Abstract：
PROBLEM:A 7.2% increase in patient volume from 130,700 to 140,800 in 2012 prompted St Joseph's Regional Medical Center Emergency Department to review existing triage processes to decrease turnaround time. "Pivot triage" is a new, efficient intake process that entails use of 4 rather than 8 determinants to identify acuity levels. The purpose of this performance improvement project was to create alternatives to traditional triage to decrease ED length of stay and door-to-physician time. METHODS:After education, the pivot process was implemented using 4 determinants established by a multidisciplinary team. The pivot process was slowly implemented for 6 hours over a 1-week period to work out processing issues. Arrival time, door-to-physician time, and departure time from the emergency department were elements used to calculate the patient's turnaround time. Length of ED stay was collected monthly beginning in the fourth quarter of 2011. Comparisons were made after Pivot implementation in the fourth quarter of 2012. RESULTS:Despite the increasing volume, the mean door-to-physician time decreased from 71 to 40 minutes, a 43.7% reduction. The overall turnaround time decreased from 220 to 181 minutes, representing approximately a 17.7% reduction. The percentage of patients who left without being seen decreased from 2.5% to 1.0%. The pivot process improved patient flow in the emergency department, reducing time spent by the patient in the department. IMPLICATIONS FOR PRACTICE:The pivot process is a viable alternative to traditional triage. Nurses are able to accurately pivot patients with a reduced amount of information.
journal_name
J Emerg Nursjournal_title
Journal of emergency nursingauthors
Christensen M,Rosenberg M,Mahon E,Pineda S,Rojas E,Soque V,Johansen MLdoi
10.1016/j.jen.2015.07.014subject
Has Abstractpub_date
2016-09-01 00:00:00pages
395-9issue
5eissn
0099-1767issn
1527-2966pii
S0099-1767(16)00057-Xjournal_volume
42pub_type
杂志文章abstract：INTRODUCTION:The objective of this study was to examine the effect of a novel mindfulness-based time-out intervention on state of mindfulness among emergency nurses and, accordingly, on patient satisfaction. METHODS:A pre-post intervention design among nurses in the emergency department was used with a between-subject...
journal_title：Journal of emergency nursing
pub_type： 杂志文章
doi：10.1016/j.jen.2020.09.009
更新日期：2020-11-30 00:00:00
abstract：INTRODUCTION:This study aimed to develop a new model on the basis of the National Early Warning Score to predict intensive care unit admission and the mortality of patients with acute pancreatitis. METHODS:Patients diagnosed with acute pancreatitis in the emergency department were enrolled. The values of the National ...
journal_title：Journal of emergency nursing
pub_type： 杂志文章
doi：10.1016/j.jen.2019.11.003
更新日期：2020-03-01 00:00:00
abstract：:We have saved a minimum of $17,064 in personnel salaries of a patient representative (based on minimum wage and no paid benefits) during the past year. Although our liaison program was initially started as a cost-saving measure, the benefits of the program cannot be measured in monetary terms. Although this venture wa...
journal_title：Journal of emergency nursing
pub_type： 杂志文章
doi：10.1016/s0099-1767(95)80006-9
更新日期：1995-02-01 00:00:00
abstract：INTRODUCTION:Family-centered care recognizes the integral role of the family in the health and well-being of the pediatric patient. However, implementing a family-centered care approach often requires significant philosophical, practice, and environmental changes. A self-assessment inventory of family-centered practice...
journal_title：Journal of emergency nursing
pub_type： 杂志文章,多中心研究
doi：10.1067/men.2001.115285
更新日期：2001-06-01 00:00:00
abstract：INTRODUCTION:Patient satisfaction, an important measurable outcome, allows nurses to assess what can be improved in nursing practice. The purpose of this study is to compare expectations of patients and nurses using 3 nursing care attributes: 1) friendliness, courtesy, and respectfulness; 2) comfort measures; and 3) de...
journal_title：Journal of emergency nursing
pub_type： 杂志文章
doi：10.1016/j.jen.2013.02.010
更新日期：2014-07-01 00:00:00
abstract：INTRODUCTION:For children with autism spectrum disorder (ASD) and sensory-processing disorder (SPD), an unexpected visit to the emergency department can be an overwhelming experience that creates intensifying behaviors and an unsafe clinical interaction for the child, nurses, and providers. Although resources exist to ...
journal_title：Journal of emergency nursing
pub_type： 杂志文章
doi：10.1016/j.jen.2018.12.002
更新日期：2019-07-01 00:00:00
abstract：:Care of the patient with MI who receives thrombolytic therapy is an exciting challenge for the emergency nurse. By interrupting the process of cellular ischemia and necrosis, thrombolysis can salvage jeopardized myocardial tissue and lead to better patient outcome. Nursing interventions can help prevent possible compl...
journal_title：Journal of emergency nursing
pub_type： 杂志文章
doi：
更新日期：1989-03-01 00:00:00
abstract：:The rise in ED utilization among older adults is a nursing concern, because emergency nurses are uniquely positioned to have a positive impact on the care of older adults. Symptoms have been associated with ED utilization; however, it remains unclear whether symptoms are the primary reason for ED utilization. The purp...
journal_title：Journal of emergency nursing
pub_type： 杂志文章
doi：10.1016/j.jen.2016.10.001
更新日期：2017-01-01 00:00:00
abstract：:The care of the psychiatric patient in the emergency department offers yet another opportunity for emergency nurses to draw on specialty nursing resources or to create expanded roles for emergency practitioners themselves. As our emergency departments continue to encounter increasing numbers of patients, the need for ...
journal_title：Journal of emergency nursing
pub_type： 杂志文章
doi：
更新日期：1992-12-01 00:00:00
abstract：INTRODUCTION:New Zealand has an ethnically diverse population and continues to host immigrants from different countries. The present study aimed to examine the factors associated with ED use among new Asian immigrants in New Zealand. METHODS:A secondary analysis of 2016-2017 New Zealand Health Survey database. Univari...
journal_title：Journal of emergency nursing
pub_type： 杂志文章
doi：10.1016/j.jen.2020.07.011
更新日期：2021-01-01 00:00:00
abstract：OBJECTIVE:To determine what effect nurses' experience of interpersonal violence had on proposed nursing care of battered women ED patients. METHODS:One hundred ninety-five emergency nurses completed surveys on their personal experiences with violence involving patients or intimate partners and on their proposed nursin...
journal_title：Journal of emergency nursing
pub_type： 杂志文章
doi：10.1067/men.2002.124991
更新日期：2002-06-01 00:00:00
abstract：INTRODUCTION:ED crowding is a public health crisis, limiting quality and access to lifesaving care. The purpose of this study was to (1) evaluate the feasibility of radio-frequency identification tags to measure clinician-patient contact and (2) to test the relationship between ED occupancy and clinician-patient contac...
journal_title：Journal of emergency nursing
pub_type： 杂志文章
doi：10.1016/j.jen.2018.03.005
更新日期：2018-11-01 00:00:00
abstract：INTRODUCTION:Nurses, by the nature of their practice, are in a unique position to help patients complete advance directives (ADs). This article focuses on an open-ended question that was part of a larger quantitative survey, "What do emergency nurses need to increase their ability to assist patients with ADs?" METHODS...
journal_title：Journal of emergency nursing
pub_type： 杂志文章
doi：10.1016/j.jen.2005.02.001
更新日期：2005-04-01 00:00:00
abstract：:Teddy bear/doll clinics continue to offer a feasible, effective opportunity to reach the community's children and their health information needs. Many thanks to Sunny B. Lee, RN, BS (Swedish Covenant Hospital, Chicago), and Kathy Powell, RN, PhD, and Barb Pierce, RN, MS (Children's Hospital, Birmingham). ...
journal_title：Journal of emergency nursing
pub_type： 杂志文章
doi：10.1016/s0099-1767(97)90060-x
更新日期：1997-02-01 00:00:00
abstract：:The National Institutes of Health Stroke Scale (NIHSS) is commonly used in Comprehensive Stroke Centers, but it has not been easily implemented in smaller centers. The aim of this study was to assess whether nurse providers who were naive to stroke assessment scales could obtain accurate stroke severity scores using o...
journal_title：Journal of emergency nursing
pub_type： 杂志文章
doi：10.1016/j.jen.2016.09.002
更新日期：2017-05-01 00:00:00
abstract：INTRODUCTION:This quality-improvement project aimed to evaluate the effectiveness of implementing multidisciplinary education and deploying utilization tools aimed at reducing the inappropriate insertion of indwelling urinary catheters (IUCs) in the emergency department. Literature supports the use of decision support ...
journal_title：Journal of emergency nursing
pub_type： 杂志文章
doi：10.1016/j.jen.2012.07.022
更新日期：2014-05-01 00:00:00
abstract：BACKGROUND:ED boarding is a major issue in many hospitals. ED boarding occurs when there is insufficient hospital capacity to supply inpatient beds for admitted patients. ED boarding is not only a problem because of increased wait times for patients but also because it results in delays in administration of medication,...
journal_title：Journal of emergency nursing
pub_type： 杂志文章
doi：10.1016/j.jen.2018.10.006
更新日期：2019-03-01 00:00:00
abstract：INTRODUCTION:Prediabetes is an important public health issue. In 2011, 79 million Americans had prediabetes, and 7 million were undiagnosed. By 2025, the number of persons with prediabetes is projected to increase to 472 million globally. For many, the emergency department may be the only source of medical care or inte...
journal_title：Journal of emergency nursing
pub_type： 杂志文章
doi：10.1016/j.jen.2013.02.002
更新日期：2014-07-01 00:00:00
abstract：:People who are emotionally distraught or mentally ill are rarely predictable. A calm, reassuring, but firm and decisive manner is most effective in dealing with out-of-control patients. Staff members should be careful to never position themselves with a potentially violent or distraught patient between them and the do...
journal_title：Journal of emergency nursing
pub_type： 杂志文章
doi：
更新日期：1991-10-01 00:00:00
abstract：INTRODUCTION:Workplace violence is a significant occupational hazard in health care. As the largest group of employees in health care, nurses are particularly vulnerable to workplace violence, with those who work in emergency departments being especially at risk. The purpose of this research was to study the phenomenon...
journal_title：Journal of emergency nursing
pub_type： 杂志文章,多中心研究
doi：10.1016/j.jen.2005.07.008
更新日期：2005-12-01 00:00:00
abstract：:TAC and half-strength TAC appear to be highly effective and convenient local anesthetic agents that offer an advantage over injected lidocaine in acceptance by children. The use of TAC is not without risk (cocaine toxicity, theft, and abuse). The decision of whether to use TAC is usually made by the physicians in the ...
journal_title：Journal of emergency nursing
pub_type： 杂志文章
doi：
更新日期：1994-06-01 00:00:00
abstract：:Trauma nurse experts often are included on the professional teams who survey hospitals for trauma center designation. Evaluation of trauma nursing care includes interviews with staff and review of policies, procedures, and other documents. Medical records are reviewed to validate the verbal reports and examine complia...
journal_title：Journal of emergency nursing
pub_type： 杂志文章
doi：
更新日期：1989-09-01 00:00:00
abstract：UNLABELLED:Indwelling urinary catheters (IUCs) are placed frequently in older adults in the emergency department (ED). Though often a critical intervention, IUCs carry significant risks. Our objective was to examine current knowledge, attitudes, and practice of emergency nurses and other providers regarding IUC placeme...
journal_title：Journal of emergency nursing
pub_type： 杂志文章
doi：10.1016/j.jen.2015.02.013
更新日期：2015-09-01 00:00:00
abstract：INTRODUCTION:Pediatric emergency nurses who are directly involved in clinical care are in key positions to identify the needs and concerns of patients and their families. The 2010 Institute of Medicine report on the future of nursing supports the active participation of nurses in the design and implementation of soluti...
journal_title：Journal of emergency nursing
pub_type： 杂志文章
doi：10.1016/j.jen.2019.07.014
更新日期：2019-11-01 00:00:00
abstract：OBJECTIVE:The primary purpose of this study was to compare the rate of hemolysis in blood samples obtained by an i.v. catheter versus the rate in samples obtained by venipuncture (Vacutainer tubes and needles; Becton Dickinson Vacutainer Systems, Franklin Lakes, N.J.). Subsequently, variance in i.v. catheter diameter w...
journal_title：Journal of emergency nursing
pub_type： 临床试验,杂志文章,随机对照试验
doi：10.1016/s0099-1767(96)80213-3
更新日期：1996-12-01 00:00:00
abstract：INTRODUCTION:Family violence is common with significant long-term negative health effects. Health professionals are recognised as key providers of family violence intervention. In 2002, the Hawke's Bay District Health Board launched a Family Violence Intervention Programme in its emergency department. The intervention ...
journal_title：Journal of emergency nursing
pub_type： 杂志文章
doi：10.1016/j.jen.2008.05.004
更新日期：2009-04-01 00:00:00
abstract：INTRODUCTION:The purpose of this study was to describe characteristics, insights, and decision making of expert emergency nurses practicing in a triage environment. METHODS:A qualitative, descriptive study design was used. A purposive sample of 10 expert nurses from 2 midwestern emergency departments was recruited for...
journal_title：Journal of emergency nursing
pub_type： 杂志文章
doi：10.1067/men.2002.127513
更新日期：2002-10-01 00:00:00
abstract：:The purpose of this facility-level case report was to describe our facility's leadership process of applying the Donabedian model to structure an early response to the coronavirus disease pandemic relative to emergency care. Using the Donabedian model as a guide, both structure and process changes were implemented to ...
journal_title：Journal of emergency nursing
pub_type： 杂志文章
doi：10.1016/j.jen.2020.10.008
更新日期：2020-12-11 00:00:00
abstract：INTRODUCTION:This study examined the efficacy and feasibility of a collaborative iontophoresis procedure for dermal anesthesia prior to lumbar puncture (LP) in adult ED patients. METHODS:Patients were randomized to receive lidocaine by iontophoresis or needle infiltration. Emergency nurses and physicians completed a c...
journal_title：Journal of emergency nursing
pub_type： 临床试验,杂志文章,随机对照试验
doi：10.1016/j.jen.2004.08.010
更新日期：2004-10-01 00:00:00
abstract：:HBO is the definitive treatment for carbon monoxide poisoning, air or gas embolism, and decompression sickness. It is an important adjunct to other treatment modalities in the management of patients with cyanide poisoning, exceptional blood loss (anemia), crush injury, and gas gangrene. In addition, HBO has many inves...
journal_title：Journal of emergency nursing
pub_type： 杂志文章
doi：
更新日期：1989-05-01 00:00:00
