A review of the Transitional Emergency Nurse Practitioner

Lutze, Matthew; Ratchford, Andrew; Fry, Margaret

doi:10.1016/j.aenj.2011.06.003

Cited by 7 publications

(5 citation statements)

References 26 publications

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“…The most prevalent model evaluated within the literature is the Emergency Nurse Practitioner (ENP) role. Despite slight role variations across nations, ENPs generally assume the responsibility for patients presenting with minor injuries or illnesses, and operate within throughput management systems such as Fast‐Track and See‐and‐Treat . Studies on ENP models of care consistently report reduced waiting times (WT) and length of stay (LOS) for lower acuity patients, and increased patient satisfaction .…”

Section: Resultsmentioning

confidence: 99%

“…Despite slight role variations across nations, ENPs generally assume the responsibility for patients presenting with minor injuries or illnesses, and operate within throughput management systems such as Fast-Track and Seeand-Treat. [31][32][33][34] Studies on ENP models of care consistently report reduced waiting times (WT) [35][36][37] and length of stay (LOS) 34,38 for lower acuity patients, and increased patient satisfaction. 26,39 Evidence also suggests ENPs offer improved quality of care (reduced errors causing adverse events, lower unplanned re-presentation rates), improved continuity of care, 35 and less staff turnover when compared to Senior House Officers (SHOs).…”

Section: Workforce Models Of Carementioning

confidence: 99%

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Review article: Emergency department models of care in the context of care quality and cost: A systematic review

Wylie

Crilly

Toloo

et al. 2015

Emerg Medicine Australasia

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To identify current ED models of care and their impact on care quality, care effectiveness, and cost. A systematic search of key health databases (Medline, CINAHL, Cochrane, EMbase) was conducted to identify literature on ED models of care. Additionally, a focused review of the contents of 11 international and national emergency medicine, nursing and health economic journals (published between 2010 and 2013) was undertaken with snowball identification of references of the most recent and relevant papers. Articles published between 1998 and 2013 in the English language were included for initial review by three of the authors. Studies in underdeveloped countries and not addressing the objectives of the present study were excluded. Relevant details were extracted from the retrieved literature, and analysed for relevance and impact. The literature was synthesised around the study's main themes. Models described within the literature mainly focused on addressing issues at the input, throughput or output stages of ED care delivery. Models often varied to account for site specific characteristics (e.g. onsite inpatient units) or to suit staffing profiles (e.g. extended scope physiotherapist), ED geographical location (e.g. metropolitan or rural site), and patient demographic profile (e.g. paediatrics, older persons, ethnicity). Only a few studies conducted cost-effectiveness analysis of service models. Although various models of delivering emergency healthcare exist, further research is required in order to make accurate and reliable assessments of their safety, clinical effectiveness and cost-effectiveness.

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Section: Resultsmentioning

confidence: 99%

Section: Workforce Models Of Carementioning

confidence: 99%

Review article: Emergency department models of care in the context of care quality and cost: A systematic review

Wylie

Crilly

Toloo

et al. 2015

Emerg Medicine Australasia

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“…Several ‘within ED’ interventions and strategies identified in this review. These interventions were grouped under four common themes as follows: (1) area within ED staffed by PHCPs to manage lower acuity ED patients streamlined at triage, 29 (2) PHCPs located next to ED (sharing common triage with ED) to manage lower acuity ED patients streamed at triage as well as self-directed patients, 30 (3) PHCPs located at ED triage 31 to manage lower acuity ED patients and (4) PHCPs fully integrated within the ED to manage ED patients along with the ED team 32 ( online supplemental appendix table 6 ).…”

Section: Resultsmentioning

confidence: 99%

“…The PHCP triage intervention involved patient management strategies such as, ‘see and treat’ lower acuity patients, 31 diverting low-acuity patients to adjacent/co-located primary care centre or after-hours primary care centre, 33 or the triage nurse was given increased authority to order diagnostic investigations or initiate a specified protocol. 34 A few ‘within ED’ interventions involved low-acuity patients streamlined at triage to a PHCP working alone within ED (eg, rapid medical assessment units, 35 fast-track units 36 or emergency care access points 35 for management).…”

Section: Resultsmentioning

confidence: 99%

Interventions and strategies involving primary healthcare professionals to manage emergency department overcrowding: a scoping review

et al. 2021

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ObjectivesTo conduct a scoping review to identify and summarise the existing literature on interventions involving primary healthcare professionals to manage emergency department (ED) overcrowding.DesignA scoping review.Data sourcesA comprehensive database search of Medline (Ovid), EMBASE (Ovid), Cochrane Library (Wiley) and CINAHL (EBSCO) databases was conducted (inception until January 2020) using peer-reviewed search strategies, complemented by a search of grey literature sources.Eligibility criteriaInterventions and strategies involving primary healthcare professionals (PHCPs: general practitioners (GPs), nurse practitioners (NPs) or nurses with expanded role) to manage ED overcrowding.MethodsWe engaged and collaborated, with 13 patient partners during the design and conduct stages of this review. We conducted this review using the JBI guidelines. Two reviewers independently selected studies and extracted data. We conducted descriptive analysis of the included studies (frequencies and percentages).ResultsFrom 23 947 records identified, we included 268 studies published between 1981 and 2020. The majority (58%) of studies were conducted in North America and were predominantly cohort studies (42%). The reported interventions were either ‘within ED’ (48%) interventions (eg, PHCP-led ED triage or fast track) or ‘outside ED’ interventions (52%) (eg, after-hours GP clinic and GP cooperatives). PHCPs involved in the interventions were: GP (32%), NP (26%), nurses with expanded role (16%) and combinations of the PHCPs (42%). The ‘within ED’ and ‘outside ED’ interventions reported outcomes on patient flow and ED utilisation, respectively.ConclusionsWe identified many interventions involving PHCPs that predominantly reported a positive impact on ED utilisation/patient flow metrics. Future research needs to focus on conducting well-designed randomized controlled trials (RCTs) and systematic reviews to evaluate the effectiveness of specific interventions involving PHCPs to critically appraise and summarise evidence on this topic.

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“…Previous research has demonstrated patients receive more health information and better discharge instructions when compared with traditional care. [29][30][31][32] Emergency nurse practitioners are a hybrid service delivery model, holding both nursing and medical skills with an emphasis on health promotion, education and holistic care. The challenge facing health services today is to provide quality of care to ED patients while balancing the complex need for increased demand of services.…”

Section: Referral Patternsmentioning

confidence: 99%

Evaluating patient presentations for care delivered by emergency nurse practitioners: A retrospective analysis of 12 months

Jennings

Mckeown

O’Reilly

et al. 2013

Australasian Emergency Nursing Journal

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A review of the Transitional Emergency Nurse Practitioner

Cited by 7 publications

References 26 publications

Review article: Emergency department models of care in the context of care quality and cost: A systematic review

Review article: Emergency department models of care in the context of care quality and cost: A systematic review

Interventions and strategies involving primary healthcare professionals to manage emergency department overcrowding: a scoping review

Evaluating patient presentations for care delivered by emergency nurse practitioners: A retrospective analysis of 12 months

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