Effectiveness of an Advanced Practice Emergency Nurse Role in a Minor Injuries Unit

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.