Abstract
Background
Increasing numbers of people are seeking unscheduled medical care in United States’
emergency departments, which contributes to delayed throughput and increased patient
length of stay. Implementation of nurse-initiated protocols, such as those for throat
pain, initiates early diagnostic testing, optimizes patient throughput strategies,
and promotes adherence to clinic practice guidelines for an additional segment of
patients.
Aim
To evaluate the effect of an evidence-based throat-pain protocol.
Methods
The medical records for 117 patients presenting with throat pain to the emergency
department were reviewed and separated into 3 groups: no testing, medical provider–initiated
testing, or nurse-initiated testing using the protocol. Main outcome variables were
number of patients that left without being seen (LWBS), patient length of stay, and
antibiotic prescribing.
Results
No patients LWBS from the nurse-initiated testing group or no-testing group compared
with 3% from the medical provider–initiated group. By eliminating these LWBS patients,
there is a potential cost savings of $3,420 over a 12-month period. The overall mean
length of stay was 6 minutes shorter in the nurse-initiated group than the other 2
groups evaluated. Antibiotic prescriptions were given for 48% of patients in the protocol
group compared with 52% in the medical provider group and 70% in the no-testing group.
Conclusion
Although this department has only partially implemented a protocol for throat pain,
it highlights the benefits to reduce the number of patients that LWBS and reduce patient
length of stay. The use of the protocol also improved adherence to clinical practice
guidelines for testing and antibiotic prescribing.
Contribution to Emergency Nursing Practice
- •With increasing wait times across the country, it is important to consider all time-saving strategies to improve ED throughput, such as a nurse-initiated throat-pain protocol.
- •Adoption of practices that support diagnostics testing early in the patient visit decreases the number of patients who leave without being seen.
- •Nursing application of a throat-pain protocol increases adherence to clinical practice guidelines and improves antibiotic stewardship.
Key words
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Biography
Deanna Settelmeyer, Member, Mr. Jefferson’s ENA, is Doctor of Nursing Practice candidate at University of Virginia School of Nursing, Charlottesville, VA.
Article info
Publication history
Published online: September 21, 2017
Footnotes
Earn Up to 6.0 Hours. See page 315.
Identification
Copyright
Published by Elsevier Inc. on behalf of Emergency Nurses Association.
