Abstract
Background
Nurse-initiated interventions potentially provide an opportunity for earlier response
for time sensitive presentations to the Emergency Department, and may improve time-to-treatment,
symptomatic relief and patient flow through the department.
Objective
To determine the effectiveness of nurse-initiated interventions on patient outcomes
in the Emergency Department.
Method
The review followed the JBI methodology for reviews of quantitative evidence. Each
study was assessed by two independent reviewers and data were extracted from included
papers using standardized data extraction tools. Outcomes of interest included time-to-treatment,
relief of acute symptoms, waiting times and admission rates.
Results
Twenty-six studies were included in the final review, with a total of 9144 participants.
Nine were randomized control trials, 17 had a quasi-experimental design. Twelve of
the studies involved pediatric patients only and 14 included adult patients only.
Interventions, protocols and outcomes were heterogeneous across studies. Overall,
nurse-initiated interventions were effective in reducing time-to-analgesia, time-to-treatment
for acute respiratory distress as well as improved pain relief and decreased admission
rates.
Conclusion
To achieve early intervention and timely relief of acute symptoms, nurses should seek
to consistently implement nurse-initiated interventions into their care of patients
in the Emergency Department. Several findings are made to inform practice, however
future high-quality research with locally specific strategies is required to improve
certainty and quality of findings.
Keywords
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Article info
Publication history
Published online: March 13, 2021
Accepted:
January 24,
2021
Received in revised form:
January 24,
2021
Received:
August 30,
2020
Identification
Copyright
© 2021 College of Emergency Nursing Australasia. Published by Elsevier Ltd. All rights reserved.
