• Natasha Jennings, Arushi Kansal, Gerard O'Reilly, Biswadev Mitra, and Glenn Gardner.
• School of Nursing & Institute for Health & Biomedical Innovation, Queensland University of Technology, Victoria Park Rd, Kelvin Grove, Qld 4059, Australia; Emergency and Trauma Centre, The Alfred Hospital, Commercial Road, Prahran, Victoria 3004, Australia. Electronic address: N.Jennings@alfred.org.au.
• Int Emerg Nurs. 2015 Apr 1; 23 (2): 71-4.

ObjectivesTo evaluate quality of care delivered to patients presenting to the emergency department (ED) with pain and managed by emergency nurse practitioners by: 1 Evaluating time to analgesia from initial presentation 2 Evaluating time from being seen to next analgesia 3 Measuring pain score documentationBackgroundThe delivery of quality care in the emergency department (ED) is emerging as one of the most important service indicators being measured by health services. Emergency nurse practitioner services are designed to improve timely, quality care for patients. One of the goals of quality emergency care is the timely and effective delivery of analgesia for patients. Timely analgesia is an important indicator of ED service performance.MethodsA retrospective explicit chart review of 128 consecutive patients with pain and managed by emergency nurse practitioners was conducted. Data collected included demographics, presenting complaint, pain scores, and time to first dose of analgesia. Patients were identified from the ED patient information system (Cerner log) and data were extracted from electronic medical records.ResultsPain scores were documented in 67 (52.3%; 95% CI: 43.3-61.2) patients. The median time to analgesia from presentation was 60.5 (IQR 30-87) minutes, with 34 (26.6%; 95% CI: 19.1-35.1) patients receiving analgesia within 30 minutes of presentation to hospital. There were 22 (17.2%; 95% CI: 11.1-24.9) patients who received analgesia prior to assessment by a nurse practitioner. Among patients who received analgesia after assessment by a nurse practitioner, the median time to analgesia after assessment was 25 (IQR 12-50) minutes, with 65 (61.3%; 95% CI: 51.4-70.6) patients receiving analgesia within 30 minutes of assessment.ConclusionsThe majority of patients assessed by nurse practitioners received analgesia within 30 minutes after assessment. However, opportunities for substantial improvement in such times along with documentation of pain scores were identified and will be targeted in future research.Copyright © 2014 Elsevier Ltd. All rights reserved.

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