IMMEDIATE BEDDING

That Guy, BSN, RN, EMT-B · Apr 14, 2014

We tried that, and have gone away from it and now back to it to a modified version all within 3 months. Im curious what others say too

Esme12, ASN, BSN, RN · Apr 14, 2014

These things make me chuckle sometimes. While great in theory...it is not possible most of the time.

If you have an abundance of beds and staff this is entirely possible and a great thing. If however you are like most of the ED's in the US you are overcrowded and understaffed for the population/volume you serve. With facilities decreasing the number of inpatient beds to increase revenue and an ever increasing boarding time in ED's across the nation this remains an unobtainable goal.

While the JC wants ED wait times decreased...what they really care about is making sure you can follow consistently the policies set forth by the facility. They are not so focused on the policy as they are on the compliance/quality/consistency of the policies effectiveness.

The importance is to institute the best practice for patient care, bedside registration when open beds are available to provide the most expeditious quality care possible to the patient.

The ENA has set forth a position statement. http://www.ena.org/SiteCollectionDocuments/Position%20Statements/ImprovingFlowThroughputReduceCrowding.pdf

Usually a modified version of immediate bedding to eventually put in place that can prove quality and consistent compliance.

here is an interesting thread from 2008 I'm interested how this has changed....https://allnurses.com/emergency-nursing/immediate-bedding-thoughts-349211.html

Sassy5d · Apr 14, 2014

When we have available beds, we take pt to room and begin process. Or we immediately drag their name to a room as soon as we arrive them if we triage them in a different room. Not much else you can do if your beds are full.

Crux1024 · Apr 15, 2014

We do this, have been for about a year. The process for us is called Bypass Rapid Assessment Triage (BRAT). When there are at least 2 available beds, patients are met at the front by a triage nurse and registration person. They come up, state their complaint, get registered by the clerk. While that's happening, the nurse is looking for an appropriate bed according to their complaint and calling the nurse to let them know.

There was some pushback when it first started, and with times of high census, we are unable to do it. Its mostly accepted now. Generally we are able to BRAT for several hours, tapering to normal triage in the afternoon and evening. Obviously, this will require communication with the charge nurse and floor nurses and everyone has to be on board. We room them as soon as we can in the system and I remember being told we have significantly reduced our door to doctor time.

turnforthenurse, MSN, NP · Apr 15, 2014

We only do this if someone needs to come back right away, like chest pain with hx MI + other risk factors, s/s acute stroke, etc..

I feel like bringing patients back immediately works if you're not very busy and have a lot of open beds but when you are busy you need to know what is going on. What if you immediately bed a patient which takes up your last ER bed and then you have an ambulance rolling in? I just don't see it working, tbh.