Doctor of Nursing Practice Program

• Committee Chair Name & Credentials:
  Susanna Rudy, DNP, MSN, MFS, AG-ACNP, FNP-BC, ENP, CCRN
• Committee Member Name & Credentials:
  Jennifer Wilbeck, DNP, APRN, FAAN, FAANP

DNP Project Abstract

Advanced Practice Provider in Triage Impact on Emergency Department Crowding Metrics

Purpose
The purpose of this project was to positively impact median length of stay (LOS) and left without being seen (LWBS) rates at a freestanding emergency department (FSED) by utilizing an advanced practice provider in triage (PIT) during peak arrival times.

Methods
Retrospective data was collected to examine the impact of utilizing an APP in triage on the department’s LWBS and LOS. Data was collected for two weeks pre and post implementation. Increased provider hours to allow for overlapping coverage between 3pm and 6pm.

Results
Daily median LOS increased by 5 minutes, this was artificially increased due convoluted data generated by the analysis software.  LWBS rate increased from 3% to 5% but remained lower than the department’s previous max of 9%.  Daily census also averaged 15 patients per day higher during implementation due to a surge in local COVID-19 cases.

Implications for Practice
No prior studies exist for utilization of a PIT at a FSED. Limitations include single site and short duration of implementation. Future studies should focus on controlling variables to generate more reliable data to further support PIT as a positive application for ED department flow.