Evidence Based Clinical Orders

Emergency Departments are increasingly being forced by their administration to focus on improving “Through-Put” times. One of the areas that can positively impact this goal is the streamlining of the ordering process. Dr. Irma Nin, M.D., an emergency physician from Venice, Florida has developed, both from experience and published literature, an Evidence Based cost effective system for the ordering process.

Her expertise has shown that training triage nurses to use physician-determined criteria allows appropriate testing to be performed and the results to be ready in many cases in time for the physician’s first interaction with the patient.

The Triage Nurse is trained to take the History, perform a basic “hands on” exam, and then, based on the findings, implement a set of standardized standing orders. Some of the areas that lend themselves to this concept include: Congestive Heart Failure and G.I. Bleeding. Risks involved with establishing and using these standards are reduced because they are all based on published evidence.

At each facility where she consults, Dr. Nin works with the group and the nurses to develop individualized protocols for that facility. She then trains the nurses to implement the process, which in most cases includes developing a comfortable level with the performance of the “hands on” exam.

You are welcome to visit with Dr. Nin to discuss her ideas at Booth # 1512 at the ACEP Scientific Assembly in New Orleans, October 15-17, 2006.

You can also contact Dr. Nin by leaving her a message at www.medaphase.net.