ED Imaging and Culture Follow-up, an Innovative QI Program Utilizing Nurse Practitioners

2.50
Hdl Handle:
http://hdl.handle.net/10755/162716
Type:
Presentation
Title:
ED Imaging and Culture Follow-up, an Innovative QI Program Utilizing Nurse Practitioners
Abstract:
ED Imaging and Culture Follow-up, an Innovative QI Program Utilizing Nurse Practitioners
Conference Sponsor:Emergency Nurses Association
Conference Year:2001
Author:Vaughn, Kristi, RN, MN, ACNP-CS, CEN
P.I. Institution Name:Oregon Health Sciences University
UHN-52
Department of Emergency Medicine
Contact Address:3181 Sam Jackson Park Road, Portland, OR, 97201, USA
Contact Telephone:(503) 494-5708
Co-Authors:Anne Hedger, RN, MN, ACNP-CS, ANP-CS; and Dawn Rondeau, RN, MS, ACNP-CS
Clinical Topic: Emergency care practitioners (ECPs) order numerous imaging studies and cultures to assist in the diagnosis of medical and traumatic conditions. The final radiology reading and culture reports are seldom available prior to final diagnosis and disposition. Emergency Departments (ED) must have a quality improvement (QI) mechanism for follow-up of final reports. This project describes the utilization of ED Nurse Practitioners (NPs) to manage this program. Implementation: Initially this QI program consisted of an Emergency Medicine resident or faculty who inconsistently reviewed positive cultures forwarded by the laboratory, and all discordant radiographic findings by the staff radiologist. With the addition of NP faculty in 1997, a core group was available to regularly review these discordant cases. In the case of positive cultures, the NP reviews the chart to determine whether appropriate intervention was initiated during the initial ED evaluation. The NP completes the process by contacting the patient, the primary care provider (PCP), and initiates additional treatment as indicated. Outcomes: Over the last three years, the NP's have managed this QI program with the goal of following-up positive results within 24 hours. Only 0.4% of the imaging studies had discordant readings requiring a change in management. The majority of significant missed studies were extremity films (65%), followed by chest (17%), and spine (11%). There was an average of two positive culture studies per day of which less than 1% required a change in treatment. This program has lead to more rapid and corrective management of positive results. Recommendations: As EDs become busier, patient follow-up tends to not occur in a timely manner. In this QI program, NPs have consistently kept PCPs in the communication loop, have improved collegiality with the Radiology department, and provided more timely patient contact. NP faculty can consistently manage and provide timely intervention for discordant radiology readings and positive laboratory cultures. Upon completion of this poster review, the participant will be able to: 1) Develop an emergency department radiology follow-up program; 2) Identify methods to utilize nurse practitioners in the ED; and 3) Describe an emergency department quality improvement program for renewing positive bold cultures. [Clinical Poster Presentation]
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 Imaging and Culture Follow-up, an Innovative QI Program Utilizing Nurse Practitionersen_GB
dc.identifier.urihttp://hdl.handle.net/10755/162716-
dc.description.abstract<table><tr><td colspan="2" class="item-title">ED Imaging and Culture Follow-up, an Innovative QI Program Utilizing Nurse Practitioners</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">2001</td></tr><tr class="item-author"><td class="label">Author:</td><td class="value">Vaughn, Kristi, RN, MN, ACNP-CS, CEN</td></tr><tr class="item-institute"><td class="label">P.I. Institution Name:</td><td class="value">Oregon Health Sciences University<br/>UHN-52<br/>Department of Emergency Medicine</td></tr><tr class="item-address"><td class="label">Contact Address:</td><td class="value">3181 Sam Jackson Park Road, Portland, OR, 97201, USA</td></tr><tr class="item-phone"><td class="label">Contact Telephone:</td><td class="value">(503) 494-5708</td></tr><tr class="item-email"><td class="label">Email:</td><td class="value">vaughnk@ohsu.edu</td></tr><tr class="item-co-authors"><td class="label">Co-Authors:</td><td class="value">Anne Hedger, RN, MN, ACNP-CS, ANP-CS; and Dawn Rondeau, RN, MS, ACNP-CS</td></tr><tr><td colspan="2" class="item-abstract">Clinical Topic: Emergency care practitioners (ECPs) order numerous imaging studies and cultures to assist in the diagnosis of medical and traumatic conditions. The final radiology reading and culture reports are seldom available prior to final diagnosis and disposition. Emergency Departments (ED) must have a quality improvement (QI) mechanism for follow-up of final reports. This project describes the utilization of ED Nurse Practitioners (NPs) to manage this program. Implementation: Initially this QI program consisted of an Emergency Medicine resident or faculty who inconsistently reviewed positive cultures forwarded by the laboratory, and all discordant radiographic findings by the staff radiologist. With the addition of NP faculty in 1997, a core group was available to regularly review these discordant cases. In the case of positive cultures, the NP reviews the chart to determine whether appropriate intervention was initiated during the initial ED evaluation. The NP completes the process by contacting the patient, the primary care provider (PCP), and initiates additional treatment as indicated. Outcomes: Over the last three years, the NP's have managed this QI program with the goal of following-up positive results within 24 hours. Only 0.4% of the imaging studies had discordant readings requiring a change in management. The majority of significant missed studies were extremity films (65%), followed by chest (17%), and spine (11%). There was an average of two positive culture studies per day of which less than 1% required a change in treatment. This program has lead to more rapid and corrective management of positive results. Recommendations: As EDs become busier, patient follow-up tends to not occur in a timely manner. In this QI program, NPs have consistently kept PCPs in the communication loop, have improved collegiality with the Radiology department, and provided more timely patient contact. NP faculty can consistently manage and provide timely intervention for discordant radiology readings and positive laboratory cultures. Upon completion of this poster review, the participant will be able to: 1) Develop an emergency department radiology follow-up program; 2) Identify methods to utilize nurse practitioners in the ED; and 3) Describe an emergency department quality improvement program for renewing positive bold cultures. [Clinical Poster Presentation]</td></tr></table>en_GB
dc.date.available2011-10-27T10:32:56Z-
dc.date.issued2011-10-17en_GB
dc.date.accessioned2011-10-27T10:32:56Z-
dc.description.sponsorshipEmergency Nurses Associationen_GB
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