Diane Louise Paulson1. 1. Madigan Army Medical Center, Fort Lewis, WA, USA. diken@comcast.net
Abstract
INTRODUCTION: In today's health care environment, nurses are sometimes substituted with unlicensed assistive personnel (UAP), despite the lack of research into the possible negative effects. This study compared the wait time and the number of patients who left without being seen (LWBS) between triage systems that use nurses (including licensed practical nurses, nurses with an associate's degree, and nurses with a baccalaureate degree) versus UAP. METHODS: This study was a comparative descriptive retrospective chart review. The sample consisted of 2 parts: Part 1 involved charts for every fifth patient presenting to the emergency department during the second shift in April 1997 (N = 323) and April 1998 (N = 281). Part 2 included the monthly number of patients who LWBS between January 1997 and April 1998. Data were collected from department-generated reports with use of investigator-designed forms. Specific time increments were calculated and compared between triage systems via 2-tailed t tests. The number of patients who LWBS was analyzed for trends. RESULTS: Wait time decreased by 73 minutes and the number of patients who LWBS decreased by 85% when nurses performed triage. DISCUSSION: Results of this study show that a triage system using nurses provided more services during triage and were associated with less wait time after triage and a decreased likelihood of patients LWBS compared with the triage system using UAP.
INTRODUCTION: In today's health care environment, nurses are sometimes substituted with unlicensed assistive personnel (UAP), despite the lack of research into the possible negative effects. This study compared the wait time and the number of patients who left without being seen (LWBS) between triage systems that use nurses (including licensed practical nurses, nurses with an associate's degree, and nurses with a baccalaureate degree) versus UAP. METHODS: This study was a comparative descriptive retrospective chart review. The sample consisted of 2 parts: Part 1 involved charts for every fifth patient presenting to the emergency department during the second shift in April 1997 (N = 323) and April 1998 (N = 281). Part 2 included the monthly number of patients who LWBS between January 1997 and April 1998. Data were collected from department-generated reports with use of investigator-designed forms. Specific time increments were calculated and compared between triage systems via 2-tailed t tests. The number of patients who LWBS was analyzed for trends. RESULTS: Wait time decreased by 73 minutes and the number of patients who LWBS decreased by 85% when nurses performed triage. DISCUSSION: Results of this study show that a triage system using nurses provided more services during triage and were associated with less wait time after triage and a decreased likelihood of patientsLWBS compared with the triage system using UAP.