Impact of the Advanced Practice Nurse in Triage of Primary Care Emergency Departments

IF 2.3 4区医学 Q2 EMERGENCY MEDICINE Journal of Emergency Nursing Pub Date : 2025-05-01 DOI:10.1016/j.jen.2024.11.001

Ángela Jiménez-García MSC, RN, Genoveva Pérez-Romero MSC, RN, Cesar Hueso-Montoro PhD, MSC, RN, María Paz Garcia-Caro PhD, MSC, Rafael Montoya-Juárez PhD, MSC

{"title":"Impact of the Advanced Practice Nurse in Triage of Primary Care Emergency Departments","authors":"Ángela Jiménez-García MSC, RN, Genoveva Pérez-Romero MSC, RN, Cesar Hueso-Montoro PhD, MSC, RN, María Paz Garcia-Caro PhD, MSC, Rafael Montoya-Juárez PhD, MSC","doi":"10.1016/j.jen.2024.11.001","DOIUrl":null,"url":null,"abstract":"<div><h3>Introduction</h3><div>This study aimed to compare the time spent on episodes seen by primary care emergency departments before (2017) and after (2019) the inclusion of an advanced practice nurse in patient classification.</div></div><div><h3>Methods</h3><div>Records from 3 primary care emergency departments in 2017 (n = 18,663) and 2019 (n = 22,632) were compared using Student <em>t</em> and chi-square tests. Waiting time for classification, classification time, and total time spent in the consultation area were compared for total episodes, levels of priority, reasons for consultation, and previous clinical processes.</div></div><div><h3>Results</h3><div>Mean waiting time decreased in 2019 for all episodes (<em>P</em> < .001), priorities IV (<em>P</em> < .001) and V (<em>P</em> < .001), respiratory (<em>P</em> < .001) and skin and subcutaneous tissue diseases (<em>P</em> = .015), and previous chronic processes (<em>P</em> = .042). Mean classification time increased in 2019 for all episodes (<em>P</em> < .001); priorities III (<em>P</em> < .001), IV (<em>P</em> < .001), and V (<em>P</em> = .045); several reasons for consultation, and previous processes. Mean total time spent in the consultation area decreased in 2019 for all (<em>P</em> = .002), priority V (<em>P</em> < .001), skin and subcutaneous tissue diseases (<em>P</em> = .010), and fever episodes (<em>P</em> = .021).</div></div><div><h3>Discussion</h3><div>The inclusion of nurses with advanced nursing practice roles reduces the waiting time and length of stay in the emergency department, but increases the classification time, which could be linked to early interventions.</div></div>","PeriodicalId":51082,"journal":{"name":"Journal of Emergency Nursing","volume":"51 3","pages":"Pages 487-497"},"PeriodicalIF":2.3000,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Emergency Nursing","FirstCategoryId":"3","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S0099176724003313","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"EMERGENCY MEDICINE","Score":null,"Total":0}

引用次数: 0

Abstract

Introduction

This study aimed to compare the time spent on episodes seen by primary care emergency departments before (2017) and after (2019) the inclusion of an advanced practice nurse in patient classification.

Methods

Records from 3 primary care emergency departments in 2017 (n = 18,663) and 2019 (n = 22,632) were compared using Student t and chi-square tests. Waiting time for classification, classification time, and total time spent in the consultation area were compared for total episodes, levels of priority, reasons for consultation, and previous clinical processes.

Results

Mean waiting time decreased in 2019 for all episodes (P < .001), priorities IV (P < .001) and V (P < .001), respiratory (P < .001) and skin and subcutaneous tissue diseases (P = .015), and previous chronic processes (P = .042). Mean classification time increased in 2019 for all episodes (P < .001); priorities III (P < .001), IV (P < .001), and V (P = .045); several reasons for consultation, and previous processes. Mean total time spent in the consultation area decreased in 2019 for all (P = .002), priority V (P < .001), skin and subcutaneous tissue diseases (P = .010), and fever episodes (P = .021).

Discussion

The inclusion of nurses with advanced nursing practice roles reduces the waiting time and length of stay in the emergency department, but increases the classification time, which could be linked to early interventions.

查看原文

微信好友朋友圈 QQ好友复制链接

本刊更多论文

高级执业护士对基层急诊分诊的影响

本研究旨在比较初级保健急诊科在将高级执业护士纳入患者分类之前（2017年）和之后（2019年）在突发事件上花费的时间。方法：采用Student t检验和卡方检验对2017年（n = 18,663）和2019年（n = 22,632） 3个初级保健急诊科的记录进行比较。等待分类的时间、分类时间和在会诊区域花费的总时间比较了总发作次数、优先级、会诊原因和以前的临床过程。结果：2019年，所有疾病（P < 0.001）、IV级（P < 0.001）和V级（P < 0.001）、呼吸系统（P < 0.001）和皮肤及皮下组织疾病（P = 0.015）以及既往慢性疾病（P = 0.042）的平均等待时间均有所减少。2019年所有发作的平均分类时间增加（P < 0.001）；III级（P < 0.001）、IV级（P < 0.001）和V级（P = 0.045）；咨询的几个原因，以及之前的流程。2019年，所有患者在会诊区域的平均总时间（P = 0.002）、优先级V （P < 0.001）、皮肤和皮下组织疾病（P = 0.010）和发烧发作（P = 0.021）均有所减少。讨论：纳入具有高级护理实践角色的护士减少了在急诊科的等待时间和住院时间，但增加了分类时间，这可能与早期干预有关。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文去求助

来源期刊

Journal of Emergency Nursing 医学-护理

CiteScore

3.10

自引率

11.80%

发文量

132

审稿时长

46 days

期刊介绍： The Journal of Emergency Nursing, the official journal of the Emergency Nurses Association (ENA), is committed to the dissemination of high quality, peer-reviewed manuscripts relevant to all areas of emergency nursing practice across the lifespan. Journal content includes clinical topics, integrative or systematic literature reviews, research, and practice improvement initiatives that provide emergency nurses globally with implications for translation of new knowledge into practice. The Journal also includes focused sections such as case studies, pharmacology/toxicology, injury prevention, trauma, triage, quality and safety, pediatrics and geriatrics. The Journal aims to mirror the goal of ENA to promote: community, governance and leadership, knowledge, quality and safety, and advocacy.