2.50
Hdl Handle:
http://hdl.handle.net/10755/162398
Type:
Presentation
Title:
Converting the Waiting Room to an Early Treatment Area
Abstract:
Converting the Waiting Room to an Early Treatment Area
Conference Sponsor:Emergency Nurses Association
Conference Year:2010
Author:Parone, Dominic, RN, BSN,CEN
P.I. Institution Name:Virtua Memorial Hospital
Title:Staff Nurse
Contact Address:175 Madison Ave, Mt. Holly, NJ, 08060, USA
Contact Telephone:609-929-7632
Co-Authors: Timothy D. Marks, RN, MSN, CEN
[ENA Annual Conference - Evidence-based Practice Presentation]

Purpose: The Emergency Department (ED) waiting room is an area of opportunity for the initiation of early treatment of patients. This can reduce overall throughput times, increase patient satisfaction scores, and decrease the rate of left without being seen (LWOBS).

Design: The Early Treatment Area (ETA) project was designed as a quality improvement project. The ETA project was launched in March 2007 and data was collected and analyzed retrospectively from March 2007 to September 2009. Data sources included the EDÆs electronic medical records and the Press Ganey patient satisfaction database.

Setting: A 433-bed Joint Commission and stroke accredited, community-based hospital, located in Southern New Jersey. The ED uses 43 treatment areas to care for an average of 75,000 patients per year.

Participants/Subjects: The ETA project included every patient who presented to the ED. Patients who met the criteria for our advanced nursing treatment guidelines had interventions started while waiting for a treatment room.

Methods: Once triaged, the triage nurse selects from one of the 14 preapproved Nursing Care Guidelines that is the most appropriate to the patient's complaint and unique factors. These guidelines address complaints such as generalized pain, asthma, abdominal pain, suspected stroke and chest pain. The triage nurse administers any necessary medications. The ED technician assists with all diagnostic testing that is ordered as a part of the guidelines (e.g., EKGs, X-rays, Point of care tesing, blood and/or urine tests).

Results/Outcomes: Within a month of implementation, LWOBS rates dropped by 22% and continued to drop a total of 69% after 30 months. Patient satisfaction increased 182% within a month and continued to increase 213% after 30 months. Door to disposition time decreased by 11.5% within a month and continued to decrease 18% by the conclusion of the 30 month period. In addition staff satisfaction increased. The overall job satisfaction rate increased from 84% to 95 % over a two year period, according to an annual employee opinion survey. In addition the ED employee turnover rate decreased from 14% to 0 percent in 30 months. These matrixes improved despite a 25% increase in patient volume during the 30 month period

Implications: The waiting room in the ED is an area of great potential for improving the timely care of patients. Nursing care guidelines serve as a tool that can facilitate nursing interventions in triage and enhance patient's safety and correct placement in an overcrowded ED environment. With the right processes and support in place, patients can receive nurse- initiated, quality care shortly after arrival to the ED.
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.titleConverting the Waiting Room to an Early Treatment Areaen_GB
dc.identifier.urihttp://hdl.handle.net/10755/162398-
dc.description.abstract<table><tr><td colspan="2" class="item-title">Converting the Waiting Room to an Early Treatment Area</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">Parone, Dominic, RN, BSN,CEN</td></tr><tr class="item-institute"><td class="label">P.I. Institution Name:</td><td class="value">Virtua Memorial Hospital</td></tr><tr class="item-author-title"><td class="label">Title:</td><td class="value">Staff Nurse</td></tr><tr class="item-address"><td class="label">Contact Address:</td><td class="value">175 Madison Ave, Mt. Holly, NJ, 08060, USA</td></tr><tr class="item-phone"><td class="label">Contact Telephone:</td><td class="value">609-929-7632</td></tr><tr class="item-email"><td class="label">Email:</td><td class="value">enorap@comcast.net</td></tr><tr class="item-co-authors"><td class="label">Co-Authors:</td><td class="value"> Timothy D. Marks, RN, MSN, CEN</td></tr><tr><td colspan="2" class="item-abstract">[ENA Annual Conference - Evidence-based Practice Presentation] <br/><br/>Purpose: The Emergency Department (ED) waiting room is an area of opportunity for the initiation of early treatment of patients. This can reduce overall throughput times, increase patient satisfaction scores, and decrease the rate of left without being seen (LWOBS). <br/><br/>Design: The Early Treatment Area (ETA) project was designed as a quality improvement project. The ETA project was launched in March 2007 and data was collected and analyzed retrospectively from March 2007 to September 2009. Data sources included the ED&AElig;s electronic medical records and the Press Ganey patient satisfaction database. <br/><br/>Setting: A 433-bed Joint Commission and stroke accredited, community-based hospital, located in Southern New Jersey. The ED uses 43 treatment areas to care for an average of 75,000 patients per year. <br/><br/>Participants/Subjects: The ETA project included every patient who presented to the ED. Patients who met the criteria for our advanced nursing treatment guidelines had interventions started while waiting for a treatment room. <br/><br/>Methods: Once triaged, the triage nurse selects from one of the 14 preapproved Nursing Care Guidelines that is the most appropriate to the patient's complaint and unique factors. These guidelines address complaints such as generalized pain, asthma, abdominal pain, suspected stroke and chest pain. The triage nurse administers any necessary medications. The ED technician assists with all diagnostic testing that is ordered as a part of the guidelines (e.g., EKGs, X-rays, Point of care tesing, blood and/or urine tests). <br/><br/>Results/Outcomes: Within a month of implementation, LWOBS rates dropped by 22% and continued to drop a total of 69% after 30 months. Patient satisfaction increased 182% within a month and continued to increase 213% after 30 months. Door to disposition time decreased by 11.5% within a month and continued to decrease 18% by the conclusion of the 30 month period. In addition staff satisfaction increased. The overall job satisfaction rate increased from 84% to 95 % over a two year period, according to an annual employee opinion survey. In addition the ED employee turnover rate decreased from 14% to 0 percent in 30 months. These matrixes improved despite a 25% increase in patient volume during the 30 month period<br/><br/>Implications: The waiting room in the ED is an area of great potential for improving the timely care of patients. Nursing care guidelines serve as a tool that can facilitate nursing interventions in triage and enhance patient's safety and correct placement in an overcrowded ED environment. With the right processes and support in place, patients can receive nurse- initiated, quality care shortly after arrival to the ED.<br/></td></tr></table>en_GB
dc.date.available2011-10-27T10:27:32Z-
dc.date.issued2011-10-17en_GB
dc.date.accessioned2011-10-27T10:27:32Z-
dc.description.sponsorshipEmergency Nurses Associationen_GB
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