Medical Directives – What it Means to You

A number of strategies are used to improve Emergency Department (ED) flow at Chatham-Kent Health Alliance (CKHA) campuses in Wallaceburg and Chatham. One of them is the using “Medical Directives”.

Medical Directives allow the ED nurses to begin or complete some treatments and diagnostic tests before the patient is seen by a physician or nurse practitioner. Empowering nurses to start these actions at the very beginning of the ED visit allows certain basic emergency procedures to be completed more quickly and efficiently, leading to safer patient care and better patient flow.

As an example, a patient with an injured wrist is assessed by the nurse at Triage by starting the directive - the patient is then sent for an x-ray of the wrist. When the patient is later seen by the physician or nurse practitioner, the x-ray has already been done and the pictures are in the computer, available for review. Without a directive, there would have been a wait to see the physician or nurse practitioner, then a wait to have the x-ray done, and then wait again to be seen to review the results.

Consider two patients arriving with chest pain, one to an ED with appropriate directives and the other to an ED with no directives. The first patient will have the nurses start an IV, apply oxygen, obtain an EKG, send standard blood work and will be given aspirin by the time the physician sees the patient. The other will only have their clothes removed and will be lying in a stretcher waiting for the physician to arrive.

The aim is to make our emergency departments function better while we provide safe and high quality patient care. Medical Directives are one of the tools we use at CKHA to achieve that aim.