Nurse-driven protocols provide countless benefits for emergency departments, including saving money, reducing left-without-being-seen rates, and improving patient experience. But making the most of these protocols comes with challenges, from knowing when to use them, to ensuring nurses follow them, to establishing them in the first place.
Dawn Peta, Ashley Barney and Sarah K. Wells talked about the well-documented benefits of nurse-driven protocols.
“They’re standardized. They’re there for a reason. They’re evidence based. If we’re using them as often as we can, there’s going to be better outcomes,” said session co-presenter Dawn Peta, BN, RN, ENC(C), FAEN, a rural clinical instructor at Alberta Health Services in Canada. “Why aren’t we?”
That’s among the questions that the Emergency Nursing 2026 session, “Empowering Practice: Protocols that Improve International ED Outcomes” intended to help answer.
Some of the most common nurse protocols include chest pain, flank pain, stroke and sepsis, and following them can lead to positive outcomes. Peta cited Canadian research showing that utilizing nurse-driven protocols decreased ED crowding, led to faster pain relief for patients, streamlined workflows, boosted staff and patient satisfaction, and enabled nurses to work within the full scope of their practice.
“We’re here to serve the public. We’re here to ensure that they’re satisfied with the care that they’re being given,” Peta said. “By optimizing and using these nurse protocols, they feel seen. They feel heard.”
They can also help speed care when every second counts, like for stroke and sepsis patients.
“These protocols are helping us get ahead of the game,” said session co-presenter Ashley Barney, BSN, RN, CEN, a certified emergency nurse at Intermountain Health-Spanish Fork Hospital in Utah.
Having established protocols in place also helps nurses and EDs do more with less, which is especially important when budget constraints collide with increased patient volume and acuity.
“We need to do more and more with less and less,” said session co-presenter Sarah K. Wells, MSN, RN, CEN, CNL, consultant and founder of NTN Consults and New Thing Nurse. “This is a way to make that care time more efficient, to make sure we’re utilizing those minutes.”
Despite the well-documented benefits, establishing nurse protocols can be a challenge. That’s why when making the case for implementing them, it’s not enough to tout clinical benefits. Nurses also need to speak the “language of dollars and cents,” Wells said. For instance, saving five minutes per sepsis patient in door-to-antibiotic time every day adds up significantly over the course of the year.
Session attendees also shared some of their own challenges, including not being allowed to start IVs in the waiting room and patients leaving after they receive their test results but before they’ve seen a provider. One attendee shared that adding the phrase “pending provider review,” can help alleviate the LWBS issue.
Helping to prevent patients leaving before seeing a provider was a key takeaway for Lisa Bock, MSN, who works in shared governance at Legacy Emanuel Medical Center in Portland, Oregon.
“These kinds of sessions help our committee come up with ideas and collaborate with leadership,” she said.