George S, Read S, Westlake L, Williams B, Fraser-Moodie A, Pritty P
Department of Public Health Medicine, University of Sheffield Medical School.
BMJ. 1992 Apr 4;304(6831):876-8. doi: 10.1136/bmj.304.6831.876.
To compare formal nurse triage with an informal prioritisation process for waiting times and patient satisfaction.
Accident and emergency department of a district general hospital in the midlands in 1990.
Patients attending between 8:00 am and 9:00 pm over six weeks were grouped for analysis according to whether triage was operating at time of presentation and by their degree of urgency as assessed retrospectively by an accident and emergency consultant.
5954 patients presenting over six weeks.
Time waited between first attendance in the department and obtaining medical attention, and patient satisfaction measured by questionnaire.
Complete data on waiting time were collected on 5037 patients (85%). Only 1213 of the 2515 (48%) patients presenting during the triage period were seen by a triage nurse. Patients in the triage group waited longer than those in the no triage group in all four retrospective priority categories, though differences were significant for only the two most urgent categories (difference in median waiting time 10.5 (95% confidence interval 3.5 to 14) min for category 1 and 8.5 (3 to 12) min for category 2). Responses to the patient satisfaction questionnaire were similar in the two groups except for the question relating to anxiety relating to pain.
This study fails to show the benefits claimed for formal nurse triage. Nurse triage may impose additional delay for patient treatment, particularly among patients needing the most urgent attention.
比较正式护士分诊与非正式优先排序流程在等待时间和患者满意度方面的差异。
1990年中部地区一家区级综合医院的急诊科。
对六周内上午8点至晚上9点就诊的患者，根据就诊时是否进行分诊以及急诊顾问回顾性评估的紧急程度进行分组分析。
六周内就诊的5954名患者。
首次到科室就诊至获得医疗护理的等待时间，以及通过问卷调查测量的患者满意度。
收集了5037名患者（85%）的完整等待时间数据。在分诊期间就诊的2515名患者中，只有1213名（48%）由分诊护士接诊。在所有四个回顾性优先级类别中，分诊组患者的等待时间均长于非分诊组患者，不过只有两个最紧急类别差异具有统计学意义（1类患者中位等待时间差异为10.5（95%置信区间3.5至14）分钟，2类患者为8.5（3至12）分钟）。除了与疼痛焦虑相关的问题外，两组患者对患者满意度问卷的回答相似。
本研究未能显示正式护士分诊所宣称的益处。护士分诊可能会给患者治疗带来额外延迟，尤其是在最需要紧急关注的患者中。
