[See & treat emergency department: the shift from doctors to nurses with advanced skills. A literature review].
OBJECTIVE
Overcrowding and long waiting times are among the chronic problems of emergency Departments. The effectiveness and safety of See and Treat approach were assessed searching the available literature.


METHODS
The following key words were searched in Medline: See and Treat, Minor Injuries Unit, Fast Track, Emergency Department, and Emergency Nurse Practitioner selecting articles in English and Italian.


RESULTS
The 21 articles selected include 15 original studies, 2 systematic reviews and 3 letters. The large majority of the studies support the implementation of an advanced nurse practitioner (ANP) to screen patients and reduce waiting times for patients with minor codes. Although the results of the studies come to the same conclusion, the methodological quality is weak and the costs of the implementation of an ANP need to be further explored.


CONCLUSIONS
To implement a minor injury service the role and competences of ANPs need to be discussed, together with role boundaries with medical doctors. Patients should be able to choose if they prefer to be visited by a doctor. Guidelines and protocols should be implemented and strictly followed.
Bambi
Stefano
S
Diportimento di Emergenza, Accettazione ed Accoglienza AO Universitaria Careggi, Firenze.
Giusti
Monica
M
Becattini
Giovanni
G
D004638:Emergency Treatment / Q000451:nursing; D006801:Humans; D009722:Nurse Practitioners; D010820:Physicians