Standardized Protocols for Optimizing Emergency Department Care ACEP/ENA Joint Statement-Standardized Protocols for Optimizing Emergency Department Care ACEP/ENA Joint Statement

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The American College of Emergency Physicians (ACEP) and the Emergency Nurses Association (ENA) support and endorse the use of standardized nursing protocol orders in the emergency department (ED). These protocols, also known as standardized procedures or order sets, allow nursing staff to initiate patient evaluation and care before being seen by a physician or advanced practice provider. The use of standardized protocols is safe and effective in improving patient care by reducing variation, enhancing workflow, and improving coordination and evidence-based care.<br /><br />ACEP and ENA acknowledge the need for timely high-quality care in the ED, especially during times when a licensed practitioner is not immediately available. In these instances, facilities have found it beneficial to begin evaluation and care under standardized protocols enacted by nursing staff. These protocols include actions such as time-sensitive evaluations or treatments, enhancing patient comfort, reducing ED time, and improving overall patient safety and experience.<br /><br />Standardized protocols should be developed collaboratively with input from physician and nursing leadership, as well as other relevant hospital departments. They should be based on the best available evidence, and in cases where there is insufficient evidence, consensus-based protocols are appropriate.<br /><br />These protocols should identify the pre-approving physician or medical staff body, and nursing staff services rendered under the protocols should be reimbursed as if ordered by a physician or advanced practice provider. The use of standardized protocols does not create a physician-patient relationship, and robust education and continuous quality improvement programs should be in place.<br /><br />ACEP and ENA encourage regulatory and credentialing bodies to develop policies and procedures for standardized protocols taking into account these considerations.

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Keywords

American College of Emergency Physicians

Emergency Nurses Association

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