Date of Graduation

Summer 8-9-2017

Document Access

Restricted Project/Capstone - USF access only

Degree Name

Master of Science in Nursing (MSN)

College/School

School of Nursing and Health Professions

Abstract

A team based practice change project was led by a clinical nurse leader in an outpatient urgent care center to optimize efficacy and efficiency related to standardization of the triage process. After a microsystem assessment revealed excessive wait times for patients and variation in staff documentation in the electronic health record, utilization of smart-phrases was implemented to enhance patient safety and satisfaction. Patients and families dread unnecessary waiting and perceive it as dissatisfying and a waste of valuable time. Triage assessment in the waiting room facilitates the provision of timely, personalized patient care. The patient is given the opportunity to relay their health concerns, while the nurse is able to perform a quick assessment to ensure patient safety and stability. Over 14 months, Urgent Care Center has implemented a quality improvement project to establish a standardized triage protocol. The project systematized triage through the implementation of smart-phrases and introduction of a redesigned triage work flow algorithm. The results from this assessment flagged areas of inconsistency such as the long delay in initial nurse assessment due to lack of an ever-present triage nurse which led to inconsistencies in nursing assessment. Smart-phrases have fostered a more cohesive and accurate process of patient assessment. The evaluation of the smart-phrase intervention indicated that nurses gained increased confidence in utilizing their nursing triage skills. This project is part of an overall organizational goal to create a culture of continuous learning and improvement across settings. Clearly, the benefits and the contributions of a clinical nurse leader have provided an evidence-based and team approach to revise, update and test the redesign of a standardized triage protocol.

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