Triage Agreement

Our study showed little correspondence between the patient`s perceived priority and the actual nurse to whom the triage category was assigned. There is a lack of comparable studies in this area. Inter-rater studies have focused primarily on the validation of triage scales by the eyes of different health practitioners such as nurses, emergency physicians and general practitioners [26, 29-31]. Our study is the first to show that triage of undifferentiated gastroenterology transfers is possible with a decision algorithm by nurses. Of all the undifferentiated transfers, our study nurses were able to apply an endoscopy-triage code to 42% to 51% of the transfers. This was compared to 61% of the transfers that our gastroenterologist was able to select for endoscopy. Gerdtz MF, Collins M, Chu M, Grant A, Chernomoroff R, Pollard C, Harris J, Watertheil J. Optimizing triage consistency in Australian emergencies: The Adult Education Kit. Emerg Med Australas. 2008;20:250–9. In order to address the ethical concerns that underpin triage in conflict and humanitarian crises, new triage and classification frameworks have been proposed, specifically aimed at respect for human rights. Scientists have argued that new framework conditions should prioritize informed consent and rely only on established medical criteria to meet the human rights considerations of the 1864 Geneva Convention and the Universal Declaration of Human Rights,[55] but no comprehensive triage model has been adopted by international bodies.

In the UK, the most widely used triage system is the Smart Incident Command System[37], which is taught in the MIMMS (Medical Management and Major Medical Assistance) training programme. [38] British forces use this system for operations. It ranks victims from priority 1 (must be treated immediately) to priority 3 (can wait for delayed treatment). There is an additional priority 4 (expected, maybe even die during treatment), but the use of this category requires a leading medical authority. In the case of a typical hospital triage system, a triage nurse or physician will make requests for admission from the emergency physician for patients who need reception, i.e., physicians who care for patients from other floors who can be transferred because they no longer need that level of care (i.e., the patient in intensive care is stable for the medical floor). This helps patients sink more efficiently in the hospital. It is possible that the accuracy of triage and the proportion of transfers that can be selected by nurses can be improved through more formal training. However, we wanted to test a pragmatic approach in which registered nurses who work in endoscopy and who were not nurse endoscopes can be asked to perform triage tasks with limited training and a robust decision algorithm. Results: There was no significant difference between the triage outcomes of nurses and doctors (P According to the utilitarian model, triage works to maximize survival outcomes for most people.

This approach implies that some individuals may likely suffer or perish to allow the majority to survive. Triage officers must allocate limited resources and balance the needs of an individual against the population as a whole. While the primary mission of hospital emergency services (EDs) is to care for the sick and acutely injured, they also provide a safety net for people who do not have access to private health services or who cannot afford private health services [1, 2]. This coincides with the increase in demand and use of EDs in many countries, including Australia [3, 4]. While many factors contribute to this increase, there is some literature reporting “inappropriate” users [5-9], also known as “primary care” or “family physician (GP)” patients. Proponents of this expertise use criteria such as a low triage category and no need for admission to hospitals to assert that these patients should not be in a ED at all and should instead go to a primary health service [10, 11]. . . .