Decreasing ED Throughput Time with the Use of Nurse Sensitive Protocol

Emergency department (ED) crowding is a phenomenon that has been a problem for the United States and has extended to other countries as well. The media has recently given attention to this dilemma due to unfortunate events that have occurred as a byproduct of crowding. The literature on this topic is extensive and one possible solution to decrease waiting times and delay in EDs is the use of nurse sensitive protocols to increase throughput.;Thus, the Input-Throughput-Output model of ED crowding gives explanation to the causes and provides possible solutions to this dilemma. The focus of this project was based on the throughput aspect of the model. The purpose of the project was to address an area that dealt with the throughput process in the ED by implementing the Ottawa Ankle Rules (OAR) protocol to assist the ED staff in anticipating and treating ankle and foot injury patients. The setting was the Express Care (EC) area of the ED at the University of Virginia Health System. The OARs were implemented with these patients to determine if the length of stay in the ED would decrease with this protocol in place.;The results of this project support the findings within the literature that with the use of the OARs among nursing staff, there is a decrease in ED waiting times and a decrease in ED length of stay (LOS) by improving throughput. Of the four time measurements recorded, there was a statistically significant decrease in LOS in all but one time frame. With the use of the OARs among nurses, there was a statistically significant decrease of 45 minutes in the overall LOS of patients with ankle or foot injuries.