Johansen Mette Brehm, Forberg Jakob Lundager
Center for Health Management, Department of Organisation, Copenhagen Business School, Denmark.
Dan Med Bull. 2011 Oct;58(10):A4311.
Formalized triage in the emergency department (ED) is not widely used in Denmark; this study explores the effects of introducing a five-level process triage system in a Danish ED.
Semi-structured qualitative interviews were conducted with 15 emergency nurses. The interviews were preceded by observations of the work of the ED nurses in which focus was on the triage process.
Formalized triage was experienced to improve the overview of patients and resources at the ED, and the nurses described that they felt more assured when prioritizing between patients. Communication and coordination were also improved by the triage system. But more time spent on documentation and reevaluation may cause the nurses to feel professionally inadequate if adequate resources are not provided. Furthermore, the triage system has reduced the focus on the humanistic and psychosocial aspects of nursing. Difficulties were occasionally experienced when categorizing patients with diffuse symptoms according to the standardized triage symptoms and signs' algorithms.
Introducing a formalized triage system in the ED was experienced to give a better overview and more overall control of ED patients. Adequate resources are needed to ensure that a stronger focus on documentation and re-evaluation related to triage does not produce a feeling of professional inadequacy among the staff.
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丹麦急诊科尚未广泛采用规范化分诊；本研究探索在丹麦一家急诊科引入五级流程分诊系统的效果。
对15名急诊护士进行了半结构化定性访谈。访谈之前对急诊护士的工作进行了观察，重点是分诊过程。
护士们认为规范化分诊改善了急诊科患者和资源的整体情况，并且表示在对患者进行优先排序时更有信心。分诊系统还改善了沟通与协调。但是，如果没有提供足够的资源，花在记录和重新评估上的时间增多可能会让护士们感到专业能力不足。此外，分诊系统减少了对护理人文和社会心理方面的关注。根据标准化分诊症状和体征算法对症状不明确的患者进行分类时偶尔会遇到困难。
在急诊科引入规范化分诊系统有助于更好地了解和全面管理急诊患者。需要充足的资源来确保，在更注重与分诊相关的记录和重新评估时，不会让工作人员产生专业能力不足的感觉。
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