Emergency department (ED) triage is used to identify patients' level of urgency and treat them

looking at mortality rates in patients seeking emergency care conclude that the rate of death is substantially higher during times of crowding (Richardson, 2006, p. 213).

A visit to the emergency department (ED) is usually associated with negative thoughts by most people. It creates preconceived images of overcrowded waiting rooms and routine long waits for treatment (Jarousse, 2011). From 1996 to 2006, ED visits increased annually from 90.3 million to 119.2 million (32% increase). During this same time period, the number of EDs has declined by 186 facilities creating the age old lower supply and greater demand concept (Crane & Noon, 2011). There are many contributing factors that have led to an increase in ED visits. A few of these key drivers include lack of primary care access, rising of the uninsured population, dwindling mental health services, and the growing elderly

S (situation): Hi, my name Kelsey and I am a nurse in the emergency department. I am calling about Shannon O’Reilly’s most recent laboratory results.

The emergency services need to be called, and given all the correct information, such as, if you are with the casualty now, how many people are involved, the patients age/gender, if they are conscious. Computer software then uses this information to determine the priority of the call which is then categorised into emergency or non emergency.

Bedside reporting involves giving information or a report to the oncoming nurse in the presence of a patient. This method gives the patient an opportunity to ask questions and get clarification regarding his or her care. Bedside reporting increases patient satisfaction, quality of healthcare and nurse-to-nurse responsibility. Hospitals need to design a better handoff process that can easily reduce patient risks and increase patients’ involvement in their care. Emergency rooms shift reports usually take place at the nursing station of every patient care area. The departing nurse gives information verbally to the oncoming shift. Therefore,

Once the patients arrive to the unit, if the person belongs to either scheduled induction or C-Section, they are provided with a delivery room. If the patient does not belong to previously mentioned categories, and about to deliver, she is moved to a delivery room. One final category is, where patients come in because they feel that they are about to be in labor or the patients that experience various pregnancy related complications. These patients are monitored by the nurse, seen by the physician and put under observation. If any of those observation patients are about to go into labor, they will be moved to delivery room. The rest of the patients will be treated and discharged. A quick registration will be done for all patients as soon as they enter the unit. Additional documentation for triaged patients will be done after they are moved to triage. For patients in labor or C-Section, it will be done earliest of patient’s

Burney, M., Underwood, J., McEvoy, S., Nelson, G., Dzierba, A., Kauari, V., & Chong, D. (2012). Early detection and treatment of severe sepsis in the emergency department: identifying barriers to implementation of a protocol-based approach. Journal Of Emergency Nur

Triage is usually the first step of the emergency room and helps determine severity of each patient. Once through triage, the patient

This study will include nurses that are currently working in emergency department with at least six months of experience with varying ages and levels of education. The emergency nurses would be required to complete a formal training on understanding the Emergency Severity Index (ESI) algorithm and the complexities in accurately assigning a triage level. The level of competence of the nurses will be increased if they participate in the online educational opportunities. In addition to the formal course, an online acuity level triage designation course will also be implemented. The ED leadership team will be instrumental in encouraging staff to participate so they are adequately prepared to function as a triage

An emergency room nurse may assist in moving patients, taking blood labs and must use care and compassion while treating or informing patients of their condition. They may help physicians during exams and treatments, and monitor and record patients conditions, evaluate patients response to treatment and notify the doctor when appropriate. The information collected will be used by the emergency room nurse to identify factors related to discharge and advise the patient and family on how to continue their proper health care after leaving the hospital. Upon discharge the ER nurse will provide referrals to other health care individuals for follow up treatment to ensure continued care.

Triage is the categorizing of patients by order of who needs to be seen most urgently. It can be broken into three stages; emergent, urgent, and non-urgent. Emergent is immediately life or limb threatening. An example of an urgent case would be a dog that ingested half a bag of grapes 45 minutes ago or a male cat with a suspected blocked urinary tract with no urination for the past 12 hours or more. Urgent needs to be treated but is not life threatening or limb threatening if left untreated for several hours. An example of an urgent case would be a puppy that jumped off the couch and is now lame on its front right leg or a bird that comes in with a broken wing after a brief scuffle with the household cat.. Non-urgent should be treated but time is not a factor. An example of a non-urgent case would be

Suppose there is a patch call with a patient exhibiting chest pain and the ambulance is five minutes out. In this case, the room is equipped and prepared with all the essential needs for the chest pain patient upon their arrival in the ambulance. After the patient has arrived, the primary nurse on duty receives a report from the Emergency Medical Technician (EMT) that accompanied and provided initial care to the patient in the ambulance. At the same time, the secondary nurse and ERT become technical, or hands on. The patient is administered oxygen, cardiac monitors are placed, an EKG is administered, locks and labs are drawn, normal saline is administered, and a urinalysis is taken along with the patients’ blood glucose level. Each of these tasks is initiated prior to the Emergency Room Medical Doctor (MD) seeing the patient, or at the same time. Emergency

Patients arriving in the ED are triaged by a nurse then placed in an ED room according to their acuity. After being evaluated by a physician, the patient is either released to home or admitted. When the decision is made for the patient to be admitted, a request for an inpatient bed is placed to nursing administration who then assigns an available bed. If there is not an appropriate bed available, the patient must remain in the ED bed. This effectively reduces the capacity of the ED causing the department to either divert patients or patients will leave without being seen. Every patient who is diverted or leaves without being seen is lost opportunity cost to the hospital.

Several existing problems precipitated the creation of the triage system implemented by Kathryn Angell in an effort to deliver improved medical care. The main problem was a lack of coordination in service delivery. This lack of coordination caused excessive wait times on the order of anywhere from 23 to 40 minutes to see a nurse, 40 to 50 minutes to see a doctor, and as long as 55 minutes to get a prescription filled. The practice of all nurses being involved initially in seeing all patients caused duplication of efforts, including repeating questions and examinations, and resulted in procedural bottlenecks. Additionally, there were inconsistent levels of service and extreme variation in treatment because of the different experience

Sepsis is a debilitating, potentially life threatening condition that has become a big burden on the health system worldwide. Early recognition and aggressive timely treatment have proven to be life saving interventions. South Miami Hospital (SMH) aims to provide safe care to our community by implementing and utilizing evidence –based guidelines and protocols. According to research, early identification of patients presenting with signs and symptoms of sepsis is crucial to patients’ survival. In order to achieve this goal SMH Emergency Department (ED) implemented a triage sepsis-screening tool, an intervention that as evidenced by research helps to recognize patients at risk for developing sepsis or presenting with this devastating disease.