[Process nurse: the experience of the Emergency Department of Fano]

Abstract

. Process nurse: the experience of the Emergency Department of Fano.

Introduction: Overcrowding in Emergency Departments (ED) is a common worldwide phenomenon. Strategies are needed to manage the excessive influx and length of stay in the Accidents and Emergency (A&E) ward, which may adversely affect the organization of care. The process nurse (PN) has been proposed, but the literature lacks rigorous studies on its effectiveness.

Purpose: The pilot study was conducted to evaluate how the PN affects thre length of stay and drop-out rate after triage of selected users accessing the A&E.

Methods: The PN was introduced in the A&E of the Santa Croce Hospital in Fano-AST Pesaro Urbino. Users with codes 3, 4, 5 and the most frequent causes for A&E visits were included. The length of stay and drop-out rate after triage were compared between users assigned to the PN and those who, at the same time and with the same problem and access codes, followed the standard process.

Results: In November 2022, 943 users were enrolled, 214 cared by the PN and 729 with standard care. The mean time spent in the A&E was significantly lower in the PN group (206.7 ± SD 144.2 minutes vs 282.4 ± SD 208.9 minutes, p <0.0001). The discharge rate was higher in the PN group (89.7% vs 75.3% p <0.0001), while the drop-out rate was lower (9.8% vs 24.1% p <0.0001).

Conclusions: The results highlight the potentialities of PN in the A&E and at triage, emphasizing its ability to speed up, facilitate, and optimize care pathways.