Effect of a Nurse Practitioner in Triage on Patient Length of Stay and Satisfaction

2.50
Hdl Handle:
http://hdl.handle.net/10755/198361
Category:
Abstract
Type:
Presentation
Title:
Effect of a Nurse Practitioner in Triage on Patient Length of Stay and Satisfaction
Author(s):
Boardwine, Arnie
Author Details:
Arnie Boardwine, BS, RN, CEN; email: board001@mc.duke.edu
Abstract:
[ENA Annual Conference 2011 - Evidence-based Practice Presentation] Effect of a Nurse Practitioner in Triage on Patient Length of Stay and Satisfaction

Purpose: Multiple government reports and professional journals have highlighted the crowded state of emergency departments (EDs) nationwide. Many EDs have developed protocols for initiating patient workups in triage. We hypothesized that allotting a Nurse Practitioners (NP) in Triage would decrease ED length of stay and increase patient satisfaction.

Design: Prospective cohort study with both historical and concurrent control.

Setting: An urban academic level 1 trauma and tertiary care hospital ED with an average annual census of 70,000 visits.

Participants/Subjects: Adult patients presenting over a 6 month period from July 2010 to December 2010. Patients with an Emergency Severity Index (ESI) 4 & 5 were selected for evaluation by triage nurse practitioners. When the nurse practitioner was unavailable, patients were brought to a treatment room and received standard care.

Methods: One triage room was allotted for the rapid nurse practitioner evaluation process, which allowed for history and physical assessment, electrocardiograms, and completion of necessary interventions for disposition. Data measured included ED lengths of stay (LOS) in minutes and patient satisfaction scores (as measured by Press Ganey). Groups were compared using Mann-Whitney U test with significance of p is less than 0.05.

Results/Outcomes: Patients (ESI 4&5) who were evaluated and disposition by the nurse practitioner had an average length of stay of 21.8 minutes. For patients who were treated in the main ED their average LOS was 129.6 minutes (p=0.003). The overall department median LOS was 350 minutes prior to the intervention and 280 minutes after the intervention (p=0.004). Patient satisfaction scores were 85.2 for those seen by a nurse practitioner vs. 83.4 for standard care group.

Implications: Even at the cost of two nurse practitioners and a triage room, the rapid NP eval process resulted in decreased lengths of stay and increased patient satisfaction on an individual level and systemically. This intervention appears useful to increase emergency department throughput and patient satisfaction.

Repository Posting Date:
21-Dec-2011
Date of Publication:
21-Dec-2011
Conference Date:
2011
Conference Name:
ENA Annual Conference 2011
Conference Host:
Emergency Nurses Association
Note:
Item supplied by the event sponsor in abstract-only format. Please contact the author(s) (if contact information is listed) and/or the event sponsor to obtain a full-text copy of this item. It is the responsibility of the event sponsor to receive author permission prior to posting conference abstracts in this repository.

Full metadata record

DC FieldValue Language
dc.type.categoryAbstracten_US
dc.typePresentationen_US
dc.titleEffect of a Nurse Practitioner in Triage on Patient Length of Stay and Satisfactionen_GB
dc.contributor.authorBoardwine, Arnieen_US
dc.author.detailsArnie Boardwine, BS, RN, CEN; email: board001@mc.duke.eduen_US
dc.identifier.urihttp://hdl.handle.net/10755/198361-
dc.description.abstract[ENA Annual Conference 2011 - Evidence-based Practice Presentation] Effect of a Nurse Practitioner in Triage on Patient Length of Stay and Satisfaction<br/><br/>Purpose: Multiple government reports and professional journals have highlighted the crowded state of emergency departments (EDs) nationwide. Many EDs have developed protocols for initiating patient workups in triage. We hypothesized that allotting a Nurse Practitioners (NP) in Triage would decrease ED length of stay and increase patient satisfaction. <br/><br/>Design: Prospective cohort study with both historical and concurrent control. <br/><br/>Setting: An urban academic level 1 trauma and tertiary care hospital ED with an average annual census of 70,000 visits.<br/> <br/>Participants/Subjects: Adult patients presenting over a 6 month period from July 2010 to December 2010. Patients with an Emergency Severity Index (ESI) 4 & 5 were selected for evaluation by triage nurse practitioners. When the nurse practitioner was unavailable, patients were brought to a treatment room and received standard care. <br/> <br/>Methods: One triage room was allotted for the rapid nurse practitioner evaluation process, which allowed for history and physical assessment, electrocardiograms, and completion of necessary interventions for disposition. Data measured included ED lengths of stay (LOS) in minutes and patient satisfaction scores (as measured by Press Ganey). Groups were compared using Mann-Whitney U test with significance of p is less than 0.05. <br/><br/>Results/Outcomes: Patients (ESI 4&5) who were evaluated and disposition by the nurse practitioner had an average length of stay of 21.8 minutes. For patients who were treated in the main ED their average LOS was 129.6 minutes (p=0.003). The overall department median LOS was 350 minutes prior to the intervention and 280 minutes after the intervention (p=0.004). Patient satisfaction scores were 85.2 for those seen by a nurse practitioner vs. 83.4 for standard care group.<br/><br/>Implications: Even at the cost of two nurse practitioners and a triage room, the rapid NP eval process resulted in decreased lengths of stay and increased patient satisfaction on an individual level and systemically. This intervention appears useful to increase emergency department throughput and patient satisfaction.<br/><br/>en_GB
dc.date.available2011-12-21T12:47:28Z-
dc.date.issued2011-12-21T12:47:28Z-
dc.date.accessioned2011-12-21T12:47:28Z-
dc.conference.date2011en_US
dc.conference.nameENA Annual Conference 2011en_US
dc.conference.hostEmergency Nurses Associationen_US
dc.description.noteItem supplied by the event sponsor in abstract-only format. Please contact the author(s) (if contact information is listed) and/or the event sponsor to obtain a full-text copy of this item. It is the responsibility of the event sponsor to receive author permission prior to posting conference abstracts in this repository.-
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