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.