Evaluating The Quality Of Care Delivered By An Emergency Department Fast Track Unit With Both Nurse Practitioners

Evaluating The Quality Of Care Delivered By An Emergency Department Fast Track Unit With Both Nurse Practitioners

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Dinh, M., Walker, A., Parameswaran, A., & Enright, N. (2012). “Evaluating the quality of care delivered by an emergency department fast track unit with both nurse practitioners and doctors.”
Australasian Emergency Nursing Journal, 15(4), 188-194.
1. Summary of Article: This article reported the quality of care in an FTA delivered by emergency nurse practitioners (NPs) and medical doctors (MDs). Patient satisfaction was measured using self-administered survey after the patient was treated in the FTA. They were also given a survey 2 weeks after discharge. Adverse outcomes were also measured independently.
2. Research Elements: A convenience sample was obtained in an Australian ED FTA. Patients were randomly selected to either see an NP or an MD. Out of the 320 enrolled in the study, 236 patients completed the survey. Descriptive statistics were used to summarize overall care. The strength of this study is the systematic evaluation of quality of care. This study’s limitation was that only 75% of the chosen patients completed the evaluation. Another limitation was the fact that the FTA only employed one NP who had more than 7 years of experience, making it difficult to compare to equally experienced medical staff (Dinh, Walker, Parameswaren, & Enright, 2012).
3. Outcome: Research Results: High quality of care was given by NPs and MDs, and health outcomes and adverse event rates were similar. NPs experienced higher patient satisfaction scores.
4. Significance to Nursing Practice: This article supports the implementation of an FTA. While both the MP and the NP demonstrated high quality of care, NPs yielded higher patient satisfaction scores. This is important to both the delivery of care in an FTA, but also the impact on the nursing...

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...on of an FTA and was compared to the data obtained for 6 months after the implementation. Strengths of this study included the use of dedicated senior staff for FTA patients. Limitations to this study included enhanced resources and an increase in number of patients after implementation, as well as a difference in the case mix (Ieraci, Digiusto, Sonntag, Dann, & Fox, 2008).
3. Outcomes: Research results: Wait times, treatment times, and LWBS rates were significantly lower in patients that were seen post-implementation.
4. Significance for Nursing and Patient Care: This study supports the use of an FTA with a unique way of streaming patients. With the positive results, this study is consistent with other studies of FTAs. However, without other studies to support this “lean thinking,” one would have to do further research to support this method of streaming patients.

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