Answer for NUR 590 Based on the PICOT you developed for NUR-550, summarize the intervention you are proposing Re: Topic 1 DQ 1 For uninsured and Medi-Cal patients, does the use of physician led triage in the emergency department compared to nurse led triage, lead to shorter length of stay for non-acute visits after six months?

Answer for NUR 590 Based on the PICOT you developed for NUR-550, summarize the intervention you are proposing

Re: Topic 1 DQ 1

For uninsured and Medi-Cal patients, does the use of physician led triage in the emergency department compared to nurse led triage, lead to shorter length of stay for non-acute visits after six months?

Physician In Triage (PIT) programs exhibit some benefits as they do reduce time from arrival to all results resulted (Franklin et al., 2021). Providers in triage allow for a quick disposition Although it does not shorten the overall length of stay in the Ed (Franklin et al., 2021). This study supports my PICOT statement as the average length of stay is for all patients of the ED whether they are discharged or admitted. Studies have shown that boarding hours contribute to extended length of stay. With PIT programs non acute patients will have a shorter length of stay as providers are able to move towards a disposition in a shorter amount of time.

There are some gaps as it relates to the literature review as the studies do not specifically state that provider lead triages will shorten length of stay for an uninsured patients, although the studies do imply that quicker dispositions will lead to quicker discharges which supports the need of PIT for uninsured non- acute ED visits. A study that analyzed an ED’s visits from July 2020 to July 2021 showed that 61.4% of 30,737 ED visits were non-urgent (Alnasser et al., 2023). If extended length of stay is attributed to increased boarding hours, it would be beneficial for PIT programs to be implemented in the fast-track area of the ED.

References

Alnasser, S., Alharbi, M., AAlibrahim, A., Aal Ibrahim, A., Kentab, O., Alassaf, W., & Aljahany, M.

(2023). Analysis of Emergency Department Use by Non-Urgent Patients and Their Visit Characteristics at an Academic Center. International journal of general medicine, 16, 221–232. https://doi.org/10.2147/IJGM.S391126

Franklin, B. J., Li, K. Y., Somand, D. M., Kocher, K. E., Kronick, S. L., Parekh, V. I.,

Goralnick, E., Nix, A. T., & Haas, N. L. (2021). Emergency Department

Provider in Triage: Assessing Site-Specific Rationale, Operational Feasibility,

and Financial Impact. Journal of the American College of Emergency

Physicians open, 2(3), e12450. https://doi.org/10.1002/emp2.12450