The T2 nurse - A novel role to reduce time to treatment for critically ill patients in a metropolitan emergency department.

Background: Delayed access to treatment in the Emergency Department for patients presenting with time-critical presentations leads to increased morbidity and mortality. This study aimed to determine if the introduction of a novel 'T2 Nurse' nursing role to initiate assessment and treatment for time-critical (category 2) patients reduces time to treatment (TTT).

Methods: This pre/post-implementation pilot study used routinely collected performance data from all category 2 patients presenting to an emergency department in NSW, Australia from January 2023 to July 2024 using regression analysis.

Results: 17,332 pre-implementation records and 16,989 post-implementation records were examined. The mean average TTT pre-implementation was 27 min compared to 12 min during the program, with a mean daily average TTT reduced by 15.4 min post-implementation. After adjusting for seasonal variation, the T2 program significantly reduced average waiting time by approximately 8 min. There was a sustained increase in performance targets with over 80 % of category 2 patients seen within the recommended time post-implementation (a 42 % increase).

Conclusion: The implementation of a T2 nurse role led to statistically and clinically significant sustained improvements in TTT particularly when the T2 Nurse initiates treatment, which may lead to improved health outcomes.