George S, Read S, Westlake L, Fraser-Moodie A, Pritty P, Williams B
Department of Public Health Medicine, University of Sheffield Medical School.
J Epidemiol Community Health. 1993 Aug;47(4):312-5. doi: 10.1136/jech.47.4.312.
To investigate whether the greater urgency assigned to accident and emergency patients by triage nurses than by accident and emergency doctors was uniform across all patient groups.
Patients attending an accident and emergency department between 8.00 am and 9.00 pm over a six week period were assessed prospectively for degree of urgency by triage nurses, and retrospectively for urgency by one of two consultant accident and emergency doctors. Patients were grouped according to their clinical mode of presentation.
An accident and emergency department of a district general hospital in the Midlands, UK, in 1990.
1213 patients who presented over six weeks.
As might be expected, patients' conditions were assessed as being more urgent prospectively than retrospectively. This finding, however, was not uniform across all patient groups. Nurses' assessments of urgency tended to favour children and patients who presented with eye complaints and gave less priority to medical cases, particularly those with cardiorespiratory symptoms.
These findings have implications for all those involved in the organisation of triage systems and in the training of nurses in accident and emergency departments. It is essential that judgements on how urgently patients need to be seen are made in a completely objective manner.
调查分诊护士对急症患者判定的紧急程度高于急症科医生这一情况在所有患者群体中是否一致。
对六周内上午8点至晚上9点期间前往急症科就诊的患者进行前瞻性评估，由分诊护士评估紧急程度，并由两名急症科顾问医生之一进行回顾性评估。患者根据其临床就诊方式分组。
1990年英国中部地区一家区级综合医院的急症科。
六周内前来就诊的1213名患者。
正如预期的那样，前瞻性评估中患者病情的紧急程度高于回顾性评估。然而，这一发现并非在所有患者群体中都一致。护士对紧急程度的评估往往偏向儿童和眼部不适的患者，而对内科病例，尤其是有心肺症状的病例给予的优先级较低。
这些发现对所有参与分诊系统组织和急症科护士培训的人员都有启示。对患者需要多紧急就诊做出判断时，必须完全客观。
