Implementation of a Standardized Protocol for Telehealth Provider in Triage to Improve Efficiency and ED Throughput: A Quality Improvement Project.

There has been a significant rise in the number of emergency department (ED) visits over the past 15 years despite the number of ED providers and treatment spaces remaining fixed (M. P. Lin et al., 2018). A hospital's need to quickly initiate care upon patient arrival is of paramount importance to combat these ED overcrowding trends. A teleprovider in triage (TPIT) program without a standardized operating protocol leads to significant provider practice variations and limits effectiveness of a TPIT program. The intention of this health care project was to reduce ED time metrics and reduce the number of patients who left before evaluation by implementing a standardized TPIT protocol. This standardization allowed for a more predictable experience for the patient and ED staff. This quality improvement project involved developing and implementing a standardized TPIT protocol to improve TPIT efficiency and throughput. Patient ED visit metrics were collected during the pre- and postimplementation periods to evaluate for any improvement in throughput due to the TPIT protocol. The TPIT advanced practice providers (APPs) showed significant improvement in knowledge following the TPIT protocol education with an increase in provider comfort (p < 0.05). Time spent by the TPIT provider on each patient encounter was reduced by 23%, demonstrating increased provider efficiency. Improvements in discharge lengths of stay (LOS) (p = 0.68) and room to discharge LOS (p < 0.05) were noted following the implementation of the TPIT protocol. CONCLUSIONS: The implementation of the TPIT protocol provided improvements in APP knowledge and understanding of the process while increasing provider efficiency. Improvements were identified in specific ED patient metrics demonstrating the significance of the TPIT protocol on patient care.

Abdominal aortic aneurysm: an often asymptomatic and fatal men's health issue.

Men are more likely than women to develop an abdominal aortic aneurysm (AAA), a disease that is often asymptomatic and has up to a 90% risk of mortality if the aneurysm ruptures. What many men do not know is that an AAA can easily be identified through an ultrasound screening, and if the aneurysm is >5.5 cm, it can be surgically repaired to prevent a life-threatening rupture. Although current AAA screening recommendations focus on men between the ages of 65 and 75 years, who have ever smoked, recent evidence suggest many men of ages 50 to 80 years, regardless of smoking status, may also be at risk for developing an AAA. This article presents a comprehensive overview of AAA disease and summarizes current evidence-based diagnostic and treatment guidelines, the importance of educating men about this health issue, and the need for more widespread AAA ultrasound screening opportunities.

The importance of instruction on mass casualty incidents in baccalaureate nursing programs: perceptions of nursing faculty.

This study examined whether a relationship exists between mass casualty incident knowledge and perceived importance of incorporating competencies regarding mass casualty incidents into baccalaureate nursing programs by faculty in Louisiana. A total of 285 educators in baccalaureate nursing programs in Louisiana were asked to complete the survey instrument; usable surveys was collected from 166 participants (58%). Results indicated participants had limited training and life experiences regarding mass casualty incidents, as well as limited knowledge of mass casualty incidents. However, participants perceived mass casualty incident instruction as important for inclusion in nursing curricula. There was a positive relationship between self-perceived knowledge of mass casualty incidents and perceived importance of including these competencies into the nursing curriculum. These findings suggest schools of nursing take steps to identify or train a pool of educators who can teach mass casualty incident preparation.