Journal of Nuclear Cardiology | Official Journal of the American Society of Nuclear Cardiology
How to Achieve Patient-Centered
Testing: Role of the Protocol Nurse
Patricia N. Salimi, RN, Joelyn B. Niggel, RN,
Friederike K. Keating, MD
University of Vermont Medical Center
Copyright American Society of Nuclear Cardiology
Journal of Nuclear Cardiology | Official Journal of the American Society of Nuclear Cardiology
BACKGROUND
1- Patient-centered testing: right test, right patient
2- Communication between ordering and
performing thought to be important
3- At our lab, non-medically trained staff followed
scripts to schedule patients
4- Can the expertise of nurses be used to improve
this process?
Copyright American Society of Nuclear Cardiology
Journal of Nuclear Cardiology | Official Journal of the American Society of Nuclear Cardiology
METHODS
A. Study type:
A.
Retrospective observational cohort.
B. Study subjects: Consecutive patients
undergoing ETT or MPI stress tests
C. Intervention: Change from script-driven
scheduling to nurse review of all orders
D. Study endpoints:
A. Number of studies that could not be performed as
scheduled
Copyright American Society of Nuclear Cardiology
Journal of Nuclear Cardiology | Official Journal of the American Society of Nuclear Cardiology
RESULTS
7%
6%
5%
4%
*
Period 1 (n=1136)
*
3%
Period 2 (n=943)
* *
Period 3 (n=992)
2%
1%
*
0%
No-Show
Cancel
Reschedule
Move
Day-of-testing events during six months before (Period 1) and 12 months after (periods 2 and
3) the implementation of protocol nursing, as a percentage of all tests ordered, for nuclear
stress (MPI) and nonimaging stress tests (ETT). * p<0.05 for comparison with period 1
Copyright American Society of Nuclear Cardiology
Journal of Nuclear Cardiology | Official Journal of the American Society of Nuclear Cardiology
RESULTS
12%
5%
No Change
13%
Modality Changed
63%
Location Changed
Care Coordination
Stress First
7%
Protocol nurse interventions after implementing protocol nursing (periods 2 and 3)
Copyright American Society of Nuclear Cardiology
Journal of Nuclear Cardiology | Official Journal of the American Society of Nuclear Cardiology
CONCLUSIONS
1- Protocol nurses contribute measurably to
patient-centered testing
2- An optimal patient-centered approach could
include a combination of electronic point-ofordering tools and expert nurse review of orders.
Copyright American Society of Nuclear Cardiology