2.50
Hdl Handle:
http://hdl.handle.net/10755/162727
Type:
Presentation
Title:
Triage Tuesdays: A Novel Approach to Disaster Education
Abstract:
Triage Tuesdays: A Novel Approach to Disaster Education
Conference Sponsor:Emergency Nurses Association
Conference Year:2007
Author:Langley, Denise, RN, BSN, CEN
P.I. Institution Name:Oregon Health & Science University
Title:Nursing Practice Education Coordinator
Contact Address:3181 SW Sam Jackson Park Road, Portland, OR, 97239, USA
Contact Telephone:(503) 494-7521
Co-Authors:Mercedes Wilson, RN BSN
Purpose: Mass casualty incident (MCI) triage typically occurs at the disaster scene, and emergency department (ED) personnel are usually not involved. It is not surprising, then, that ED staff attendance at disaster triage lectures and drills tends to be low, and that the emergency response literature provides little information on initial hospital or nurse-initiated MCI triage. Yet should disaster strike near or on-site of a medical facility, ED staff must be prepared to assume the disaster triage role. To address this need, our ED designed a cost-effective program to train emergency nurses in MCI triage in a hospital setting that both reinforces learning and maximizes RN participation.

Design: "Triage Tuesdays" is a 5-week; comprehensive, longitudinal staff education and quality improvement project designed by the ED nurse practitioner, education coordinator, and emergency preparedness coordinator. Participation in the program is mandatory for all triage-eligible nurses.

Setting: A 42-bed emergency department in an academic, Level 1, trauma center.

Participants: Patients admitted to the emergency department on any Tuesday of the 5-week study period, regardless of transport mode (e.g., helicopter, ambulance, walk-in). The project required no active patient involvement or gathering of additional patient information.

Methods: Experienced registered nurses (RNs) triaged patients entering the ED on Tuesdays of a 5-week period using the Emergency Severity Index triage system. The nurses then re-triaged the patients, using either the START (Simple Triage and Rapid Treatment) algorithm for adults, or the pediatric version, JUMPSTART for minors. Staff members not qualified to triage were excluded from the project. All disaster triage assessments were analyzed for accuracy using chart reviews by the two project coordinators and, when possible, concurrently, with severity acuity scores. This step provided nurses with immediate feedback and opportunities for learning. Retrospective chart audits captured data when the evaluator (one of the two project coordinators) was not physically present. Summary results were displayed in the unit, and individual results sent electronically each week to nurse participants. Staff learning and information retention was assessed at the conclusion of the 5-week period by monitoring disaster triage accuracy rates, and again six months later.

Results: Conventional lectures in disaster triage and disaster drills average only a 30% attendance rate and provide limited opportunity for hands-on training. In contrast, the Triage Tuesday program garnered an RN participation rate of 75% and required each RN's active involvement in the program. Direct program costs were negligible, i.e., the expense of designing a stamp for use on patients' charts. Indirect costs covered the two project coordinators' time (both budgeted positions in the emergency department). Cumulative nursing accuracy rates increased from 61% to 100% by the study's conclusion, and random retesting six months later resulted in a retained rate of 95%.

Recommendations: Significant increases in staff participation, triage accuracy, and recall of disaster management principles can be achieved through this hands-on, personalized approach to disaster triage training. Real-time individual feedback, weekly graphs, and the self-contained nature of this project resulted in success. Triage Tuesday drills will be incorporated into ongoing departmental education and integrated into the annual competencies.
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.titleTriage Tuesdays: A Novel Approach to Disaster Educationen_GB
dc.identifier.urihttp://hdl.handle.net/10755/162727-
dc.description.abstract<table><tr><td colspan="2" class="item-title">Triage Tuesdays: A Novel Approach to Disaster Education</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">Langley, Denise, RN, BSN, CEN</td></tr><tr class="item-institute"><td class="label">P.I. Institution Name:</td><td class="value">Oregon Health &amp; Science University</td></tr><tr class="item-author-title"><td class="label">Title:</td><td class="value">Nursing Practice Education Coordinator</td></tr><tr class="item-address"><td class="label">Contact Address:</td><td class="value">3181 SW Sam Jackson Park Road, Portland, OR, 97239, USA</td></tr><tr class="item-phone"><td class="label">Contact Telephone:</td><td class="value">(503) 494-7521</td></tr><tr class="item-email"><td class="label">Email:</td><td class="value">langleyd@ohsu.edu</td></tr><tr class="item-co-authors"><td class="label">Co-Authors:</td><td class="value">Mercedes Wilson, RN BSN</td></tr><tr><td colspan="2" class="item-abstract">Purpose: Mass casualty incident (MCI) triage typically occurs at the disaster scene, and emergency department (ED) personnel are usually not involved. It is not surprising, then, that ED staff attendance at disaster triage lectures and drills tends to be low, and that the emergency response literature provides little information on initial hospital or nurse-initiated MCI triage. Yet should disaster strike near or on-site of a medical facility, ED staff must be prepared to assume the disaster triage role. To address this need, our ED designed a cost-effective program to train emergency nurses in MCI triage in a hospital setting that both reinforces learning and maximizes RN participation.<br/><br/>Design: &quot;Triage Tuesdays&quot; is a 5-week; comprehensive, longitudinal staff education and quality improvement project designed by the ED nurse practitioner, education coordinator, and emergency preparedness coordinator. Participation in the program is mandatory for all triage-eligible nurses.<br/><br/>Setting: A 42-bed emergency department in an academic, Level 1, trauma center.<br/><br/>Participants: Patients admitted to the emergency department on any Tuesday of the 5-week study period, regardless of transport mode (e.g., helicopter, ambulance, walk-in). The project required no active patient involvement or gathering of additional patient information.<br/><br/>Methods: Experienced registered nurses (RNs) triaged patients entering the ED on Tuesdays of a 5-week period using the Emergency Severity Index triage system. The nurses then re-triaged the patients, using either the START (Simple Triage and Rapid Treatment) algorithm for adults, or the pediatric version, JUMPSTART for minors. Staff members not qualified to triage were excluded from the project. All disaster triage assessments were analyzed for accuracy using chart reviews by the two project coordinators and, when possible, concurrently, with severity acuity scores. This step provided nurses with immediate feedback and opportunities for learning. Retrospective chart audits captured data when the evaluator (one of the two project coordinators) was not physically present. Summary results were displayed in the unit, and individual results sent electronically each week to nurse participants. Staff learning and information retention was assessed at the conclusion of the 5-week period by monitoring disaster triage accuracy rates, and again six months later.<br/><br/>Results: Conventional lectures in disaster triage and disaster drills average only a 30% attendance rate and provide limited opportunity for hands-on training. In contrast, the Triage Tuesday program garnered an RN participation rate of 75% and required each RN's active involvement in the program. Direct program costs were negligible, i.e., the expense of designing a stamp for use on patients' charts. Indirect costs covered the two project coordinators' time (both budgeted positions in the emergency department). Cumulative nursing accuracy rates increased from 61% to 100% by the study's conclusion, and random retesting six months later resulted in a retained rate of 95%.<br/><br/>Recommendations: Significant increases in staff participation, triage accuracy, and recall of disaster management principles can be achieved through this hands-on, personalized approach to disaster triage training. Real-time individual feedback, weekly graphs, and the self-contained nature of this project resulted in success. Triage Tuesday drills will be incorporated into ongoing departmental education and integrated into the annual competencies.</td></tr></table>en_GB
dc.date.available2011-10-27T10:33:08Z-
dc.date.issued2011-10-17en_GB
dc.date.accessioned2011-10-27T10:33:08Z-
dc.description.sponsorshipEmergency Nurses Associationen_GB
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