Time to analgesia for care delivered by nurse practitioners in the emergency department: A retrospective chart audit

Jennings, Natasha, Kansal, Arushi, O'Reilly, Gerard, Mitra, Biswadev, & Gardner, Glenn E. (2015) Time to analgesia for care delivered by nurse practitioners in the emergency department: A retrospective chart audit. International Emergency Nursing, 23(2), pp. 71-74.

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Abstract

Objectives

To evaluate quality of care delivered to patients presenting to the emergency department (ED) with pain and managed by emergency nurse practitioners by measuring:

1) Evaluate time to analgesia from initial presentation

2) Evaluate time from being seen to next analgesia

3) Pain score documentation

Background

The delivery of quality care in the emergency department (ED) is emerging as one of the most important service indicators being measured by health services. Emergency nurse practitioner services are designed to improve timely, quality care for patients. One of the goals of quality emergency care is the timely and effective delivery of analgesia for patients. Timely analgesia is an important indicator of ED service performance.

Methods

A retrospective explicit chart review of 128 consecutive patients with pain and managed by emergency nurse practitioners was conducted. Data collected included demographics, presenting complaint, pain scores, and time to first dose of analgesia. Patients were identified from the ED Patient Information System (Cerner log) and data were extracted from electronic medical records

Results

Pain scores were documented in 67 (52.3%; 95% CI: 43.3-61.2) patients. The median time to analgesia from presentation was 60.5 (IQR 30-87) minutes, with 34 (26.6%; 95% CI: 19.1-35.1) patients receiving analgesia within 30 minutes of presentation to hospital. There were 22 (17.2%; 95% CI: 11.1-24.9) patients who received analgesia prior to assessment by a nurse practitioner. Among patients that received analgesia after assessment by a nurse practitioner, the median time to analgesia after assessment was 25 (IQR 12-50) minutes, with 65 (61.3%; 95% CI: 51.4-70.6) patients receiving analgesia within 30 minutes of assessment.

Conclusions

The majority of patients assessed by nurse practitioners received analgesia within 30 minutes after assessment. However, opportunities for substantial improvement in such times along with documentation of pain scores were identified and will be targeted in future research.

Impact and interest:

3 citations in Scopus
3 citations in Web of Science®
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ID Code: 74064
Item Type: Journal Article
Refereed: Yes
Additional URLs:
DOI: 10.1016/j.ienj.2014.07.002
ISSN: 1878-013X
Subjects: Australian and New Zealand Standard Research Classification > MEDICAL AND HEALTH SCIENCES (110000)
Australian and New Zealand Standard Research Classification > MEDICAL AND HEALTH SCIENCES (110000) > NURSING (111000) > Clinical Nursing - Secondary (Acute Care) (111003)
Divisions: Current > QUT Faculties and Divisions > Faculty of Health
Current > Institutes > Institute of Health and Biomedical Innovation
Current > Schools > School of Nursing
Copyright Owner: Copyright 2014 Elsevier
Copyright Statement: This is the author’s version of a work that was accepted for publication in International Emergency Nursing. Changes resulting from the publishing process, such as peer review, editing, corrections, structural formatting, and other quality control mechanisms may not be reflected in this document. Changes may have been made to this work since it was submitted for publication. A definitive version was subsequently published in International Emergency Nursing, Vol 23 Issue 2 DOI: 10.1016/j.ienj.2014.07.002
Deposited On: 16 Jul 2014 23:20
Last Modified: 12 May 2016 02:18

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