Published in:
01-04-2019 | Brief Report
How to achieve patient-centered testing: role of the protocol nurse
Authors:
Patricia N. Salimi, RN, Joelyn B. Niggel, RN, Friederike K. Keating, MD
Published in:
Journal of Nuclear Cardiology
|
Issue 2/2019
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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.