title: The impact of an Emergency Department ambulance offload nurse role: A retrospective comparative study.
abstract: OBJECTIVE
  This study aimed to evaluate the impact of an Emergency Department Ambulance Offload Nurse (EDAOLN) role on patient and health services outcomes in one Queensland Emergency Department (ED).
  
  
  METHODS
  A retrospective study of all ED presentations (n=21,454) made to a tertiary hospital ED in Queensland, Australia, during July 9, 2012 - November 2, 2012; 39days before (T1), during (T2) and after (T3) the introduction of the trial of an EDAOLN role. The primary outcome of interest was time to be seen by a clinician.
  
  
  RESULTS
  Demographic and clinical profiles of ED presentations made during each of the time periods were relatively similar. Time to be seen improved marginally during the trial period of the EDAOLN (T1: 34min vs. T2: 31min, p=0.002). The proportion of hospital admissions and those who did not wait differed between T1 and T2 (lower during T2 vs. T3). Most outcomes were not sustained when the role was removed (i.e. T2 vs. T3), and most returned close to baseline (i.e. T1 vs. T3).
  
  
  CONCLUSIONS
  As part of a health services framework designed to improve timely access to emergency care, an EDAOLN may be one of several options to consider.
authors.affiliation: School of Nursing and Midwifery Griffith University, Australia. Electronic address: tanya.greaves@griffithuni.edu.au.
authors.forename: Tanya
authors.initials: T
authors.lastname: Greaves
authors.affiliation: School of Nursing and Midwifery and NHMRC Centre of Research Excellence in Nursing, Menzies Health Institute Queensland, Griffith University and Intensive Care Unit, Princess Alexandra Hospital, Brisbane, Australia.
authors.forename: Marion
authors.initials: M
authors.lastname: Mitchell
authors.affiliation: Menzies Health Institute, Queensland, Griffith University, Australia.
authors.forename: Ping
authors.initials: P
authors.lastname: Zhang
authors.affiliation: Department of Emergency Medicine, Gold Coast Health and Menzies Health Institute, Queensland, Griffith University, Australia.
authors.forename: Julia
authors.initials: J
authors.lastname: Crilly
mesh_terms: D000293:Adolescent; D000328:Adult; D000552:Ambulances; D004636:Emergency Service, Hospital / Q000639:trends; D005260:Female; D006801:Humans; D007587:Job Description; D008297:Male; D008875:Middle Aged; D024802:Nurse's Role; D009726:Nurses / Q000639:trends; D062209:Patient Handoff / Q000592:standards* / Q000639:trends; D063868:Patient Outcome Assessment; D011793:Queensland; D012189:Retrospective Studies; D013997:Time Factors; D000078329:Workforce
keywords: Ambulances; Emergency Services; Hospitals; Nursing; Patient outcome assessment