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

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.