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Solution
Discussion of the Project
Chapter One, Part 1:
Introduction to the Project:
Overcrowding in the Emergency Department(ED) continues to be a countrywide problem ad is linked to increased patient morbidity and fatalities hence the need to initiate a DPI project. To reduce overcrowding in the ED patient wait time and subsequent overcrowding, a Clinical Inter-Professional Team in Triage (CITiT model is proposed as the practice intervention (Abir et al, 2019).
Background of the Project:
The ED becomes overcrowded due to factors like inadequate resources and infrastructure like limited treatment rooms, insufficient staffing nurses to attend to the patients. Steep rise in patients presenting in the ED was seen after the enactment of the Affordable care Act of 2010. Other causes of overcrowding include the primary care provider referring their patients to ED for testing that is not urgent, leading to patient congestion and, eventually, overcrowding (Morley et al., 2018). With increased patient wait time, poor patient outcomes result together with decreased patient satisfaction.
Problem Statement
It was not known if or to what degree the implementation of the Clinical Interprofessional team in triage __________________would impact __on the number of patients who left without being seen by a physician___________ when compared to _usual Registered nurse only ______________ among _ambulatory and non-ambulatory patients in the ED__________ (population).
Purpose of the Project
The purpose of this pre and post intervention ________( i.e., quantitative pretest posttest) project was to determine if or to what degree the implementation of ___a CITiT ______________ (intervention) would impact ____decrease the patient wait time to less than two hours__________(what) when compared to ___patient wait time of more than two hours____________________ among __adult ambulatory patients _________(population) in a __Emergency Depart ___a primary acute care hospital ___ (setting i.e., primary care clinic, ER, OR) in ________ (state) over _a period of 28 days______ (time).
Clinical Question(s):
To what degree does the implementation of __CITiT_____________ (intervention) impacts __the rate of patients who left without being seen________________ (what) when compared to _patients who spent more than 2 hours ____________ among ____ambulatory patients _________ (population) patients in an acute hospital care____ (setting) in _period of ______ (state) over 4 weeks?
Then, include a leading phrase to introduce the questions, such as:
The following clinical questions guide this quantitative project:
Q1____In times of overcrowding in the ED can a CITiT reduce door to physician wait time and the patient’s length of stay.____________;
Q2 ____In the ED setting does the implementation of a CITiT model intervention improve the RNs efficiency and decrease the rate of patients who LWBS.____________
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Advancing Scientific Knowledge:
After conducting a PICOT Question guided systematic search followed by a systematic review, the literature identified an existing research gap in that the standard interventions had either a physician or a nurse only in triage while those with team triage (Liu et al., 2018).
References
Abir, M., Goldstick, J. E., Maltsberger, R., Williams, A., Bauhoff, S., Parekh, V. I., & Desmond, J. S. (2019). Evaluating the impact of emergency department crowding on disposition patterns and outcomes of discharged patients. International journal of emergency medicine, 12(1), 4.
Liu, J., Masiello, I., Ponzer, S., & Farrokhnia, N. (2018). Can interprofessional teamwork reduce patient throughput times? A longitudinal single-center study of three different triage processes at a Swedish emergency department. BMJ Open, 8(4), e019744.
Morley, C., Unwin, M., Peterson, G. M., Stankovich, J., & Kinsman, L. (2018). Emergency department crowding: a systematic review of causes, consequences and solutions. PloS one, 13(8).