Electronic alerts for triage protocol compliance among emergency department triage nurses

James F Holmes Jr, Joshua Freilich, Sandra L. Taylor, David Buettner

Research output: Contribution to journalArticle

3 Citations (Scopus)

Abstract

Background: Alerts embedded in electronic health records (EHRs) are designed to improve processes at the point of care. Objective: The aim of this study was to determine if an EHR alert-at emergency department (ED) triage-increases the ED triage nurse's utilization of triage protocols. Methods: ED triage nurses were randomized to receive either a passive EHR alert or no intervention for patients with the following complaints: minor trauma with extremity injuries or female patients with abdominal pain. The EHR alert notified the nurse that the patient was eligible for diagnostic testing: radiographs for patients with injured extremities or urinalysis for female patients with abdominal pain. Results: Twenty-eight nurses triaged 20,410 patients in the 6months before the intervention and 19,157 in the 6months after the intervention. Before the intervention, the urinalysis protocol was implemented in 101/624 (16.2%) patients triaged by the intervention group and 116/711 (16.3%) triaged by the control group. After the intervention, the urinalysis protocol was implemented in 146/530 (27.6%) patients triaged by the intervention group and 174/679 (25.6%) triaged by the control group. Before the intervention, the radiograph protocol was implemented in 58/774 (7.5%) patients triaged by the intervention group and 45/684 (6.6%) triaged by the control group. After the intervention, the radiograph protocol was implemented in 78/614 (12.7%) patients triaged by the intervention group and 79/609 (13.0%) triaged by the control group. Conclusion: The use of a passive EHR alert to promote ED triage protocols showed little benefit. Before the widespread implementation of EHR alerts for patient care, rigorous studies are required to determine the best alert methods and the impacts of such interventions.

Original languageEnglish (US)
Pages (from-to)226-230
Number of pages5
JournalNursing Research
Volume64
Issue number3
DOIs
StatePublished - May 16 2015

Fingerprint

Guideline Adherence
Triage
Hospital Emergency Service
Nurses
Electronic Health Records
Urinalysis
Control Groups
Abdominal Pain
Extremities
Point-of-Care Systems
Wounds and Injuries
Patient Care

Keywords

  • electronic medical record
  • emergency services
  • triage

ASJC Scopus subject areas

  • Nursing(all)

Cite this

Electronic alerts for triage protocol compliance among emergency department triage nurses. / Holmes Jr, James F; Freilich, Joshua; Taylor, Sandra L.; Buettner, David.

In: Nursing Research, Vol. 64, No. 3, 16.05.2015, p. 226-230.

Research output: Contribution to journalArticle

Holmes Jr, James F ; Freilich, Joshua ; Taylor, Sandra L. ; Buettner, David. / Electronic alerts for triage protocol compliance among emergency department triage nurses. In: Nursing Research. 2015 ; Vol. 64, No. 3. pp. 226-230.
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abstract = "Background: Alerts embedded in electronic health records (EHRs) are designed to improve processes at the point of care. Objective: The aim of this study was to determine if an EHR alert-at emergency department (ED) triage-increases the ED triage nurse's utilization of triage protocols. Methods: ED triage nurses were randomized to receive either a passive EHR alert or no intervention for patients with the following complaints: minor trauma with extremity injuries or female patients with abdominal pain. The EHR alert notified the nurse that the patient was eligible for diagnostic testing: radiographs for patients with injured extremities or urinalysis for female patients with abdominal pain. Results: Twenty-eight nurses triaged 20,410 patients in the 6months before the intervention and 19,157 in the 6months after the intervention. Before the intervention, the urinalysis protocol was implemented in 101/624 (16.2{\%}) patients triaged by the intervention group and 116/711 (16.3{\%}) triaged by the control group. After the intervention, the urinalysis protocol was implemented in 146/530 (27.6{\%}) patients triaged by the intervention group and 174/679 (25.6{\%}) triaged by the control group. Before the intervention, the radiograph protocol was implemented in 58/774 (7.5{\%}) patients triaged by the intervention group and 45/684 (6.6{\%}) triaged by the control group. After the intervention, the radiograph protocol was implemented in 78/614 (12.7{\%}) patients triaged by the intervention group and 79/609 (13.0{\%}) triaged by the control group. Conclusion: The use of a passive EHR alert to promote ED triage protocols showed little benefit. Before the widespread implementation of EHR alerts for patient care, rigorous studies are required to determine the best alert methods and the impacts of such interventions.",
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