2.50
Hdl Handle:
http://hdl.handle.net/10755/162429
Type:
Presentation
Title:
The Sorting Hat: An Evidence-based Approach to Triage
Abstract:
The Sorting Hat: An Evidence-based Approach to Triage
Conference Sponsor:Emergency Nurses Association
Conference Year:2011
Author:Gomez, Belkys Teresa, RN, MSN, CPEN
P.I. Institution Name:Central DuPage Hospital
Title:Education Consultant
Contact Address:25 North Winfield Road, Winfield, IL, 60190, USA
Contact Telephone:630-933-6129
Co-Authors:Janet DiCosola, RN, BSN, CEN
[ENA Leadership Conference] Evidence-based Practice Presentation: The Sorting Hat: An Evidenced Based Approach to Triage

Purpose: Triage is an essential door to health care. Accurately identifying sick patients is crucial in providing care efficiently. The purpose of this evidence based project was to streamline the triage process, assure the Emergency Severity Index (ESI) scale is utilized appropriately, and maintain patient safety while aligning our objective with management to assure quality care.

Design: Although this is an evidence based project focused on stream lining the triage process making it more efficient, the design for the ESI component of the project is a descriptive retrospective chart review of 900 randomly selected ED patients from 2009 to 2010. The study received approval from the hospital Institutional Review Board (IRB).

Setting: The institution is a 316 bed community, level II center. The ED is a 36 bed unit with an average annual census of 68,000 visits.

Participants: Random records from adult patients were evaluated in the ED from January through March of 2009. This provided the researchers with baseline data on the accuracy of the utilization of ESI. October through December of 2009 provided the researchers with data on the utilization of ESI post education. October through December 2010 will provide researchers with maintenance data on the utilization of ESI.

Methods: A review of literature was performed to establish best practices in streamlining the triage process. A triage protocol was created with specific roles for nurses. Changes were made on two separate occasions with IRB approval to improve efficiency with the process. For the chart review, charts were reviewed together and assigned ESI scores after reading triage documentation.

Results: The purpose of this evidence based project was two fold. The triage process was streamlined and made more efficient by removing 3 out of 5 steps in the triage process. This allowed for patient treatment to be started more rapidly. The second part of the project demonstrated that the nurses were not utilizing ESI accurately. During the first chart review, ESI was utilized accurately 30% of the time with the most common ESI categorization of 3. Patients were consistently being under triaged. After education was provided, the second chart review demonstrated 67% accuracy with ESI. The maintenance data will be collected later this year.

Implication: The implications of this evidence based project were essential in further understanding of triage as a process, not a location. Another implication was the recognition of accurate ESI categorizations leading to streamlining patients through the triage area and placing patients in the correct location within the department. Dissemination of study results has resulted in peer accountability in accurate ESI categorization and staff engagement in process improvement.
Repository Posting Date:
27-Oct-2011
Date of Publication:
17-Oct-2011
Sponsors:
Emergency Nurses Association

Full metadata record

DC FieldValue Language
dc.typePresentationen_GB
dc.titleThe Sorting Hat: An Evidence-based Approach to Triageen_GB
dc.identifier.urihttp://hdl.handle.net/10755/162429-
dc.description.abstract<table><tr><td colspan="2" class="item-title">The Sorting Hat: An Evidence-based Approach to Triage</td></tr><tr class="item-sponsor"><td class="label">Conference Sponsor:</td><td class="value">Emergency Nurses Association</td></tr><tr class="item-year"><td class="label">Conference Year:</td><td class="value">2011</td></tr><tr class="item-author"><td class="label">Author:</td><td class="value">Gomez, Belkys Teresa, RN, MSN, CPEN</td></tr><tr class="item-institute"><td class="label">P.I. Institution Name:</td><td class="value">Central DuPage Hospital</td></tr><tr class="item-author-title"><td class="label">Title:</td><td class="value">Education Consultant</td></tr><tr class="item-address"><td class="label">Contact Address:</td><td class="value">25 North Winfield Road, Winfield, IL, 60190, USA</td></tr><tr class="item-phone"><td class="label">Contact Telephone:</td><td class="value">630-933-6129</td></tr><tr class="item-email"><td class="label">Email:</td><td class="value">Teresa_gomez@cdh.org; nadter95@sbcglobal.net</td></tr><tr class="item-co-authors"><td class="label">Co-Authors:</td><td class="value">Janet DiCosola, RN, BSN, CEN</td></tr><tr><td colspan="2" class="item-abstract">[ENA Leadership Conference] Evidence-based Practice Presentation: The Sorting Hat: An Evidenced Based Approach to Triage<br/><br/>Purpose: Triage is an essential door to health care. Accurately identifying sick patients is crucial in providing care efficiently. The purpose of this evidence based project was to streamline the triage process, assure the Emergency Severity Index (ESI) scale is utilized appropriately, and maintain patient safety while aligning our objective with management to assure quality care.<br/><br/>Design: Although this is an evidence based project focused on stream lining the triage process making it more efficient, the design for the ESI component of the project is a descriptive retrospective chart review of 900 randomly selected ED patients from 2009 to 2010. The study received approval from the hospital Institutional Review Board (IRB).<br/><br/>Setting: The institution is a 316 bed community, level II center. The ED is a 36 bed unit with an average annual census of 68,000 visits.<br/><br/>Participants: Random records from adult patients were evaluated in the ED from January through March of 2009. This provided the researchers with baseline data on the accuracy of the utilization of ESI. October through December of 2009 provided the researchers with data on the utilization of ESI post education. October through December 2010 will provide researchers with maintenance data on the utilization of ESI.<br/><br/>Methods: A review of literature was performed to establish best practices in streamlining the triage process. A triage protocol was created with specific roles for nurses. Changes were made on two separate occasions with IRB approval to improve efficiency with the process. For the chart review, charts were reviewed together and assigned ESI scores after reading triage documentation. <br/><br/>Results: The purpose of this evidence based project was two fold. The triage process was streamlined and made more efficient by removing 3 out of 5 steps in the triage process. This allowed for patient treatment to be started more rapidly. The second part of the project demonstrated that the nurses were not utilizing ESI accurately. During the first chart review, ESI was utilized accurately 30% of the time with the most common ESI categorization of 3. Patients were consistently being under triaged. After education was provided, the second chart review demonstrated 67% accuracy with ESI. The maintenance data will be collected later this year.<br/><br/>Implication: The implications of this evidence based project were essential in further understanding of triage as a process, not a location. Another implication was the recognition of accurate ESI categorizations leading to streamlining patients through the triage area and placing patients in the correct location within the department. Dissemination of study results has resulted in peer accountability in accurate ESI categorization and staff engagement in process improvement.<br/></td></tr></table>en_GB
dc.date.available2011-10-27T10:28:04Z-
dc.date.issued2011-10-17en_GB
dc.date.accessioned2011-10-27T10:28:04Z-
dc.description.sponsorshipEmergency Nurses Associationen_GB
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