately by nursing (Nash, 2009). Combining the role of the triage nurse and the medical screening capability of the nurse practitioner creates a significantly positive impact on ED patient waiting times and left without being seen rates. The consolidation of these steps decreases ED patientsÆ waiting times and subsequent left without being seen rates before a medical screening exam (MSE) can be performed.

Purpose: The purpose of this study was to develop a new protocol that (1) reduced the length of time between the patient's ED arrival and receipt of an MSE(WT) and (2) reduced the number of ESI Level 3 patients who LWBS.

Design: A prospective design, with a retrospective database review was utilized.

Participants and Setting: The study was conducted at an urban Level 1 Trauma Center emergency department which treats 100,000 patients annually, with approximately 60,000 having an ESI Level 3 acuity (Muniz, 2008). Adult patients, ESI Level 3, of either sex, marital status, ethnic group, insured or uninsured were included in this study.

Protection of human subjects
Institutional Review Board approval was obtained. All patients were treated equally and their confidentiality protected by removal of any personal identifying information from the data reviewed.

Methods: All adults, ESI Level 3, who arrived between 7:00 AM on December 6, 2009 to 11:59 PM on December 12, 2009 were included in the pilot group. Time of arrival to MSE was extracted from the patients' charts after the study period ended. Retrospective data collection was conducted for the same time period one year prior. The historical group was triaged by an RN and had a subsequent MSE by an NP.
Using the EPIC tracking system, the researchers computed the WT for both the pilot and historical patients' groups. Data was also extracted to determine the number of patients in the pilot group who LWBS and compared to the historical group.

Data Analysis: Descriptive statistics was used to identify sample participants. A T-test compared the WT and the number of patients who LWBS by a medical provider during the accelerated triage pilot study and during the historical period.

Results: Data analysis is currently in progress.

Implications: NP accelerated triage significantly reduces ED waiting times and left without being seen rates for adult ESI Level 3 patients.
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.titleNurse Practitioner Accelerated Triageen_GB
dc.identifier.urihttp://hdl.handle.net/10755/162384-
dc.description.abstract<table><tr><td colspan="2" class="item-title">Nurse Practitioner Accelerated Triage</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">Kamienski, Mary, PhD, APRN, FAEN, CEN</td></tr><tr class="item-institute"><td class="label">P.I. Institution Name:</td><td class="value">University of Medicine and Dentistry of New Jersey University Hospital</td></tr><tr class="item-author-title"><td class="label">Title:</td><td class="value">Assistant Dean Graduate Program/Associate Professor</td></tr><tr class="item-address"><td class="label">Contact Address:</td><td class="value">65 Bergen Street, Newark, NJ, 07101, USA</td></tr><tr class="item-phone"><td class="label">Contact Telephone:</td><td class="value">973-972-7451</td></tr><tr class="item-email"><td class="label">Email:</td><td class="value">drmaryrn@aol.com; kamienma@umdnj.edu</td></tr><tr class="item-co-authors"><td class="label">Co-Authors:</td><td class="value">Barbara Carroll, MSN, DNPc ; Deborah Kanobel, MSN, DNPc</td></tr><tr><td colspan="2" class="item-abstract">[ENA Annual Conference - Research Presentation]<br/>Nurse Practitioners are in a pivotal position to help fill gaps in health care. Prolonged waiting times (WT) and subsequent left without being seen(LWBS) by a qualified healthcare provider are significant emergency department problems across the country (Levsky, Young, Masullo, Miller, Herold, 2008, Chan, Kileen, Kelly, Guss, 2005) and around the world (Grant, Spain, Green, 1999, Travers, &amp; Lee, 2006, Terris, Leman, O&AElig;Connor, Wood, 2004). Internationally, triage has been recognized as the domain of the emergency nurse (Choi, Wong, &amp; Lau, 2006, Richardson, Braitberg, Yeoh, 2004, Spaite et al., 2002, Travers, &amp; Lee, 2006, Terris, Leman, O&AElig;Connor, Wood, 2004). Typically, triage and medical screening exams are two independent processes and in some institutions, both steps are handled separately by nursing (Nash, 2009). Combining the role of the triage nurse and the medical screening capability of the nurse practitioner creates a significantly positive impact on ED patient waiting times and left without being seen rates. The consolidation of these steps decreases ED patients&AElig; waiting times and subsequent left without being seen rates before a medical screening exam (MSE) can be performed.<br/><br/>Purpose: The purpose of this study was to develop a new protocol that (1) reduced the length of time between the patient's ED arrival and receipt of an MSE(WT) and (2) reduced the number of ESI Level 3 patients who LWBS.<br/><br/>Design: A prospective design, with a retrospective database review was utilized. <br/><br/>Participants and Setting: The study was conducted at an urban Level 1 Trauma Center emergency department which treats 100,000 patients annually, with approximately 60,000 having an ESI Level 3 acuity (Muniz, 2008). Adult patients, ESI Level 3, of either sex, marital status, ethnic group, insured or uninsured were included in this study.<br/><br/>Protection of human subjects<br/> Institutional Review Board approval was obtained. All patients were treated equally and their confidentiality protected by removal of any personal identifying information from the data reviewed. <br/><br/>Methods: All adults, ESI Level 3, who arrived between 7:00 AM on December 6, 2009 to 11:59 PM on December 12, 2009 were included in the pilot group. Time of arrival to MSE was extracted from the patients' charts after the study period ended. Retrospective data collection was conducted for the same time period one year prior. The historical group was triaged by an RN and had a subsequent MSE by an NP. <br/> Using the EPIC tracking system, the researchers computed the WT for both the pilot and historical patients' groups. Data was also extracted to determine the number of patients in the pilot group who LWBS and compared to the historical group. <br/><br/>Data Analysis: Descriptive statistics was used to identify sample participants. A T-test compared the WT and the number of patients who LWBS by a medical provider during the accelerated triage pilot study and during the historical period. <br/> <br/>Results: Data analysis is currently in progress.<br/><br/>Implications: NP accelerated triage significantly reduces ED waiting times and left without being seen rates for adult ESI Level 3 patients. <br/></td></tr></table>en_GB
dc.date.available2011-10-27T10:27:16Z-
dc.date.issued2011-10-17en_GB
dc.date.accessioned2011-10-27T10:27:16Z-
dc.description.sponsorshipEmergency Nurses Associationen_GB
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