Faculty Collaboration Database

Advanced nursing interventions and length of stay in the emergency department. J Emerg Nurs 2013 May;39(3):221-5

Date

05/23/2012

Pubmed ID

22608129

DOI

10.1016/j.jen.2012.02.015

Scopus ID

2-s2.0-84877609501 (requires institutional sign-in at Scopus site)   13 Citations

Abstract

INTRODUCTION: Over the past 15 years, emergency departments have become overcrowded, with prolonged wait times and an extended length of stay (LOS). These factors cause delay in treatment, which reduces quality of care and increases the potential for adverse events. One suggestion to decrease LOS in the emergency department is to implement advanced nursing interventions (ANIs) at triage. The study purpose was to determine whether there was a difference in ED LOS between patients presenting with a chief complaint of abdominal pain who received ANIs at triage and patients who did not receive ANIs at triage.

METHODS: A retrospective chart review was performed to determine the ED LOS (mean time in department and mean time in room [TIR]). The convenience sample included ED patients who presented to a large Midwestern academic medical center's emergency department with a chief complaint of abdominal pain and Emergency Severity Index level 3. Independent-samples t tests were used to determine whether there was any statistical difference in LOS between the two groups. Cohen's d statistic was used to determine effect size.

RESULTS: Implementation of ANIs at triage for patients with low-acuity abdominal pain resulted in an increased time in department and a decreased TIR with a medium effect size.

CONCLUSION: A reduction in TIR optimizes bed availability in the emergency department. Low-acuity patients spend less time occupying an ED bed, which preserves limited bed space for the sickest patients. Results of diagnostic tests are often available by the time the patient is placed in a room, facilitating early medical decision making and decreasing treatment time.

Author List

Stauber MA

Author

Mary Ann Stauber NP APP Inpatient 2 in the Surgery department at Medical College of Wisconsin

MESH terms used to index this publication - Major topics in bold

Academic Medical Centers
Adult
Emergency Nursing
Emergency Service, Hospital
Female
Humans
Length of Stay
Male
Midwestern United States
Retrospective Studies
Severity of Illness Index
Triage