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Attitude of emergency department patients with minor problems to being treated by a nurse practitioner

Published online by Cambridge University Press:  21 May 2015

Meite S. Moser ,
Riyad B. Abu-Laban  and
Catherina A. van Beek
Meite S. Moser*
Affiliation:
Department of Emergency Medicine, Vancouver General Hospital, Division of Emergency Medicine, University of British Columbia, Vancouver, BC
Riyad B. Abu-Laban
Affiliation:
Department of Emergency Medicine, Vancouver General Hospital, Division of Emergency Medicine, University of British Columbia, Vancouver, BC The Centre for Clinical Epidemiology & Evaluation, Vancouver General Hospital, Vancouver, BC
Catherina A. van Beek
Affiliation:
Department of Emergency Medicine, Vancouver General Hospital, Division of Emergency Medicine, University of British Columbia, Vancouver, BC The Centre for Clinical Epidemiology & Evaluation, Vancouver General Hospital, Vancouver, BC
*
Department of Emergency Medicine, Vancouver General Hospital, 855 W 12th Ave., Vancouver BC V5Z 1M9; 604 875-4700, fax 604 875-4872, [email protected]

Abstract

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Introduction:

It may be appropriate for nurse practitioners (NPs) to provide care for a subset of emergency department (ED) patients with non-urgent problems. Our objective was to determine the attitude of ED patients with minor problems to being treated by an NP.

Methods:

Consecutive adults who presented to this tertiary ED on weekdays between 8 am and 4 pm were eligible for the study if they had 1 of the following 18 complaints: minor abrasions or lacerations, minor bites, minor burns, minor extremity trauma, cast check, earache, superficial foreign body, lice or pinworms, morning-after pill request, needlestick injury or body-fluid exposure, prescription refill, puncture wound, sore throat, subconjunctival hemorrhage, suture removal or wound check, tetanus immunization request, toothache, or urinary tract infection (women). Unless pain or a language barrier precluded study involvement, a triage nurse gave each patient a brief survey to be completed prior to physician assessment.

Results:

Of 728 eligible patients during the study period, 246 (34%) were invited to participate and 213 (87%) were enrolled. The mean age was 34.5 years, and 58% were men. When asked about their willingness to be treated by an NP, 72.5% said “yes” (95% confidence interval [CI], 65.8%–78.4%), 15.5% were “uncertain” (95% CI, 10.8%–21.1%) and 12.1% said “no” (95% CI, 8.0%–17.3%). Of those who said “yes,” 21% expected to also see an emergency physician during their ED visit and 67% did not. Willingness to be treated by an NP was independent of age, gender or educational status.

Conclusions:

A majority of ED patients with minor problems accepted being treated by an NP, often without additional physician assessment. Several factors, including impact on ED staffing and patient flow, logistics, cost and quality of care should be evaluated before implementing such strategies.

Keywords

emergency medicineemergency departmenthealth personnelnurse practitionerquestionnairesurvey
Type
EM Advances • Innovations en MU
Information
Canadian Journal of Emergency Medicine , Volume 6 , Issue 4 , July 2004 , pp. 246 - 252
Copyright
Copyright © Canadian Association of Emergency Physicians 2004

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