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Monday, 31 October 2011
Learning Objective 1: The learner will be able to know how to use pneumonia severity index in emergency department.
Learning Objective 2: The learner will be able to know how doee the emergency nurse practitioner managenent pneumonia patient.
The aims of this study were to explore to verify the consistency between emergency nurse practitioners (ENPs) using pneumonia severity index (PSI) assessment tool with emergency physicians using their professional skills and experience for management pneumonia patients in emergency department (ED). Prospectivestudy design was adopted using purposeful sampling technique and a medical center in northern Taiwan was used as study site. Patients who were diagnosed with pneumonia admitted to the ED of medical Center in Northern Taiwan between November to December 2008 and January 2009 were enrolled. Before study we designed a pilot study was to verify the consistency between different emergency ENPs using PSI assessment tool for management pneumonia patients in ED. There were high consistency of using PSI tool management pneumonia patients between NPs (kappa values >0.7, p<0.05). After we verify the ENPs had high consistency then we did two phases study to verify the consistency between NPs with emergency physicians management pneumonia patients in ED. The first phase there were low consistency of management pneumonia patients in ED between ENPs with emergency physicians (kappa value 0.3, p<0.01). The second phase there were still low consistency of management pneumonia patients in ED between ENPs with emergency physicians (kappa value 0.4, p<0.01). The study result showed between ENPs with emergency physicians had low consistency of management pneumonia patients in ED. The low consistency of management pneumonia patients between ENPs with emergency physicians due to the emergency physicians they were not routine using PSI tool management pneumonia patients in ED. Moreover, different emergency physician have different judgment.The PSI tool is not routine using assessment pneumonia patients in Taiwan. The PSI provided a useful prediction of medical outcome in patients who were diagnosed with pneumonia admitted in hospital the author recommend routine using PSI tool assessment pneumonia patients in Taiwan.