Evaluation of an advanced nurse practitioner led emergency rapid assessment and treatment service

IF 1.8 4区医学 Q2 NURSING

International Emergency Nursing Pub Date : 2025-09-26 DOI:10.1016/j.ienj.2025.101684

Doireann Deay , Orla O’Keefe , Mary Byrne , Barry McBrien , Aileen McCabe

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引用次数: 0

Abstract

Background

Emergency Departments (EDs) globally face persistent challenges, including overcrowding and workforce shortages, which negatively impact care quality and efficiency. Advanced Nurse Practitioners (ANPs) have demonstrated value in improving patient satisfaction, reducing wait times, and delivering cost-effective care. In Ireland, the ANP role is well-defined and regulated, supporting autonomous clinical practice.

Local problem

At Tallaght University Hospital (TUH), a significant proportion of ED presentations—abdominal pain, and chest pain was found to consume disproportionate clinical hours. A new ANP-led Emergency Rapid Assessment and Treatment (ERAT) service was introduced to target these low-acuity, high-contact-hour cohorts and alleviate ED pressures.

Method

This service evaluation, conducted between September 2022 and April 2025, assessed ERAT’s feasibility, safety, impact on ED process times, and patient satisfaction.

Results

ERAT managed 2,518 patients, with no major adverse events or in-hospital deaths. Most patients (1,766, 74.8 %) were safely discharged. While overall ED length of stay did not differ, ERAT patients had significantly shorter clinician-to-discharge times (5.9 vs. 8.9 h, p < 0.05). Of the 56 abdominopelvic CT scans ordered, 42 scans (75 %) showed acute pathology. Eighty of the 85 (94.1 %) patients who completed a patient satisfaction questionnaire reported strong agreement that care met their expectations.

Conclusion

The ERAT service is a feasible, safe, and patient-centred model for managing targeted ED presentations. Findings support ANP-led services as an effective strategy to enhance ED efficiency, optimize care delivery, and improve patient satisfaction in acute care settings.

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一名高级执业护士领导的紧急快速评估和治疗服务的评价

全球急诊科面临着持续的挑战，包括过度拥挤和劳动力短缺，这对护理质量和效率产生了负面影响。高级执业护士（ANPs）在提高患者满意度、减少等待时间和提供具有成本效益的护理方面已经证明了其价值。在爱尔兰，ANP的角色是明确和规范的，支持自主临床实践。在Tallaght大学医院（TUH），发现很大比例的急诊科表现——腹痛和胸痛——消耗了不成比例的临床时间。一项新的由anp领导的紧急快速评估和治疗（ERAT）服务针对这些低视力、高接触时间的人群，减轻了急诊科的压力。该服务评估于2022年9月至2025年4月进行，评估ERAT的可行性、安全性、对ED处理时间的影响以及患者满意度。结果serat共管理2518例患者，无重大不良事件或院内死亡。大多数患者（1766例，74.8%）安全出院。虽然总体ED住院时间没有差异，但ERAT患者的临床至出院时间显著缩短（5.9 h对8.9 h, p < 0.05）。在预定的56次骨盆CT扫描中，42次（75%）显示急性病理。85名患者中有80名（94.1%）完成了患者满意度问卷，报告强烈同意护理符合他们的期望。结论ERAT服务是一种可行的、安全的、以患者为中心的治疗ED的模式。研究结果支持anp主导的服务是提高急症室效率、优化护理服务和提高患者满意度的有效策略。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

International Emergency Nursing NURSING-

CiteScore

3.20

自引率

11.10%

发文量

期刊介绍： International Emergency Nursing is a peer-reviewed journal devoted to nurses and other professionals involved in emergency care. It aims to promote excellence through dissemination of high quality research findings, specialist knowledge and discussion of professional issues that reflect the diversity of this field. With an international readership and authorship, it provides a platform for practitioners worldwide to communicate and enhance the evidence-base of emergency care. The journal publishes a broad range of papers, from personal reflection to primary research findings, created by first-time through to reputable authors from a number of disciplines. It brings together research from practice, education, theory, and operational management, relevant to all levels of staff working in emergency care settings worldwide.