2.50
Hdl Handle:
http://hdl.handle.net/10755/162561
Type:
Presentation
Title:
Development of a Multidisciplinary Emergency Medicine Triage System
Abstract:
Development of a Multidisciplinary Emergency Medicine Triage System
Conference Sponsor:Emergency Nurses Association
Conference Year:2010
Author:Bolivar-Cano, Marie D., RN, DNP, ACNP-BC, CRNP
P.I. Institution Name:University of Alabama at Birmingham University Hospital - Emergency Department
Title:Emergency Nurse Practitioner
Contact Address:NP 1342, 619 19th St. South, Birmingham, AL, 35249-7010, USA
Contact Telephone:205-934-5105
Co-Authors:Susan J. Appel, PhD, APRN, ACNP-BC, FNP-BC, CCRN;Janyce M. Sanford, MD, FACEP, FAAEM; Hilary E. Senter, RN, BSN; India Alford, RN, BSN
Leadership Conference - Evidence-Based Practice Abstract: Development of a Multidisciplinary Emergency Medicine Triage System

Purpose: Emergency department (ED) overcrowding is problematic nationally and globally. The objectives of this pilot project were threefold: to develop a multidisciplinary emergency medicine triage system, utilizing an emergency nurse practitioner (ENP) and an emergency nurse, with physician oversight, to rapidly assess and treat patients in triage who did not warrant an ED bed; to evaluate this system by implementing it in a Level One trauma center û emergency department; and to promulgate the findings of this project and develop recommendations and strategies for possible changes to the institutionÆs triage system and hopefully, alleviate ED overcrowding.

Design: This was a quality improvement project.

Setting: A 900+ bed, tertiary-care urban university teaching hospital emergency department, located in the southeastern U.S. with approximately 60,000 patient visits per year. The emergency department averages 150 patient visits a day.

Participants/Subjects: All levels three through five ED patients (based upon the institution's five-tier Emergency Severity Index triage system), ages 19 and older, who encountered the ambulatory patient entrance to the emergency department, were seen and treated by the ENP and emergency nurse.

Methods: A retrospective review of patient records was performed regarding the four-week pilot project. Comparisons were conducted on days that the ENP and emergency nurse were present in triage versus days without the ENP and emergency nurse in triage regarding the impact of left without being seen (LWBS) and length of stay (LOS).

Results/Outcomes: The ENP and emergency nurse were present in triage for a period of 13 days versus 17 days without presence. There were approximately 2656 patients evaluated. Preliminary findings demonstrate a decrease in LWBS with ENP-emergency nurse presence in triage, while LOS was not affected.

Implications: Having ENPs in ED triage, with continued support from all levels, positively influences clinical practice change regarding LWBS and LOS. ED overcrowding is an institutional problem, as well as a national problem, that necessitates a unified, collaborative effort in improving ED patient flow, increasing patient safety, and enhancing patient relations. The emergency nurse can augment the improvement of overall healthcare outcomes by obtaining a thorough triage assessment with re-assessment; implementing standing orders/protocols, if any; informing patients of status; and communicating findings to a physician or ENP. An effective ED triage class with yearly updates/training and participation in triage projects/programs can also be beneficial.

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.titleDevelopment of a Multidisciplinary Emergency Medicine Triage Systemen_GB
dc.identifier.urihttp://hdl.handle.net/10755/162561-
dc.description.abstract<table><tr><td colspan="2" class="item-title">Development of a Multidisciplinary Emergency Medicine Triage System</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">Bolivar-Cano, Marie D., RN, DNP, ACNP-BC, CRNP</td></tr><tr class="item-institute"><td class="label">P.I. Institution Name:</td><td class="value">University of Alabama at Birmingham University Hospital - Emergency Department</td></tr><tr class="item-author-title"><td class="label">Title:</td><td class="value">Emergency Nurse Practitioner</td></tr><tr class="item-address"><td class="label">Contact Address:</td><td class="value">NP 1342, 619 19th St. South, Birmingham, AL, 35249-7010, USA</td></tr><tr class="item-phone"><td class="label">Contact Telephone:</td><td class="value">205-934-5105</td></tr><tr class="item-email"><td class="label">Email:</td><td class="value">anati2ud@hotmail.com</td></tr><tr class="item-co-authors"><td class="label">Co-Authors:</td><td class="value">Susan J. Appel, PhD, APRN, ACNP-BC, FNP-BC, CCRN;Janyce M. Sanford, MD, FACEP, FAAEM; Hilary E. Senter, RN, BSN; India Alford, RN, BSN</td></tr><tr><td colspan="2" class="item-abstract">Leadership Conference - Evidence-Based Practice Abstract: Development of a Multidisciplinary Emergency Medicine Triage System<br/><br/>Purpose: Emergency department (ED) overcrowding is problematic nationally and globally. The objectives of this pilot project were threefold: to develop a multidisciplinary emergency medicine triage system, utilizing an emergency nurse practitioner (ENP) and an emergency nurse, with physician oversight, to rapidly assess and treat patients in triage who did not warrant an ED bed; to evaluate this system by implementing it in a Level One trauma center &ucirc; emergency department; and to promulgate the findings of this project and develop recommendations and strategies for possible changes to the institution&AElig;s triage system and hopefully, alleviate ED overcrowding. <br/><br/>Design: This was a quality improvement project.<br/><br/>Setting: A 900+ bed, tertiary-care urban university teaching hospital emergency department, located in the southeastern U.S. with approximately 60,000 patient visits per year. The emergency department averages 150 patient visits a day.<br/><br/>Participants/Subjects: All levels three through five ED patients (based upon the institution's five-tier Emergency Severity Index triage system), ages 19 and older, who encountered the ambulatory patient entrance to the emergency department, were seen and treated by the ENP and emergency nurse.<br/><br/>Methods: A retrospective review of patient records was performed regarding the four-week pilot project. Comparisons were conducted on days that the ENP and emergency nurse were present in triage versus days without the ENP and emergency nurse in triage regarding the impact of left without being seen (LWBS) and length of stay (LOS).<br/><br/>Results/Outcomes: The ENP and emergency nurse were present in triage for a period of 13 days versus 17 days without presence. There were approximately 2656 patients evaluated. Preliminary findings demonstrate a decrease in LWBS with ENP-emergency nurse presence in triage, while LOS was not affected.<br/><br/>Implications: Having ENPs in ED triage, with continued support from all levels, positively influences clinical practice change regarding LWBS and LOS. ED overcrowding is an institutional problem, as well as a national problem, that necessitates a unified, collaborative effort in improving ED patient flow, increasing patient safety, and enhancing patient relations. The emergency nurse can augment the improvement of overall healthcare outcomes by obtaining a thorough triage assessment with re-assessment; implementing standing orders/protocols, if any; informing patients of status; and communicating findings to a physician or ENP. An effective ED triage class with yearly updates/training and participation in triage projects/programs can also be beneficial.<br/><br/></td></tr></table>en_GB
dc.date.available2011-10-27T10:30:16Z-
dc.date.issued2011-10-17en_GB
dc.date.accessioned2011-10-27T10:30:16Z-
dc.description.sponsorshipEmergency Nurses Associationen_GB
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