A Nurse Practitioner-Led Urgent Care Center
A Nurse Practitioner-Led Urgent Care Center
Many benefits exist to having an urgent care center specifically for patients with cancer. The most significant is the reduction of ED visits for oncology-related symptom management. Providers in the ED may be ill equipped to quickly address common cancer-related symptoms such as pain, vomiting, or bowel issues in immune-compromised patients with cancer. The ICC serves as a critical unit in which patients can be seen the same day without an appointment. The primary oncology team initially triages patient calls, followed by phone communication by the NP for additional assessment. The ICC does not use an acuity system because all referrals are treated as urgent. Complaints from patients with cancer often are more complex than the telephone triage process can delineate. NPs educated in oncology are specifically equipped to manage cancer-related issues before they become so severe that they necessitate hospitalization. Patients often are seen within minutes of arrival to the ICC, which leads to a faster relief of the symptoms versus an average four-hour visit in the ED (Press Ganey, 2010). Patients with neutropenic fever can receive antibiotic treatment within a few minutes in the ICC versus 1.7 hours in the ED, which can lead to an automatic admission to the hospital when expeditious care could warrant closely monitored outpatient treatment (Weinick et al., 2010). A patient with a mild complaint of pleuritic chest pain can get a computed tomography pulmonary embolism study, receive a dose of low-molecular weight heparin complete with self-injection teaching, and be discharged within two to three hours in the ICC.
The NPs in the ICC are able to get results of diagnostic tests faster than in other ambulatory care settings and perform the necessary procedures for patient symptom relief instead of referring the patient to another specialist. For example, a patient with a symptomatic pleural effusion can receive a therapeutic thoracentesis by a NP in the ICC and be discharged home within hours. The ICC also serves as a place in which patients can receive other outpatient procedures such as bone marrow biopsies, lumbar punctures, paracentesis, skin punch biopsies, and intrathecal chemotherapy, all performed by the NP. Patient satisfaction scores from the Press Ganey (2010) ambulatory patient satisfaction data system are monitored quarterly in the ICC and have been consistently above 80%, indicating that patients receive quality care by the NP. The ICC also uses a primary nurse model that allows for recurring patients to be seen by a familiar nurse. An established rapport is beneficial when evaluating an acute illness or symptom because the patient tends to be less anxious, and the nurse has insight on the patient's overall well-being.
Benefits of a Nurse Practitioner-Led Urgent Care
Many benefits exist to having an urgent care center specifically for patients with cancer. The most significant is the reduction of ED visits for oncology-related symptom management. Providers in the ED may be ill equipped to quickly address common cancer-related symptoms such as pain, vomiting, or bowel issues in immune-compromised patients with cancer. The ICC serves as a critical unit in which patients can be seen the same day without an appointment. The primary oncology team initially triages patient calls, followed by phone communication by the NP for additional assessment. The ICC does not use an acuity system because all referrals are treated as urgent. Complaints from patients with cancer often are more complex than the telephone triage process can delineate. NPs educated in oncology are specifically equipped to manage cancer-related issues before they become so severe that they necessitate hospitalization. Patients often are seen within minutes of arrival to the ICC, which leads to a faster relief of the symptoms versus an average four-hour visit in the ED (Press Ganey, 2010). Patients with neutropenic fever can receive antibiotic treatment within a few minutes in the ICC versus 1.7 hours in the ED, which can lead to an automatic admission to the hospital when expeditious care could warrant closely monitored outpatient treatment (Weinick et al., 2010). A patient with a mild complaint of pleuritic chest pain can get a computed tomography pulmonary embolism study, receive a dose of low-molecular weight heparin complete with self-injection teaching, and be discharged within two to three hours in the ICC.
The NPs in the ICC are able to get results of diagnostic tests faster than in other ambulatory care settings and perform the necessary procedures for patient symptom relief instead of referring the patient to another specialist. For example, a patient with a symptomatic pleural effusion can receive a therapeutic thoracentesis by a NP in the ICC and be discharged home within hours. The ICC also serves as a place in which patients can receive other outpatient procedures such as bone marrow biopsies, lumbar punctures, paracentesis, skin punch biopsies, and intrathecal chemotherapy, all performed by the NP. Patient satisfaction scores from the Press Ganey (2010) ambulatory patient satisfaction data system are monitored quarterly in the ICC and have been consistently above 80%, indicating that patients receive quality care by the NP. The ICC also uses a primary nurse model that allows for recurring patients to be seen by a familiar nurse. An established rapport is beneficial when evaluating an acute illness or symptom because the patient tends to be less anxious, and the nurse has insight on the patient's overall well-being.
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