UBC Graduate Research

Nurse practitioners' impact on overcrowding Lazzarotto, Lyndsay 2018-04

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INTRODUCTION CONCLUSIONRESULTSEmergency Department Nurse Practitioner RoleMETHODS AND MATERIALS REFERENCESADDRESSING OVERCROWDING WITHEMERGENCY DEPARTMENT NURSE PRACTITIONERSPositive Impact No Significant ImpactLength of Stay* 6 7Left Without Being Seen* 6 3Door to Provider Time* 7 4012345678NUMBER OF STUDIESBy Lyndsay Lazzarotto MN-NP, BSN, RN, NP(F) candidate• Hospital resources are not keeping up to the demands of the increasing patient volumes (Cheng & Sullivan, 2013)• Emergency Departments are looking for ways to decrease overcrowding• This literature review examined the impact Nurse Practitioners have on patient throughput within emergency departments• A literature review was performed using 14 primary studies• Nurse Practitioners were compared to physicians, physicians assistants and medical residents• Patient flow was measured through the following variables:o Left without Being Seen rateso Length of Stay timeso Door To Provider times• Nurse Practitioners have been working in emergency department settings since the 1970’s• Nurse Practitioners have practiced in British Columbia since 2005, but they are underrepresented in British Columbia’s emergency departments (CRNBC, n.d.; Sangster-Gormley, 2014)• Within the emergency department, Nurse Practitioners work in a variety of settings such as minor treatment areas, triage, and trauma settings• Emergency Department Overcrowding will continue to worsen unless changes are made in the way care is currently delivered• Nurse Practitioners can play a role in decreasing overcrowding within emergency department settings by decreasing Left Without Being Seen rates and Door to Provider times, but they may not decrease patients’ overall Length of Stay• The analysis from this literature review did not find any negative impacts on LOS, LWBS rates or DTP rates, which demonstrates that ENPs can assist with patient flow but their contribution to cost savings should be further explored.• Further high quality research should be performed to explore the impact of Nurse Practitioners within emergency department settings• Nurse Practitioners have demonstrated that they are effective at decreasing ‘Left Without Being Seen’ rates and ‘Door To Provider’ times• Patient’s cared for by Nurse Practitioners had comparable length of stay times as those cared for by other service providersCheng, A., & Sutherland, J. (2013). British Columbia's pay-for-performance experiment: Part of the solution to reduce emergency department crowding? Health Policy, 113, 86-92. Doi: https://doi.org/10.1016/j.healthpol.2013.07.010Sangster-Gormley, E. (2014). A survey of nurse practitioner practice patterns in British Columbia. Retrieved from http://www.uvic.ca/research/projects/nursepractitioners/assets/docs/NP%20Practice%20Patterns%20Report.pdfCRNBC. n.d. Nurse Practitioner. Retrieved from https://www.crnbc.ca/WhatNursesDo/TypesOfNurses/Pages/NursePractitioner.aspxRESULTS* of the 14 Studies reviewed, no studies found Nurse Practitioners negatively impacted  Length of Stay, Left Without Being Seen rates or Door to Provider Times

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