Effectiveness of an advanced practice emergency nurse role in a minor injuries unit

Abstract

Objective: To evaluate the effect of an emergency department discharge initiative (EDDI) nurse on discharge processes and patient transition outcomes.

Design: Prospective comparative study of two groups of patients, aged 18‑70 years discharged from a minor injuries unit.

Setting: Emergency Department Minor Injuries Unit at a large tertiary hospital in South East Queensland, Australia.

Subjects: In total 337 patients were eligible and 231 were included in the study. Participants were recruited into two groups one before the introduction of the intervention (n= 103) and one after the introduction of the intervention (n=128).

Intervention: Introduction of an EDDI nurse (an advanced practice role) focusing on improving patient pre‑discharge care and transition home.

Main outcome measures: Data were collected pre‑discharge and one week post discharge, using self reports of discharge planning processes and the Care Transitions Measure (CTM) Questionnaire.

Results: Patients seen by the EDDI nurse were significantly more likely to receive written discharge information, a discharge letter, information on equipment, information on medication side effects and have follow‑up arranged, than those not seen. The intervention group also had a better understanding of post discharge healthcare management with a mean CTM score of 83.3 out of a possible 100 compared with the pre‑intervention mean of 64.4. (p<0.001).

Conclusions: The introduction of an EDDI nurse in the minor injuries unit improves discharge information provision and follow‑up and leads to an improvement in post‑hospital care transition from the patient’s perspective.