Document Type

Capstone Experience

Graduation Date


Degree Name

Master of Public Health

First Committee Member

Dr. Sharon Medcalf, PhD

Second Committee Member

Keith Hansen

Third Committee Member

Dr. Catherine Buckley, MD


Emergency Departments (EDs) are a valuable and limited public health resource. In addition to treating acute medical emergencies, EDs bridge the gaps in urgent care and primary care accessibility, operating twenty-four hours a day, seven days a week, providing care regardless of an individual’s ability to pay. EDs across the country operate at or above capacity regularly, and overcrowding is projected to increase due to decreased facilities and available inpatient beds. Innovative measures are necessary to increase patient throughput and decrease length of stay while maintaining quality care. Nurse initiated standing orders, also known as nurse driven protocols, standing orders, order sets, standardized procedures, triage protocols, etc., initiated by registered nurses prior to a medical assessment by an Emergency Department Physician, Nurse Practitioner, or Physician’s Assistant, are an effective mechanism to reduce length of service.