The Impact of Triage Nurse-ordered Diagnostic Studies on Pediatric Emergency Department Length of Stay

Abstract

The results of this program were associated with a reduction in ED treatment which achieved the purpose to improve high patient flow in the emergency department. However, this intervention needs further studies to develop the nurse-ordered diagnostic studies program with more different clinical conditions and tests including triage nurses training and guideline.

Impact of employing primary healthcare professionals in emergency department triage on patient flow outcomes: a systematic review and meta-analysis

“…Eight studies reported a reduction in percentage of patient LWBS in the NP team triage intervention group, except one 17 (five 18 19 25 33 34 reported statistically significant decrease). Two 60 61 studies reported a non-significant decrease in percentage of patients LWBS in nurse triage-plus intervention group. The median effect of all estimates is a reduction in LWBS of −2.31% (IQR: −0.39 to –3.77).…”

“…We identified 23 973 relevant citations from database search, of which 40 met the inclusion criteria17–19 25 27–62 (44 study reports). The study selection process is reported using the PRISMA study flow chart (figure 1).…”

“…While the precise role of the NPs, GPs or nurses given increased authority (all referred to as primary healthcare professionals (PHCPs)) in an ED is unclear, they may provide potential benefits to improve ED times and outcomes. Studies have reported the following roles of the PHCPs at ED triage: (1) GP either triaging (seeing and treating, streaming) or supervising triage27–29; (2) NP either alone or working alongside a triage nurse (ordering investigations, streaming, seeing and treating, or assessing patients and discharging/redirecting)17–19 25 30–39; (3) Triage nurse with increased authority given extra capacities outside of their usual scope of practice to order investigations for patients before streaming to the ED MD 40–62. Although, many primary research studies have investigated the impact of PHCPs19 32 36 37 40 63 64 at triage on ED patient flow, to the best of our knowledge, there are no systematic reviews that have summarised evidence from these studies.…”

Rapid influenza diagnostic test at triage can decrease emergency department length of stay

“…Previous studies have found that focused diagnostic tests, such as chest radiography, urine testing, and electrocardiography, at triage shorten ED length of stay 9–15 . Moreover, a drive‐through influenza examination model and a dedicated influenza clinic were also reported to shorten ED length of stay 4,21 .…”

“…Although some evidence suggests that performing rapid influenza diagnostic tests in the ED shortens length of stay, 3–7 1 report found that rapid influenza diagnostic tests did not significantly shorten ED length of stay 8 . Furthermore, it has been reported that radiography, electrocardiography, and laboratory investigations performed at triage do shorten ED length of stay 9–15 . To our knowledge, no reports have shown that performing rapid influenza diagnostic tests at triage shortens ED length of stay.…”