Date of Publication


Project Team

Advisor: Margaret Aitken, DNP APRN


Purpose: Ambulatory telephone triage is critical to ensuring that patients receive assessment of acute complaints, advice and treatment in a timely manner. Protocols and standing orders help guide nurses in assessment and treatments for patients. Standing orders allow nurses to order medications under the guidance of protocols. The aim of this project was to establish protocols in order to increase nurse autonomy, decrease burden on providers, provide standardized care to patients and consensus for triage nurses.

Methods: The confidence of the nurses and needs of providers was assessed through Likert scale before and after surveys. Protocols and standing orders for three common gynecological complaints were created and implemented over six weeks.

Results: Protocols were used 24 times. Fifteen patients were treated according to protocols by the nurses directly without consultation with providers. 100% of the nurses and providers felt there was clearer guidelines and practice consensus. 50% of providers felt that the protocols had decreased the number of messages they answered.

Conclusions: The project represents a major practice change in the management of three common uncomplicated gynecological complaints. Creating protocols and standing orders allows nurses to practice with more autonomy, with clearer guidance and more consistent expectation. Using protocols and standing orders is beneficial to nurses, providers and patients in the ambulatory care setting.

Keywords: triage, protocols, ambulatory care, nursing protocol, professional practice

Document Type