Date of Conferral

2019

Degree

Doctor of Nursing Practice (DNP)

School

Nursing

Advisor

Joanne Minnick

Abstract

Increased patient wait times it the emergency department (ED) have been linked to poor patient outcomes and adverse health care events. The purpose of this quality improvement project was to determine if placing a nurse practitioner (NP) in the triage area would reduce door-to-provider times and improve patient throughput within the ED. The primary question for this quality improvement project was whether the use of NPs in the triage area would improve patient throughput and decrease wait times in the ED. A secondary question identified was if implementing an NP in the triage area would decrease patient length of stay in the ED. Rogers's diffusion of innovations model was used as a theoretical framework for the project. To evaluate the improvement in patient throughput in the ED, data were gathered for 12 months prior to and 12 months after the placement of an NP in the triage area. Data collection included door-to-provider times and door-to-discharge times. Analysis of the data using independent t tests showed no statistically significant reduction in door-to-provider times (p = .278) or overall lengths of stay in the ED (p = .235). There was an overall reduction in door-to-provider times of 11% and a 5% reduction in door-to-discharge times during the intervention. The implications of this project for social change include evidence that NPs are beneficial to the ED when used in the triage area. Based on the findings of this quality improvement project, it is recommended that an NP be placed in the triage area to decrease door-to-provider and door-to-discharge times, and to continue to improve the culture of the ED team to promote the use of NPs within the ED.

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