The clinical initiative nurse: Extending the role of the emergency nurse, who benefits?

Fry, Margaret; Jones, Keryn

doi:10.1016/j.aenj.2005.04.002

Cited by 27 publications

(39 citation statements)

References 9 publications

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“…The CIN role has been shown to impact on outcomes, such as DNW rate . One study reported a 1% reduction in DNW rates over a 12 month period following the introduction of the role ( P < 0.001) …”

Section: Resultsmentioning

confidence: 95%

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Review article: Systematic review of three key strategies designed to improve patient flow through the emergency department

Elder

Johnston

Crilly

2015

Emerg Medicine Australasia

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To explore the literature regarding three key strategies designed to promote patient throughput in the ED. CINAHL, Medline, PubMed, Scopus and Australian Government databases were searched for articles published between 1980 and 2014 using the key search terms ED flow/ throughput, ED congestion, crowding, overcrowding, models of care, physician-assisted triage, medical assessment units, nurse practitioner, did not wait (DNW) and ED length of stay (LOS). Abstracts and articles not published in English and articles published before 1980 were excluded from the review. Quantitative and qualitative studies were considered for inclusion. The National Health Medical Research Council (NHMRC) Level of Evidence Hierarchy (2009) was applied to included studies. Twenty-one articles met criteria for review. The level of evidence assessed using the NHMRC guidelines of studies ranged from I to IV, with the majority falling into the Level II-2 (n = 6) and III-3 (n = 9) range. ED LOS was the outcome most often reported. Study quality was limited with few studies adjusting for confounding factors. Only one level I systematic review was included in this review. Advanced practice nursing roles, physician-assisted triage and medical assessment units are models of care that can positively impact ED throughput. They have been shown to decrease ED LOS and DNW rates. Confounding factors, such as site specific staffing requirements, patient acuity and rest-of-hospital processes, can also impact on patient throughput through the ED.

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Section: Resultsmentioning

confidence: 95%

“…The CIN role in the ED was developed to support triage nurses. 48 It is a role that utilises advanced nursing practice that can include nurse-initiated (NI) activities, such as analgesia 33,36,49,50 and X-rays. [27][28][29][30]37 The CIN role has been shown to impact on outcomes, such as DNW rate.…”

Section: Expanded Ed Nursing Scope Of Practicementioning

confidence: 99%

Review article: Systematic review of three key strategies designed to improve patient flow through the emergency department

Elder

Johnston

Crilly

2015

Emerg Medicine Australasia

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“…3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 53 54 55 56 57 58 59 60 61 62 63 64 65 7 CIN role was designed to address the extended waiting times for ED patients by enabling the nurse to commence a range of patient investigations and treatments prior to medical assessment. 5,16 The initiation of a PIVC and pathology investigations were key interventions that the CIN was able to initiate. However, the documentation of the PIVC operator in this study was poor.…”

Section: Discussionmentioning

confidence: 99%

“…Across Australia, ED nurses initiate and undertake many extended practices, including PIVC insertion [3][4][5] These extended activities have been in response to increased workload and overcrowding. However, in the ED inserting a PIVC is viewed as avoiding a second needle puncture for the patient should they subsequently require intravenous treatments.…”

Section: Introductionmentioning

confidence: 99%

Utility of peripheral intravenous cannulae inserted in one tertiary referral emergency department: A medical record audit

Fry

Romero

Berry

2016

Australasian Emergency Nursing Journal

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Introduction:Peripheral intravenous cannulation is a common intervention performed within the Emergency Department by medical staff to assist in the delivery of care. However, previous studies have shown Emergency Department patients that have cannula device inserted are often not used. Across Australia, it is unclear the utility and frequency of use of peripheral intravenous cannulae within the emergency setting. Method: This is a random retrospective cohort study. Clinical information was retrieved from the Emergency Department Database, FirstNet and the paper medical record. Data from FirstNet included: patient demographic (age, gender) and clinical information (time of arrival, triage category, presenting problem, discharge diagnostic code, and disposition). Data from the patient medical record included: demographic (age, gender) and clinical information (Cannula usage and time of fluids, pharmacological agents, complications, pathology radiological investigations, other diagnostic uses). Results: Of the 357 randomised patients, 189 (52.9%) had 209 peripheral intravenous cannula inserted. Of these cannulae 186 (88.9%) were used within 72 hours. The majority of cannulae (70.4%; n=131) had more than one medical intervention. Conclusion:The majority of peripheral intravenous cannulae inserted during the Emergency Department visit were subsequently used for medical treatment. Further, the majority of devices were used for intravenous fluids and or medications and accessed for multiple interventions. For future audit purposes improved documentation of this procedure is needed.

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“…2003). Generally, there has been an increase in emergency nurses’ workloads with increased scope of practice (nurse initiated X‐rays, pathology and analgesia) and a corresponding increase in patient attendance to the emergency department (ED) over the last few years (Fry & Jones 2005). Many nurses, however, believe that their workloads during the winter months are further increased because of increases in patient presentations and nurses’ sick leave.…”

Section: Introductionmentioning

confidence: 99%

The effect of aromatherapy massage with music on the stress and anxiety levels of emergency nurses: comparison between summer and winter

Cooke

Holzhauser²,

Jones

et al. 2007

Journal of Clinical Nursing

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The clinical initiative nurse: Extending the role of the emergency nurse, who benefits?

Cited by 27 publications

References 9 publications

Review article: Systematic review of three key strategies designed to improve patient flow through the emergency department

Review article: Systematic review of three key strategies designed to improve patient flow through the emergency department

Utility of peripheral intravenous cannulae inserted in one tertiary referral emergency department: A medical record audit

The effect of aromatherapy massage with music on the stress and anxiety levels of emergency nurses: comparison between summer and winter

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