McCabe Catherine, O'Brien Margaurita, Quirke Mary B
Trinity College Dublin, School of Nursing & Midwifery, 24 D'Olier Street, Dublin 2, Ireland.
Tallaght University Hospital, Tallaght D 24, Ireland.
Int Emerg Nurs. 2019 Jul;45:31-35. doi: 10.1016/j.ienj.2019.03.002. Epub 2019 Apr 17.
The combined use of the Manchester Triage System (MTS) with the Early Warning Score (EWS) may be useful in ensuring both appropriate prioritisation and continued monitoring in the Emergency Department (ED) leading to early intervention for deteriorating patients thus improving patient outcomes especially in overcrowded EDs.
Determine the effect of the EWS and MTS on accuracy of the MTS and ED waiting times.
A retrospective cohort chart review of all adult patients who presented to the ED in one large hospital in Ireland (n = 10,048) at three time points between 1st September 2015-30th September 2016; 3 months prior to EWS introduction, implementation month and 9 months post-implementation.
Patients were significantly more likely to be categorised as an MTS category 2 (rather than 3-5) after the EWS was introduced (p < 0.001). Waiting times between triage and clinician review (p < 0.05) increased as did total time in the ED (p > 0.001). A similar finding was observed for patients with an MTS of 3-5.
Although positive in terms of patient outcomes, the effective and sustained combined use of the MTS and EWS requires increased bed capacity and experienced clinical staff to ensure that the ED journey time reduced rather than increased.
将曼彻斯特分诊系统（MTS）与早期预警评分（EWS）联合使用，可能有助于在急诊科（ED）确保适当的优先排序和持续监测，从而对病情恶化的患者进行早期干预，进而改善患者预后，尤其是在过度拥挤的急诊科。
确定EWS和MTS对MTS准确性和急诊科候诊时间的影响。
对2015年9月1日至2016年9月30日期间在爱尔兰一家大型医院急诊科就诊的所有成年患者（n = 10,048）进行回顾性队列图表审查；在引入EWS前3个月、实施当月以及实施后9个月这三个时间点。
引入EWS后，患者被归类为MTS 2类（而非3 - 5类）的可能性显著增加（p < 0.001）。分诊至临床医生评估之间的候诊时间（p < 0.05）以及在急诊科的总时间（p > 0.001）均有所增加。对于MTS为3 - 5类的患者也观察到了类似的结果。
尽管在患者预后方面是积极的，但MTS和EWS的有效且持续联合使用需要增加床位容量和经验丰富的临床工作人员，以确保急诊科的就诊时间减少而非增加。
