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Pnina Granat, R.N, M.A, Hadas Ben Hemo, R.N, B.A, Nika Gurklienski, R.N, M.A,
Miri Berger, R.N, M.A.
Purpose:
Examining the role of a nurse at the ENT emergency departments in Israel, in order to establish uniform working principles and guidelines.
Patients' admission to the emergency department is conducted according to triage discipline in order to gather information for establishing the urgency level and waiting time for physicians' examination. ENT emergency room is usually in the hospital clinical departments and not in the emergency department. The increase of the number of applications to the emergency department and especially to the ENT emergency, along with the lack of triage and suitable nurses, causes dissatisfaction among physicians and nurses alike, lack of uniform guidance and uniform accompanying of the ENTpatients.
Methods:
A descriptive study based on questionnaires which took place at ENT departments and ENT clinics of general hospitals in Israel. Data analysis was conducted. Descriptive statistics was used for analyzing the outcomes.
Results:
16 departments and 15 clinics participated in this study. During the morning, 84% of the patients who addressed ENT emergency room were examined at ENT clinics, while during the evening and night, 87% were examined at the ENT department.
A qualified ENT nurse was found only in three ENT emergency rooms. A nurse present during examination was found in 27% of the cases whereas in 60% of the cases, a nurse was occasionally present.
A triage at the department was not preformed in 40% of the cases. 41% of the patients had a physician' examination according to their arrival time and 83%, according to the urgency of their diagnosis.
The role of the nurse in the ENT emergency room includes: giving analgesia (72%), giving IV medications (41%) helping with the treatment of bleeding patients (93%), sending laboratory tests (64%), patient monitoring (32%), calming the patient (75%), helping in child examination (81%), guidance upon discharge (64%), helping in translation (79%) and administrative assistance (82%).
Conclusion:
Triage at ENT emergency room is partly conducted.
Nurse is only occasionally present during patients' examination.
The nurse's role is only partly performed in the emergency room. No emergency room gave an answer to all clinical needs, including organized guidelines for discharge and follow up.
ENT department nurses did not qualify an emergency medicine course.
There was no qualified nurse to treat patients in ENT emergency room.
There is a need for a qualified ENT nurse for emergency departments in Israel.
It is essential to professionalize and to expand the nurse's role at ENT emergency departments.
In order to improve the medical treatment, team work and the well being of the patients, it is essential to define the nurse's role in ENT triage by establishing unified institutional and national guidelines.