Nurse Practitioner model of care for ED ambulatory patients

The NP model in all Emergency Departments has been proven internationally, nationally and at a state level to improve access to care and service at the advanced nursing practice level for category 4 and 5 patients who present at the ED.

This service would enable the NP to practice automously and to their full scope of practice, however would work in collaboration with the interprofessional team in the ED to improve outcomes of care for patients.

The NP provides holistic patient centred care with the NP being credentialled to prescribe medications, refer to other members of the healthcare tea, and on discharge refer to the patient's General Practitioners and provide improvements in health wellness and health literacy for the patient, carer and family.  

The opportunity to test this model in the futures lab would be a great way to  identify the cohort of patients the ED NP would provide care, provide an understanding of medical and allied health staff on the scope of practice of the NP and  identify any areas of improvmement with the dynamics and workflows of the existing model of care provided in the ED.   Mental health patients would also benefit from the introduction of this model.

 

Why the contribution is important

With the demographics of healthcare changing including the aging population, patients with chronic disease the the changing role of the acute hospital, the MSHHS strategic plan identifies the challenges for the HHS in "improving our efficiency to ensure we are able to meet the demands of the community within the fiscal environment, and enhancing health service capacity by optimising the use of available infrastructure and workforce capability."  The NP model would provide the opportunity to assist in turning this challenge into an opportunity for the organisation.

It would be anticipated to have the ability to test this model should provide the evidence that the introduction of the NP for a specific cohort of patients in the ED's across the HHS would provide would improve patient outcomes with measures such as:

decreased NEAT, NEST and POST times in the ED

reduction in acute hospital admissions

improved patient satisfaction and outcomes - through evaluation

reduction in fragmented care towards a contemporay holistic patient centred care approach

by cherburns on August 13, 2019 at 11:34AM

Current Rating

4.375
Average score : 4.3
Based on : 8 votes

Comments

  • Posted by kewe August 20, 2019 at 08:57

    I have placed a similar suggestion; however believe there is merit in appointing Nurse Practitioners in the primary care setting to minimise the consumer presentation to the ED facilities. The Nurse Practitioners in Primary care need to practice from a facility outside of the ED environment, e.g. libraries or other community spaces. I acknowledge Nurse Practitioners - ED and Nurse Practitioners - Primary Care have differing clinical scope and expertise and could address this together. Behaviour modification regarding appropriate presentation is just as important as appropriate clinical care.
  • Posted by Foxcrofl August 20, 2019 at 13:36

    Great idea, to utilise the advanced skills of an NP more in the ED. This model would allow the NP role to provide valuable care and ultimately free up the ED congestion.
  • Posted by cherburns August 21, 2019 at 15:09

    Agree with comment from kewe above thankyou - both NP models would compliment each other - having witnessed the roles and their significant outcomes in other countries.
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