The Development of Practice Guidelines for Advanced Practice Clinicians in the Emergency Departments Staffed by the Utah Emergency Physicians

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Identifier 2013_Newman
Title The Development of Practice Guidelines for Advanced Practice Clinicians in the Emergency Departments Staffed by the Utah Emergency Physicians
Creator Newman, Jennifer
Subject Advanced Practice Nursing; Education, Nursing, Graduate; Systems Analysis; Nurse Practitioners; Practice Guidelines as Topic; Emergency Service, Hospital; Emergency Medical Services; Length of Stay; Patient Care; Advanced Practice Nursing
Description The emergency departments (EDs) staffed by the Utah Emergency Physicians (UEP) are faced with unique challenges. Intermountain Medical Center (IMC) and McKay-Dee Hospital are often faced with long door to provider times and an increased length of stay (LOS) for patients due to the high volume of patients that seek care. Alta View Hospital (AVH), LDS Hospital and Riverton Hospital often have department surges where staffing another physician is not cost effective but another independent provider would be helpful in caring for patients. The EDs staffed by UEP do not currently utilize APCs. Increased wait times and LOS in EDs have several consequences. The consequences include poor patient outcomes, greater patient suffering, a decrease in patient satisfaction, an increase in the number of patients who leave without treatment and an increase in anger and violence towards healthcare workers. The purpose of this project is threefold: to research the current roles of APCs in the ED, to develop clinical practice guidelines for the roles of APCs in the EDs staffed by UEP and to present the clinical practice guidelines to the UEP Executive Committee. There are millions of Americans without access to healthcare. A lack of access to primary and preventative healthcare results in an increase in ED visits. The ED is the only aspect of the health care system that is mandated by federal law to screen, and if necessary, treat all patients who seek care. Nationally, 64% of EDs use APCs. From 1993 to 2009, the number of patients seen by an APC increased from 4.1% to 14.5%. Current roles of APCs in the ED include using the APC as a ‘Provider in Triage', in ‘Caring for Specific Chief Complaints', in a ‘Collaborative Model of Care', in ‘Fast Track Units' and in ‘Observational Units'. Through a review of the literature, collaboration with content experts and site visits to hospitals that currently utilize APCs, I identified the current roles of APCs in the ED to facilitate the development of practice guidelines. The guidelines developed included using the APC in a combination of a ‘Provider in Triage' role and in a ‘Collaborative Model of Care' role at IMC and McKay Dee Hospital and in a ‘Collaborative Model of Care' at AVH, LDS and Riverton Hospitals. Final implementation included presentation to the UEP Executive Committee. The large percentage of ED visits that are classified as urgent or semi-urgent suggests that APCs are ideally suited to provide care to the vast majority of ED patients. This will lead to a decrease in LOS, a decrease in patients who leave without treatment, a decrease in anger and violence towards care givers and ultimately an increase in patient satisfaction and patient outcomes.
Relation is Part of Graduate Nursing Project, Doctor of Nursing Practice
Publisher Spencer S. Eccles Health Sciences Library, University of Utah
Date 2013
Type Text
Rights Management © 2013 College of Nursing, University of Utah
Holding Institution Spencer S. Eccles Health Sciences Library, University of Utah
Collection Nursing Practice Project
Language eng
ARK ark:/87278/s6q55mv9
Metadata Cataloger AMT
Setname ehsl_gradnu
Date Created 2014-01-29
Date Modified 2018-01-30
ID 179567
Reference URL https://collections.lib.utah.edu/ark:/87278/s6q55mv9