2.50
Hdl Handle:
http://hdl.handle.net/10755/162660
Type:
Presentation
Title:
A Triage Redesign: Creating a Screening Nurse Role
Abstract:
A Triage Redesign: Creating a Screening Nurse Role
Conference Sponsor:Emergency Nurses Association
Conference Year:2007
Author:Hinkle, Melissa, RN, MSN;
P.I. Institution Name:Virginia Commonwealth University Health System
Title:Nurse Clinician
Contact Address:1200 E. Marshall St., P.O. Box 980401, Richmond, VA, 23298-0401, USA
Contact Telephone:(804) 828-4888
Co-Authors:Michele Burt, RN, MSN
[Clinical Poster] Clinical Topic: Academic emergency departments (EDs) are traditionally associated with high volume and acuity, often resulting in longer wait times and decreased patient satisfaction. In a busy emergency department, multiple patients who are high-risk often arrive simultaneously. At a central Virginia Level I trauma center with over 80,000 annual visits, the front-end triage process was restructured as part of a departmental-defined performance improvement project. A screening nurse role was created to increase patient safety and patient satisfaction.

Implementation: An additional triage nurse was added to the current staffing model. The 24-hour/7-day a week position is staffed by a registered nurse who is located next to reception for improved visualization of patients as they enter the emergency department. All triage nurses were provided education regarding the primary functions of the role before implementation. The screening nurse performs a 30-60 second triage upon patient arrival to determine priority of patient care. Acuity level is assigned using the Emergency Severity Index (ESI) triage scale. This process allows for rapid identification of patients needing immediate intervention. Patients determined to be a level 1 or 2, are immediately transported to the treatment area by a paramedic or care partner. The screening nurse communicates the acuity rating and chief complaint via the computerized patient tracking system. Patients determined to be a level 3, 4, or 5 proceed to a triage room for a more comprehensive assessment. The screening nurse is also responsible for reassessing patients in the waiting room, providing reassurance to patients and family. The frequency of reassessment is based on acuity and length of waiting time. The paramedic or care partner assigned to triage supports this role by obtaining vital signs and providing comforts such as ice chips or a blanket. Documentation of a registered nurse assessment and vital signs are recorded on the patient record.

Outcomes: Since the implementation of this new role we have seen an increase in patient safety. While monitoring the waiting room, the screening nurse has intervened quickly when high-risk situations developed. There have been no negative outcomes in the triage area since the implementation of this new role. Leadership staff perceives they spend less time attending directly to patient complaints from the waiting room. Due to a transition in computer systems around this time period some data was lost. An ED-specific patient satisfaction survey is currently in development to obtain data related to patient satisfaction. The model offers an additional role in the emergency department with a unique focus for staff to rotate. Since implementation, there has been a documented increase in staff satisfaction in our department.

Recommendations: Further identification of potential front-end process changes must be addressed to improve patient and family satisfaction in the emergency department. This role has impacted emergency nursing practice by focusing on customer service and patient safety. Future evaluations may include exploring the correlation between ED nursing staff satisfaction and the implementation of the screening nurse role.
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.titleA Triage Redesign: Creating a Screening Nurse Roleen_GB
dc.identifier.urihttp://hdl.handle.net/10755/162660-
dc.description.abstract<table><tr><td colspan="2" class="item-title">A Triage Redesign: Creating a Screening Nurse Role</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">2007</td></tr><tr class="item-author"><td class="label">Author:</td><td class="value">Hinkle, Melissa, RN, MSN;</td></tr><tr class="item-institute"><td class="label">P.I. Institution Name:</td><td class="value">Virginia Commonwealth University Health System</td></tr><tr class="item-author-title"><td class="label">Title:</td><td class="value">Nurse Clinician</td></tr><tr class="item-address"><td class="label">Contact Address:</td><td class="value">1200 E. Marshall St., P.O. Box 980401, Richmond, VA, 23298-0401, USA</td></tr><tr class="item-phone"><td class="label">Contact Telephone:</td><td class="value">(804) 828-4888</td></tr><tr class="item-email"><td class="label">Email:</td><td class="value">Mhinkle@mcvh-vcu.edu</td></tr><tr class="item-co-authors"><td class="label">Co-Authors:</td><td class="value">Michele Burt, RN, MSN</td></tr><tr><td colspan="2" class="item-abstract">[Clinical Poster] Clinical Topic: Academic emergency departments (EDs) are traditionally associated with high volume and acuity, often resulting in longer wait times and decreased patient satisfaction. In a busy emergency department, multiple patients who are high-risk often arrive simultaneously. At a central Virginia Level I trauma center with over 80,000 annual visits, the front-end triage process was restructured as part of a departmental-defined performance improvement project. A screening nurse role was created to increase patient safety and patient satisfaction.<br/><br/>Implementation: An additional triage nurse was added to the current staffing model. The 24-hour/7-day a week position is staffed by a registered nurse who is located next to reception for improved visualization of patients as they enter the emergency department. All triage nurses were provided education regarding the primary functions of the role before implementation. The screening nurse performs a 30-60 second triage upon patient arrival to determine priority of patient care. Acuity level is assigned using the Emergency Severity Index (ESI) triage scale. This process allows for rapid identification of patients needing immediate intervention. Patients determined to be a level 1 or 2, are immediately transported to the treatment area by a paramedic or care partner. The screening nurse communicates the acuity rating and chief complaint via the computerized patient tracking system. Patients determined to be a level 3, 4, or 5 proceed to a triage room for a more comprehensive assessment. The screening nurse is also responsible for reassessing patients in the waiting room, providing reassurance to patients and family. The frequency of reassessment is based on acuity and length of waiting time. The paramedic or care partner assigned to triage supports this role by obtaining vital signs and providing comforts such as ice chips or a blanket. Documentation of a registered nurse assessment and vital signs are recorded on the patient record.<br/><br/>Outcomes: Since the implementation of this new role we have seen an increase in patient safety. While monitoring the waiting room, the screening nurse has intervened quickly when high-risk situations developed. There have been no negative outcomes in the triage area since the implementation of this new role. Leadership staff perceives they spend less time attending directly to patient complaints from the waiting room. Due to a transition in computer systems around this time period some data was lost. An ED-specific patient satisfaction survey is currently in development to obtain data related to patient satisfaction. The model offers an additional role in the emergency department with a unique focus for staff to rotate. Since implementation, there has been a documented increase in staff satisfaction in our department.<br/><br/>Recommendations: Further identification of potential front-end process changes must be addressed to improve patient and family satisfaction in the emergency department. This role has impacted emergency nursing practice by focusing on customer service and patient safety. Future evaluations may include exploring the correlation between ED nursing staff satisfaction and the implementation of the screening nurse role.</td></tr></table>en_GB
dc.date.available2011-10-27T10:31:58Z-
dc.date.issued2011-10-17en_GB
dc.date.accessioned2011-10-27T10:31:58Z-
dc.description.sponsorshipEmergency Nurses Associationen_GB
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