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强制性分诊问题对分诊流程的影响:一项定性探索性研究。

The Effect of Mandatory Triage Questions on Triage Processes: A Qualitative Exploratory Study.

出版信息

J Emerg Nurs. 2024 Jan;50(1):84-94. doi: 10.1016/j.jen.2023.06.011. Epub 2023 Jul 21.

Abstract

INTRODUCTION

The study purpose was to obtain an understanding of both the types of questions mandated for the triage encounter in emergency departments across the United States and how emergency nurses perceive the relevance of these questions to the triage process.

METHODS

A qualitative descriptive exploratory study using focus group data was used. Data were collected at an in-person emergency nursing conference held in September 2022. Data were analyzed using Mayring's 8-step process.

RESULTS

Participants (n = 35) voiced concerns about a lack of expertise at all points in the triage process. The overarching problem is reported as data required by regulatory agencies are conflated with triage assessment information. Participants in this study reported that the conflation of the triage assessment with regulatory compliance is causing significant issues in the ability of emergency nurses to appropriately evaluate patient presentations. Thematic categories were identified as who's assessing the patients? assessment or compliance? important questions, situationally important questions, questions asked before discharge, and the lack of emergency nurse input.

DISCUSSION

The conflation of regulatory data collection with patient assessment at the initial triage encounter challenges the ability of the emergency nurse to rapidly and accurately identify patients at risk of deterioration. We recommend that initial triage processes encompass questions that focus on establishing the stability of the patient and the safety of the waiting room and include inquiry relevant to the patient presentation.

摘要

简介

本研究旨在了解美国各地急诊部门分诊时必须提出的问题类型,以及急诊护士如何看待这些问题与分诊过程的相关性。

方法

本研究采用了定性描述性探索性研究,使用了焦点小组数据。数据于 2022 年 9 月在一次现场急诊护理会议上收集。采用迈林的 8 步程序进行数据分析。

结果

参与者(n=35)对分诊过程中各个环节的专业知识缺乏表示担忧。首要问题是监管机构要求的数据与分诊评估信息相混淆。本研究的参与者报告说,分诊评估与法规遵从性的混淆,导致急诊护士无法正确评估患者就诊情况的问题严重。确定的主题类别为:谁在评估患者?评估还是合规?重要的问题、情境重要的问题、出院前提出的问题,以及缺乏急诊护士的投入。

讨论

在初始分诊时,将监管数据收集与患者评估混为一谈,这给急诊护士快速准确识别有恶化风险的患者的能力带来了挑战。我们建议,初始分诊流程应包括关注患者稳定性和候诊室安全性的问题,并包括与患者就诊相关的询问。

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