Analysis of three advanced practice roles in emergency nursing

Considine, Julie; Lucas, Elspeth; Payne, Roslyn; Kropman, Matthew; Stergiou, Helen; Chiu, Herman

doi:10.1016/j.aenj.2012.10.001

Cited by 26 publications

(46 citation statements)

References 33 publications

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“…The EDAOLN role was also cost effective; producing clinically meaningful reductions in access parameters such as time to be seen for a modest cost. While other reports and studies describe similar roles, accompanying comprehensive economic evaluations of their impact on ED process measures were not apparent.…”

Section: Discussionmentioning

confidence: 99%

“…7,8,[12][13][14] During POST delays, not only is there difficulty accessing ED care, but ambulances are also unavailable to respond back to the surrounding community. 7,9,16 While a number of recommendations around the input phase of the patient's journey (that includes patients arriving to ED by ambulance) have been made, 10,[17][18][19][20][21][22] increasing volumes of patients and patient flow challenges in EDs suggest further strategies are required to support health system performance. In response to unprecedented access block and ED crowding, an ED Ambulance Off-Load Nurse (EDAOLN) role was trialled on a 24/7 basis for a 39-day period in one Australian ED.…”

Section: Introductionmentioning

confidence: 99%

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Improving emergency department transfer for patients arriving by ambulance: A retrospective observational study

Crilly

Johnston

Wallis

et al. 2019

Emerg Medicine Australasia

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Objective Extended delays in the transfer of patients from ambulance to ED can compromise patient flow. The present study aimed to describe the relationship between the use of an Emergency Department Ambulance Off‐Load Nurse (EDAOLN) role, ED processes of care and cost effectiveness. Methods This was a retrospective observational study over three periods of before (T1), during (T2) and after (T3) the introduction of the EDAOLN role in 2012. Ambulance, ED and cost data were linked and used for analysis. Processes of care measures analysed included: time to be seen by a doctor from ED arrival (primary outcome), ambulance‐ED offload compliance, proportion of patients seen within recommended triage timeframe, ED length of stay (LoS), proportion of patients transferred, admitted or discharged from the ED within 4 h and cost effectiveness. Results A total of 6045 people made 7010 presentations to the ED by ambulance over the study period. Several measures improved significantly between T1 and T2 including offload compliance (T1: 58%; T2: 63%), time to be seen (T1: 31 min; T2: 28 min), ED LoS (T1: 335 min; T2: 306 min), ED LoS <4 h (T1: 31%; T2: 33%). Some measures carried over into T3, albeit to a lesser extent. Post‐hoc analyses showed that outcomes improved most for less urgent patients. The annualised net cost of the EDAOLN (if funded from additional resources) of $130 721 could result in an annualised reduction of approximately 3912 h in waiting time to be seen by a doctor. Conclusion With the EDAOLN role in place, slight outcome improvements in several key ambulance and ED efficiency criteria were noted. During times of ED crowding, the EDAOLN role may be one cost‐effective strategy to consider.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Improving emergency department transfer for patients arriving by ambulance: A retrospective observational study

Crilly

Johnston

Wallis

et al. 2019

Emerg Medicine Australasia

View full text Add to dashboard Cite

show abstract

“…Previous studies evaluating the placement of a physician in triage have demonstrated mixed results with significant limitations [5,11,29]. However, empowering triage nurses to order analgesia, blood tests, and radiography reduces the median time for pain assessment (47 min to 1 min), the median time for analgesia administration (98 min to 28 min), waiting times, and ED LOS, while improving patient satisfaction, quality of care, and throughput [30][31][32][33][34].…”

Section: Discussionmentioning

confidence: 99%

Implementing Triage Standing Orders in the Emergency Department Leads to Reduced Physician-to-Disposition Times

Hwang

Payton

Weeks

et al. 2016

Advances in Emergency Medicine

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Emergency departments (EDs) throughout USA have improvised various processes to curb the "national epidemic" termed ED "crowding." Standing orders (SOs), one such process, are medical orders approved by the medical director and entered by nurses when patients cannot be seen expeditiously, expediting medical decision-making and decreasing length of stay (LOS) and time to disposition. This retrospective cohort study evaluates the impact of SOs on ED LOS and disposition time at a large university ED. Results indicate that SOs significantly improve ED throughput by reducing disposition time by up to 16.9% ( = 0.04), which is especially significant in busy ED settings. SOs by themselves are not sufficient for a complete diagnostic assessment. Strategies such as having a provider in the waiting area may help make key decisions earlier.

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“…Diperlukan penelitian lebih lanjut terkait efisiensi dan efektifitas pelaksanaan triase oleh perawat di intalasi gawat darurat. (Gilboy, 2012;Kalantarimeibidi, 2014 (Considine et al, 2012)…”

Section: Abstrakunclassified

Studi Fenomenologi:Peran perawat Dalam Penetapan Level Triase

Astuti

Nurjannah

Widyastuti

2018

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Triage is the process of collecting information from patients, categorizing and prioritizing patient conditions and is part of patient safety management efforts in hospitals, especially in emergency departments. The triage model is widely used in the World including Indonesia is a five-level triage that places patients on five priorities: Resucitation, Emergent, Urgent, Nonurgent, Referred. Triage is autonomously performed by registered nurses and has attended special triage training. in Indonesia, a five-level triage has been used in public hospitals, especially the role of nurses in the triage process. The purpose of this research is to know the nurse's experience in determining the triage decision. Qualitative research of descriptive phenomenology with in-depth interview technique on six emergency department nurses working in Triage room. The results were analyzed using Miles and Huberman method, obtaining three major themes, the level of triage based on the primary assessment, the nurse has not been independent, the collaboration of doctors and nurses. Trial implementation has not been a self-sustaining act of nurses and is part of a triage team where triage decisions are still dependent on physicians. Further research is needed regarding the efficiency and effectiveness of triage implementation by nurses in emergency department.

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Analysis of three advanced practice roles in emergency nursing

Cited by 26 publications

References 33 publications

Improving emergency department transfer for patients arriving by ambulance: A retrospective observational study

Improving emergency department transfer for patients arriving by ambulance: A retrospective observational study

Implementing Triage Standing Orders in the Emergency Department Leads to Reduced Physician-to-Disposition Times

Studi Fenomenologi:Peran perawat Dalam Penetapan Level Triase

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