2.50
Hdl Handle:
http://hdl.handle.net/10755/162898
Type:
Presentation
Title:
Decreasing the Emergency Department Length of Stay for the Trauma Patient
Abstract:
Decreasing the Emergency Department Length of Stay for the Trauma Patient
Conference Sponsor:Emergency Nurses Association
Conference Year:2006
Author:Dieter, Marie C., RN, PHRN, CEN
P.I. Institution Name:Lehigh Valley Hospital
Title:Core Trauma Nurse
Contact Address:1200 S. Cedar Crest Blvd., Allentown, PA, 18017, USA
Contact Telephone:(610) 402-0305
Co-Authors:Julie S. Albertson, RN, BSN, PHRN, CEN; Laurie Cartwright, RN, BSN, CEN; Rachel Horvath, RN, BSN , CEN; Rosemary Scheirer, RN, PHRN, CEN; Diana Tarone, RN, BSN
Clinical Topic: Overcrowding in the emergency department (ED) and increased ED length of stay (LOS) is a nationwide dilemma. Prolonged stays in the emergency department that result in delayed admission to the intensive care unit is especially problematic to the severely injured (trauma) patient. A study of the effects of delayed admission to intensive care units demonstrated an increase in mortality in those patients who experienced a delay in admission to such units. The goal of this project was to decrease the trauma patient's ED LOS. Implementation: This is an 800-bed Magnet designated acute care facility with a Level I trauma center that is the second busiest in Pennsylvania. The Core Trauma Nurse Team (CTNT), implemented in June of 2004, is comprised of experienced nurses from the emergency department, the trauma neuro intensive care unit (TNICU), or Medevac flight experience. There are four full time nurses and two part time nurses responsible for 24/7 coverage of the team with supplemental coverage provided by six per diem nurses. The team's responsibilities encompass all aspects of care for the trauma patient from direct patient care to liaison with all hospital departments involved in trauma-related care. The CTNT is proactive in the throughput of the trauma patient from ED admission to ED discharge. Prompt recognition of those patients who will require admission to the TNICU is key to the decreasing ED LOS. Early and ongoing communication with the bed management department, patient flow coordinators, attending and resident physicians, receiving units, and other ancillary departments all play an important role in decreasing ED LOS. Outcomes: A retrospective chart review of ED LOS for 2004 and 2005 of the trauma alert patients (second tier of a four-tiered response system) was completed. The overall ED LOS for all trauma alert patients was 214 minutes and 210 minutes in 2004 (n = 1822) and 2005 (n = 1919), respectively. Upon further investigation, by categorizing ED patients to the subset of those with intensive care and medical-surgical admissions, the ED LOS for those admitted to the ICU was 165 minutes and 139 minutes in 2004 (n = 622) and in 2005 (n=559), respectively. A 26-minute (16%) decrease on the average ED LOS for the trauma patient that was an intensive care unit (ICU) admission was observed. Trauma alert patients admitted to a medical -surgical unit had an over all 9-minute (5%) decrease in ED LOS from 2004 (252 minutes ED LOS ) to 2005 (243 minutes ED LOS). Recommendations: The Core Trauma Nurse Team has been proactive in the admission process of all trauma patients but the greatest impact has been observed with the ICU admission. The recognition of the patient who is in need of an ICU admission combined with prompt and ongoing communication with all available resources to facilitate earlier ICU admission has proven to be effective in the decreasing the ED LOS for the severely injured trauma patient. The Core Trauma Nurse Team is currently reviewing strategies to further decrease the ED LOS for both ICU and medical-surgical trauma patients for all trauma response levels. Future studies may include looking at correlations between mortality rates in this study population given.
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.titleDecreasing the Emergency Department Length of Stay for the Trauma Patienten_GB
dc.identifier.urihttp://hdl.handle.net/10755/162898-
dc.description.abstract<table><tr><td colspan="2" class="item-title">Decreasing the Emergency Department Length of Stay for the Trauma Patient</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">2006</td></tr><tr class="item-author"><td class="label">Author:</td><td class="value">Dieter, Marie C., RN, PHRN, CEN</td></tr><tr class="item-institute"><td class="label">P.I. Institution Name:</td><td class="value">Lehigh Valley Hospital</td></tr><tr class="item-author-title"><td class="label">Title:</td><td class="value">Core Trauma Nurse</td></tr><tr class="item-address"><td class="label">Contact Address:</td><td class="value">1200 S. Cedar Crest Blvd., Allentown, PA, 18017, USA</td></tr><tr class="item-phone"><td class="label">Contact Telephone:</td><td class="value">(610) 402-0305</td></tr><tr class="item-email"><td class="label">Email:</td><td class="value">marie.dieter@lvh.com</td></tr><tr class="item-co-authors"><td class="label">Co-Authors:</td><td class="value">Julie S. Albertson, RN, BSN, PHRN, CEN; Laurie Cartwright, RN, BSN, CEN; Rachel Horvath, RN, BSN , CEN; Rosemary Scheirer, RN, PHRN, CEN; Diana Tarone, RN, BSN</td></tr><tr><td colspan="2" class="item-abstract">Clinical Topic: Overcrowding in the emergency department (ED) and increased ED length of stay (LOS) is a nationwide dilemma. Prolonged stays in the emergency department that result in delayed admission to the intensive care unit is especially problematic to the severely injured (trauma) patient. A study of the effects of delayed admission to intensive care units demonstrated an increase in mortality in those patients who experienced a delay in admission to such units. The goal of this project was to decrease the trauma patient's ED LOS. Implementation: This is an 800-bed Magnet designated acute care facility with a Level I trauma center that is the second busiest in Pennsylvania. The Core Trauma Nurse Team (CTNT), implemented in June of 2004, is comprised of experienced nurses from the emergency department, the trauma neuro intensive care unit (TNICU), or Medevac flight experience. There are four full time nurses and two part time nurses responsible for 24/7 coverage of the team with supplemental coverage provided by six per diem nurses. The team's responsibilities encompass all aspects of care for the trauma patient from direct patient care to liaison with all hospital departments involved in trauma-related care. The CTNT is proactive in the throughput of the trauma patient from ED admission to ED discharge. Prompt recognition of those patients who will require admission to the TNICU is key to the decreasing ED LOS. Early and ongoing communication with the bed management department, patient flow coordinators, attending and resident physicians, receiving units, and other ancillary departments all play an important role in decreasing ED LOS. Outcomes: A retrospective chart review of ED LOS for 2004 and 2005 of the trauma alert patients (second tier of a four-tiered response system) was completed. The overall ED LOS for all trauma alert patients was 214 minutes and 210 minutes in 2004 (n = 1822) and 2005 (n = 1919), respectively. Upon further investigation, by categorizing ED patients to the subset of those with intensive care and medical-surgical admissions, the ED LOS for those admitted to the ICU was 165 minutes and 139 minutes in 2004 (n = 622) and in 2005 (n=559), respectively. A 26-minute (16%) decrease on the average ED LOS for the trauma patient that was an intensive care unit (ICU) admission was observed. Trauma alert patients admitted to a medical -surgical unit had an over all 9-minute (5%) decrease in ED LOS from 2004 (252 minutes ED LOS ) to 2005 (243 minutes ED LOS). Recommendations: The Core Trauma Nurse Team has been proactive in the admission process of all trauma patients but the greatest impact has been observed with the ICU admission. The recognition of the patient who is in need of an ICU admission combined with prompt and ongoing communication with all available resources to facilitate earlier ICU admission has proven to be effective in the decreasing the ED LOS for the severely injured trauma patient. The Core Trauma Nurse Team is currently reviewing strategies to further decrease the ED LOS for both ICU and medical-surgical trauma patients for all trauma response levels. Future studies may include looking at correlations between mortality rates in this study population given.</td></tr></table>en_GB
dc.date.available2011-10-27T10:36:02Z-
dc.date.issued2011-10-17en_GB
dc.date.accessioned2011-10-27T10:36:02Z-
dc.description.sponsorshipEmergency Nurses Associationen_GB
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