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Doctor of Nursing Practice Projects

Document Type

DNP Project

Department

School of Nursing

Date of Degree

Spring 2020

Degree

Doctor of Nursing Practice (DNP)

Primary Advisor

Joyce Pulcini, PhD, PNP- BC, FAAN; Asefeh Faraz, PhD, APRN, FNP- BC

Keywords

emergency department, provider in triage, triage

Os Triage Software

Abstract

Background: This project implemented a Provider in Triage (PIT) system in a small emergency department (ED) in Washington State. The employment of a PIT to decrease patient waiting time and improve ED flow was supported by a literature review. A needs assessment was conducted, which indicated potential benefit from a PIT system, particularly because several ED metrics are worse than national average.

Aims/Objectives: This project aimed to develop, implement, and evaluate a PIT system by employing ED Advanced Practice Clinicians (APCs). The objectives consist of evaluating the impact of a PIT system on the percentage of patients who leave without a provider examination (LWBS), the length of time from ED patient arrival to provider examination (DTP), discharge (DTD), and/or admission (DTA).

Methods: The APC worked as PIT when the ED was full, with four patients waiting. Metrics including LWBS, DTP, DTD, and DTA were evaluated with SPSS 25. The control group involved patients from one year prior to the implementation of the PIT system. Control variables were considered using regression.

Results: Chi square analysis revealed that a PIT system had no impact on LWBS. Independent t tests found that PIT had no significant impact on DTD or DTA but was associated with a longer DTP. IMPLEMENTATION OF A PROVIDER IN TRIAGE 6

Conclusions: This DNP project did not lead to critical positive findings. However, confounding factors, including provider variation, nurse staffing, and census, could have influenced the significance of the results. A larger study with a control group matched for daily census is suggested for further research.

Copyright Notice

©2020 Rachel Parmer. All rights reserved.

Recommended Citation

Parmer MPH, MSN, FNP- BC, R. (2020). Implementation of a Provider in Triage Program in a Level III Emergency Department. , (). Retrieved from https://hsrc.himmelfarb.gwu.edu/son_dnp/60

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Forensodigital in association with SUMURI LLC, USA have developed MAC OS X based Forensic tool RECON for digital triage. RECON is a tool which can be used by both novice and expert forensic examiners. It can be used for live systems and mounted media analysis. With minimum user interaction RECON extract artifacts and produce hundreds of reports in different formats.

Terraformers: space command mac os. Key Features:-

- Support MAC OS x 10.7, 10.8, 10.9 and 10.10

- Reporting formats – HTML, PDF, XML and CSV

- Artifact timeline

- File timeline

NOTE: The latest versions of Adobe Reader do not support viewing PDF files within Firefox on Mac OS and if you are using a modern (Intel) Mac, there is no official plugin for viewing PDF files within the browser window.

Forensodigital in association with SUMURI LLC, USA have developed MAC OS X based Forensic tool RECON for digital triage. RECON is a tool which can be used by both novice and expert forensic examiners. It can be used for live systems and mounted media analysis. With minimum user interaction RECON extract artifacts and produce hundreds of reports in different formats.

Terraformers: space command mac os. Key Features:-

- Support MAC OS x 10.7, 10.8, 10.9 and 10.10

- Reporting formats – HTML, PDF, XML and CSV

- Artifact timeline

- File timeline

- Global Search, Metadata and Media preview

- Bookmarking option

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- Export files

- Identify virtual Machine and export them

Chat timeline

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RAM imaging

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Get RECON for Mac OS X combined with 10 hours of online and on demand training. Learn to harness the power of automated Mac Forensics. Successful completion of the training course leads to certification in RECON for Mac OS X. Students receive lifetime access to the curriculum for version 1, including future updates on new features and forensic plugins.