From the Guidelines
Emergency department nurse standing orders should prioritize basic life support interventions, including rapid mobilization of expert resuscitation teams and competent performance of basic emergency care, to improve patient outcomes. According to 1, basic emergency care is crucial in cardiopulmonary arrest, and nurses should be able to begin this care rapidly. The priority interventions for emergency department nurse standing orders typically include:
- Pain management with analgesics such as acetaminophen or ibuprofen
- Vital sign monitoring
- Laboratory testing, including complete blood counts and basic metabolic panels
- Intravenous access establishment and fluid resuscitation with normal saline or lactated Ringer's solution
- Initial treatments for common emergent conditions, such as respiratory distress with oxygen therapy or nebulized albuterol
These interventions are critical for time-sensitive conditions where early intervention improves outcomes, as noted in 1. Standing orders empower nurses to begin essential care while simultaneously notifying physicians, thereby reducing delays in treatment and improving emergency department efficiency and patient outcomes. The arrangement of services in patient areas, as described in 1, should prioritize access to the patient and minimize interference with nursing care, but this is secondary to the immediate need for basic life support interventions. The most critical aspect of emergency department nurse standing orders is to ensure rapid initiation of basic emergency care, as this has the greatest impact on morbidity, mortality, and quality of life.
From the FDA Drug Label
The FDA drug label does not answer the question.
From the Research
Priority Interventions for Emergency Department Nurse Standing Orders
The priority interventions for emergency department nurse standing orders can be identified based on the available evidence.
- Ensuring an adequate airway is the first priority in any emergency, including clearing the mouth, inserting an oral airway, assisting with intubation, oxygen therapy, and assessing the patient's respiratory system continually 2.
- Monitoring the patient's vital signs, administering intravenous fluids and medications, inserting foley catheters, and noting urinary output are also crucial interventions 2.
- Constantly observing the patient's level of consciousness and neurological status, and documenting this information carefully, are essential for providing appropriate care 2.
- Implementing a team-based model of care, matching manpower to patient arrivals, and adopting a data-driven approach can help reduce wait times and improve patient outcomes in the emergency department 3.
- Providing frontload assessment, early collateral communication, and appropriate discharge planning can also help maximize the quality of care for vulnerable cohorts, such as older persons, in a cost-effective manner 4.
- Focusing on secondary outcomes, such as perceived continuity of care, illness perceptions, self-care capacities, psychological symptoms, and medication adherence, can help reduce unnecessary emergency department revisits and optimize emergency department utilization 5.