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The Impact of Triage Nurse-ordered Diagnostic Studies on Pediatric Emergency Department Length of Stay

  • Youwei Li
  • Qunfeng Lu
  • Hua Du
  • Jianping Zhang
  • Lingling Zhang
Original Article

Abstract

Objective

To identify the need to revise the program triage nurse-ordered diagnostic tests in the emergency department (ED) of pediatric hospital, and to evaluate implementation of this program with three laboratory routine tests, namely blood, urine and stool, which the triage nurses ordered as relevant to pediatric patients’ symptoms.

Methods

The authors retrospectively reviewed the data of patients who registered in their ED between December 2015 and April 2016, including the tests as per the orders by triage nurses, and the time they arrived and the time they had their final payments. A comparison was made of those, who stayed in the ED, with nurse-requested tests, to those without such tests.

Results

The review indicated the total number of subjects who presented in ED during the study period and were included in the study was 116,202; 65.4% with nurse-requested tests while 34.6% without such tests. On median, the length of their stay with nurse-requested tests was 229 min and without such tests was 244 min, which has significant difference (P = 0.000).

Conclusions

The results of this program were associated with a reduction in ED treatment which achieved the purpose to improve high patient flow in the emergency department. However, this intervention needs further studies to develop the nurse-ordered diagnostic studies program with more different clinical conditions and tests including triage nurses training and guideline.

Keywords

Triage nurse-ordered diagnostic studies Emergency department Emergency care Overcrowding Pediatric Nursing 

Notes

Acknowledgments

The authors sincerely thank Hua Du, Jianping Zhang and Lingling Zhang, the chief nurse and two education nurses in the Emergency Department of Shanghai Children’s Hospital, for their assistance in data collection and guidance in using triage nurse-ordered diagnostic studies program at triage.

Contributions

QL designed this study and will act as guarantor for this paper. YL participated in formulating the management methods and drafted the article. HD, JZ and LZ participated in training triage nurses to provide triage nurse-ordered diagnostic studies service and in collecting the data. All authors have read and approved this article.

Compliance with Ethical Standards

Conflict of Interest

None.

Source of Funding

The task was completed thanks to the supports from Nursing Management Program of Shanghai Municipal Commission of Health & Family Planning (No. 140822111537878).

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Copyright information

© Dr. K C Chaudhuri Foundation 2018

Authors and Affiliations

  • Youwei Li
    • 1
  • Qunfeng Lu
    • 1
  • Hua Du
    • 2
  • Jianping Zhang
    • 2
  • Lingling Zhang
    • 2
  1. 1.Nursing Department, Shanghai Children’s HospitalShanghai Jiaotong UniversityShanghaiChina
  2. 2.Emergency Department, Shanghai Children’s HospitalShanghai Jiaotong UniversityShanghaiChina

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