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- W3012758000 abstract "Abstract Introduction State regulations may impede the use of nurse-initiated protocols to begin life-saving treatments when patients arrive to the emergency department. In crowding and small-scale disaster events, this could translate to life and death practice differences. Nevertheless, research demonstrates nurses do utilize nurse-initiated protocols despite legal prohibitions. The purpose of this study was to explore the relationship of the state regulatory environment as expressed in nurse practice acts and interpretive statements prohibiting the use of nurse-initiated protocols with hospital use of nurse-initiated protocols in emergency departments. Methods A mixed-methods approach was used with a cross-sectional nationwide survey. The independent variable categorized the location of the hospital in states that have a protocol prohibition. Outcomes included protocols for blood laboratory tests, x-rays, over the counter medication, and electrocardiograms. A second analysis was completed with New York State alone because this state has the strongest language prohibiting nurse-initiated protocols. Results 350 surveys from 48 states and the District of Columbia were received. A hospital was more likely to have policies supporting nurse-initiated protocols if they were not in a state with scope of practice prohibitions. Four qualitative categories emerged: advantages, approval, prohibition, and conditions under which protocols can be used. Prohibitive language was associated with less protocol use for emergency care. Conclusion State scope of practice inconsistencies create misalignment with emergency nurse education and training, which may impede timely care and contribute to inequalities and inefficiencies in emergency care. In addition, prohibitive language places practicing nurses responding to emergencies in crowded work environments at risk." @default.
- W3012758000 created "2020-03-27" @default.
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- W3012758000 date "2020-03-23" @default.
- W3012758000 modified "2023-09-27" @default.
- W3012758000 title "State Laws and Regulations Addressing Nurse-Initiated Protocols and Use of Nurse-Initiated Protocols in Emergency Departments: A Mixed-methods Cross-sectional Survey Study" @default.
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- W3012758000 doi "https://doi.org/10.1101/2020.03.19.20038414" @default.
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