Emergency Department Triage Medical Screening Exams: Can Nurses Effectively Determine Non-emergency?

2.50
Hdl Handle:
http://hdl.handle.net/10755/162831
Type:
Presentation
Title:
Emergency Department Triage Medical Screening Exams: Can Nurses Effectively Determine Non-emergency?
Abstract:
Emergency Department Triage Medical Screening Exams: Can Nurses Effectively Determine Non-emergency?
Conference Sponsor:Emergency Nurses Association
Conference Year:1996
Author:Presley, Diane, RN, MSN
Co-Authors:Valerie Fulbright, RN, BSN
Introduction: One of the most urgent issues facing emergency departments (ED) today is its use for the treatment of minor illness. Access to health care for all Americans has been of considerable policy concern. There are a variety of reasons, institutional and economic, that patients are more likely to choose the ED for basic medical care. Providing care in a managed care setting is a catch-22 situation for many EDs. How can you refer patients back to their medical home before you perform costly exams, without violating patient transfer laws? By utilizing tight triage protocols with ED nurses performing the medical screening exam.

Method: The program was instituted in a large inner city teaching hospital in the mid-south. Formal in-services conducted by the medical director educated ED nursing staff on how to perform the medical screening exam. The exam, appropriate to the organ system related to the chief complaint, is completed on all patients. Those who have abnormal findings are evacuated in the ED. Patients who fell within certain categories and had a minor chief complaint were referred out of the ED to off-site clinics, their private physician, or to their managed care organization (MCO) MD at the request of their case manager.

Results: During March 1995 through January 1996, 5341 patients were referred out. This represented 28% of the total patients who presented for emergency treatment. Follow up QA phone calls using the National Health Enhancement system, CENTRAMAX, noted that 61% of the patients contacted accessed another clinic or followed up with their MCO, and 33% felt better by the next day. The satisfaction rate for these patients was 96%. Less than 2% of patients recalled needed re-triage within 42 hours with worsening condition. Inability to contact 30% of the patients was related to inappropriate or disconnected numbers.

Conclusion: Medical screening exams performed by registered ED nurses were sufficient to identify non-emergency referrals without significant adverse outcomes. [Research Poster Presentation]
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.titleEmergency Department Triage Medical Screening Exams: Can Nurses Effectively Determine Non-emergency?en_GB
dc.identifier.urihttp://hdl.handle.net/10755/162831-
dc.description.abstract<table><tr><td colspan="2" class="item-title">Emergency Department Triage Medical Screening Exams: Can Nurses Effectively Determine Non-emergency?</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">1996</td></tr><tr class="item-author"><td class="label">Author:</td><td class="value">Presley, Diane, RN, MSN</td></tr><tr class="item-email"><td class="label">Email:</td><td class="value">res@ena.org</td></tr><tr class="item-co-authors"><td class="label">Co-Authors:</td><td class="value">Valerie Fulbright, RN, BSN</td></tr><tr><td colspan="2" class="item-abstract">Introduction: One of the most urgent issues facing emergency departments (ED) today is its use for the treatment of minor illness. Access to health care for all Americans has been of considerable policy concern. There are a variety of reasons, institutional and economic, that patients are more likely to choose the ED for basic medical care. Providing care in a managed care setting is a catch-22 situation for many EDs. How can you refer patients back to their medical home before you perform costly exams, without violating patient transfer laws? By utilizing tight triage protocols with ED nurses performing the medical screening exam.<br/><br/>Method: The program was instituted in a large inner city teaching hospital in the mid-south. Formal in-services conducted by the medical director educated ED nursing staff on how to perform the medical screening exam. The exam, appropriate to the organ system related to the chief complaint, is completed on all patients. Those who have abnormal findings are evacuated in the ED. Patients who fell within certain categories and had a minor chief complaint were referred out of the ED to off-site clinics, their private physician, or to their managed care organization (MCO) MD at the request of their case manager.<br/><br/>Results: During March 1995 through January 1996, 5341 patients were referred out. This represented 28% of the total patients who presented for emergency treatment. Follow up QA phone calls using the National Health Enhancement system, CENTRAMAX, noted that 61% of the patients contacted accessed another clinic or followed up with their MCO, and 33% felt better by the next day. The satisfaction rate for these patients was 96%. Less than 2% of patients recalled needed re-triage within 42 hours with worsening condition. Inability to contact 30% of the patients was related to inappropriate or disconnected numbers.<br/><br/>Conclusion: Medical screening exams performed by registered ED nurses were sufficient to identify non-emergency referrals without significant adverse outcomes. [Research Poster Presentation]</td></tr></table>en_GB
dc.date.available2011-10-27T10:34:54Z-
dc.date.issued2011-10-17en_GB
dc.date.accessioned2011-10-27T10:34:54Z-
dc.description.sponsorshipEmergency Nurses Associationen_GB
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