Document Detail

Does nonmedical hospital admission staff accurately triage emergency department patients?
MedLine Citation:
PMID:  19318963     Owner:  NLM     Status:  MEDLINE    
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.
Jonas Quitt; Daniel Ryser; Thomas Dieterle; Urs Lüscher; Benedict Martina; Peter Tschudi
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  European journal of emergency medicine : official journal of the European Society for Emergency Medicine     Volume:  16     ISSN:  1473-5695     ISO Abbreviation:  Eur J Emerg Med     Publication Date:  2009 Aug 
Date Detail:
Created Date:  2009-07-08     Completed Date:  2009-10-15     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9442482     Medline TA:  Eur J Emerg Med     Country:  England    
Other Details:
Languages:  eng     Pagination:  172-6     Citation Subset:  IM    
Interdisciplinary Emergency Department, University Hospital Basel, Basel, Switzerland.
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MeSH Terms
Aged, 80 and over
Child, Preschool
Emergency Nursing
Emergency Service, Hospital*
Medical Receptionists
Medical Staff, Hospital
Middle Aged
Observer Variation
Prospective Studies
Quality Assurance, Health Care
Triage / standards*
Young Adult

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