edoc

Does nonmedical hospital admission staff accurately triage emergency department patients?

Quitt, J. and Ryser, D. and Dieterle, T. and Lüscher, U. and Martina, B. and Tschudi, P.. (2009) Does nonmedical hospital admission staff accurately triage emergency department patients? European journal of emergency medicine, Vol. 16. pp. 172-176.

Full text not available from this repository.

Official URL: http://edoc.unibas.ch/dok/A6006175

Downloads: Statistics Overview

Abstract

OBJECTIVES: Utilization of hospital emergency departments (EDs) is continuously increasing. Though nurses and physicians are ultimately responsible for the definite triage decisions, initial ED patient triage is frequently performed by hospital admission staff. This study analyzes the quality of assessment of the severity of emergencies and the choice of treatment unit made by hospital admission staff. METHODS: One thousand fifty-nine consecutive surgical and medical patients entering the ED of the University Hospital Basel during an 11-day period were independently assessed by hospital admission staff without formal medical training, ED nursing staff, and ED physicians. Emergencies were classified by severity (intervention within minutes/hours/days) or by severity and resource utilization (immediate intervention with/without life-threatening condition, delayed intervention with high/low/no demand of resources). Emergency assessment and triage decision (surgical/medical, outpatient/inpatient treatment) were documented independently by all three ED staff groups. RESULTS: In 64% of the cases, initial assessment by admission staff corresponded with the final assessment by the ED physician. Concordance was, however, poor (kappa=0.23). Underestimation of the severity occurred in 7.5% of cases without severe or lethal consequences. Ninety-four percent of patients were treated in the unit to which they were originally triaged by the admission staff. CONCLUSION: Triage quality regarding the choice of treatment unit was found to be excellent, whereas the quality of the assessment of the severity of the emergency by nonmedical ED admission staff was acceptable. ED patients have to be assessed by medical staff early after admission to ensure adequate and timely interventions.
Faculties and Departments:03 Faculty of Medicine > Bereich Medizinische Fächer (Klinik) > Institut für Hausarztmedizin IHAMB > Hausarztmedizin (Tschudi)
03 Faculty of Medicine > Departement Klinische Forschung > Bereich Medizinische Fächer (Klinik) > Institut für Hausarztmedizin IHAMB > Hausarztmedizin (Tschudi)
03 Faculty of Medicine > Bereich Medizinische Fächer (Klinik) > Allgemeine innere Medizin USB > Ambulante innere Medizin (Hess C)
03 Faculty of Medicine > Departement Klinische Forschung > Bereich Medizinische Fächer (Klinik) > Allgemeine innere Medizin USB > Ambulante innere Medizin (Hess C)
UniBasel Contributors:Tschudi, Peter and Martina, Benedict and Dieterle, Thomas
Item Type:Article, refereed
Article Subtype:Research Article
Bibsysno:Link to catalogue
Publisher:Lippincott Williams & Wilkins
ISSN:0969-9546
Note:Publication type according to Uni Basel Research Database: Journal article
Related URLs:
Identification Number:
Last Modified:01 Mar 2013 11:14
Deposited On:01 Mar 2013 11:13

Repository Staff Only: item control page