Date Available

12-4-2018

Year of Publication

2018

Degree Name

Doctor of Nursing Practice

Advisor

Dr. Julianne Ossege

Committee Member

Dr. Elizabeth Tovar

Co-Director of Graduate Studies

Dr. Michelle Pendleton

Abstract

PURPOSE: Emergency Departments (ED) are a vital part of healthcare and they provide lifesaving services to patients that are acutely ill. However, the latest data shows that 42% of ED visits are related to medical complaints that can be managed by a primary care provider (PCP). The purpose of this study was to assess the need for a fast track within a midwestern suburban Emergency Department (ED) that is based upon the Family Nurse Practitioner (FNP) fast track model.

METHODS: This study was a descriptive study examining the usage of the ED for non-urgent medical complaints from January 1st 2017 to December 31st 2017 for two patient samples. The 1st sample was population level data on 9770 patients that were discharged from the ED with a non-urgent diagnosis. The second sample was a retrospective chart review of 200 patients discharged from the ED with a non-urgent diagnosis. This sample examined ED utilization data of patient demographics, time of presentation to the ED, frequency of ED usage for 2017 and insurance status. Further data collected were ED time metrics and patient satisfaction data for 2017.

RESULTS: The analysis found the ED had high rates of usage amongst pediatric patients, African Americans, women and patient’s with public health insurance. From the two patient samples the most common non-urgent discharge diagnosis was pharyngitis. Further data indicated the ED scored below pre-determined patient satisfaction metrics and wait times are higher than national averages.

CONCLUSION: Findings of this study revealed that a 31% of patients utilized this ED for non-urgent medical complaints, all of which can be managed by a FNP. There is further room for improvement in the metrics of ED wait times and patient satisfaction. Based on the results of this study the implementation of a FNP fast track may positively impact ED wait times, overcrowding, decrease the amount of patients that leave without being seen and increase patient satisfaction.

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