1. How to achieve patient-centered testing: role of the protocol nurse.
- Author
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Salimi PN, Niggel JB, and Keating FK
- Subjects
- Aged, Body Mass Index, Decision Support Systems, Clinical, Female, Humans, Male, Middle Aged, Myocardial Infarction diagnostic imaging, Patient Safety, Prospective Studies, Quality Improvement, Research Design, Tomography, Emission-Computed, Single-Photon, United States, Cardiology organization & administration, Cardiology standards, Exercise Test nursing, Myocardial Perfusion Imaging nursing, Nurses, Patient-Centered Care
- Abstract
Introduction: Patient-centered cardiac testing is predicated on choosing the right test for the right patient. We studied the effects of changing from script-driven scheduling to nurse-driven protocoling of stress tests., Methods and Results: A protocol nurse reviewed records before scheduling and communicated with patients and ordering providers if needed. We found that instituting nurse protocolling of all non-imaging (ETT) and nuclear (MPI) stress tests (N = 3071) resulted in protocol changes in 37% of our patients, and reduced the proportion of tests that could not be performed as scheduled by 56% and cancelations by 71% (P < 0.001 for each). These changes were sustained over two successive 6-month periods following a baseline observation period of 6 months. For MPI, the most frequent nurse interventions were re-protocoling as stress-first MPI (12% of tests), changing test location for clinical reasons (13%), changing stress modality (7%), and care coordination (5%)., Conclusions: Changing from script-driven scheduling to protocol nursing contributed measurably to patient-centered testing.
- Published
- 2019
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