Validation of Emergency Nurse Practitioner Competencies: Patient Complexity and Clinical Decision Making

Area of Science:

• Emergency Medicine
• Advanced Practice Nursing

Background:

• Emergency nurse practitioner (ENP) is a recognized nursing specialty.
• Limited objective data validates ENP practice in emergency care settings.

Purpose of the Study:

• To describe patient acuity, actions, decisional complexity, and disposition for ENPs.
• To analyze ENP practice in emergency departments within a single healthcare system.

Main Methods:

• Retrospective chart review of patient encounters.
• Descriptive exploratory study design.

Main Results:

• Most patients seen by ENPs were at Emergency Severity Index (ESI) 3 (56%), with significant numbers at ESI 2 (21%) and ESI 4 (21%).
• High-level Current Procedural Terminology (CPT) codes (99825+ or 99824+) were used in 50% and 94% of encounters, respectively.
• A high percentage of admissions, including to the intensive care unit, were observed.

Conclusions:

• The study illustrates the complex skills and clinical decision-making of advanced practice nurses in the emergency department.
• Further research into ENP education and training is recommended.