‘Name’
‘Instructor’s Name’
Introduction
In health care services, the nurse is the first person most patients meet when they come for treatment, and in many ways a nurse is the ‘gatekeeper’ of the access to medical services. However, for taking the correct decisions (in our profession it literally are life and death decisions), a nurse has to be equipped with the proper information regarding the patient. So proper information capturing is crucial phase in the treatment of a patient. This is where triage forms gain their significance. The Merriam-Webster dictionary definition of triage is – “the process of sorting of patients according to the urgency of their need for care “. (Merriam Webster, ND) Triage is basically a data collecting exercise, and based on the information gathered, the priority of the treatment required for the patient is determined. The aim of this project is to analyze the importance and needs of the triage form, and explore the possible ways to improve the data capturing process.
Concept
The origin of the term triage can be traced to the French word ‘trier’ which means to sort or select. The term was said to be first used during the Napoleonic wars and more recently in World War I. (Iserson & Moskop, 2007). The French doctors treating the wounded in the battle are believed to have categorized the patients into 3 groups – a) those who cannot be cured however treated, b) those who definitely will survive irrespective of the treatment they receive and, c) those who have a chance of recovery only if they are given the proper treatment. (Chipman, Hackley & Spencer, 1980) This model was followed by many health care services, particularly where there is more number of patients to be attended and only a few healthcare professionals are available. As technology evolved, this concept too grew, and many modern approaches are adapted today to categorize patients. There are lot of triage methods like simple triage, advanced triage, continuous integrated triage, reverse triage and START model triage.
Issues
Triage is not only important in disaster and war conditions but is also significant in emergency department(ED) in hospitals. Conditions in an ED can also be war like, when lot of patients comes in and the nurse has to prioritize their treatment. A nurse has to admit these patients, analyze their condition, and has to refer them to the correct care taker, which can be done only through proper implementation of triage system. Every passing year, the numbers of people who come for admission in emergency rooms keeps on increasing. On assessment it can be seen that sometimes not all patients need emergency care. But this is where people come because nowadays most doctors do not take house call, and they have fixed working hours. A hospital on the other hand, is open throughout the day and has good diagnostic facilities. Take for example the Los Angeles Children Hospital. It was originally planned for accommodating close to 30,000 patients but even by the year 1968 it started receiving 48,000 patients. It is a community run hospital with an open-door policy, so a lot of people not just children, but even adults seek treatment in its ED. (Slater, 1970)
Implementation
The resultant confusion, overcrowding and chaos can be put on a check, only if there are proper methods to assess the condition of the patient, and to determine which patient need priority treatment. Or else the nurses will be left with little time to attend the patients who actually need immediate care. Thus the triage system has come a long way in streamlining the patient’s admission in the emergency rooms. ED triage systems are normally designed to allow the most urgent cases where patient need immediate treatment to be allowed in first, and patients with less urgent conditions are served on a first come –first serve method. Certain ED triage systems enable to sort out patients with minor illness who can be directed to other physician in that facility, rather than make them wait.
Evaluation and Suggestions
Through this study we have found that data capturing through triage system can be even more optimized by use of DPP technology. The digital pen not only allows the storage of more data, it also throws light on sequence in which the data was entered. Also I would like to make the following suggestions to improve the triage process –
- Add a date of birth column which will help in determining the age of the patient and can be used for further records
- A column to capture the acuity level of the patient and to record his vital signs could also be added, which would aid the nurse in deciding on the type of treatment and prioritizing his treatment.
Conclusion
Workflow and procedures are of utmost importance in an ED, and well adapted technology driven processes can be a huge helping hand for health care professionals. In conclusion it can be said that the triage process is based on the principle of utility that is to, do greatest good to the most number of people. Triage system helps the health care professionals to allocate the available resources for achieve maximum health care benefit, and is a general guide to action for all medical workers.
References
Chipman M, Hackley BE, Spencer TS (February 1980). "Triage of mass casualties: concepts for coping with mixed battlefield injuries". Retrieved from http://www.ncbi.nlm.nih.gov/pubmed/6768037
Kenneth V. Iserson, John C. Moskop. (2007) Triage in Medicine, Part I: Concept, History, and Types. The American College of Emergency Physicians. Retrieved from http://instructor.mstc.edu/instructor/randers/documents/Triage%20in%20Medicine.pdf
Slater RR (January 1970). "Triage nurse in the emergency department". Retrieved from http://www.jstor.org/discover/10.2307/3421031?uid=3738256&uid=2&uid=4&sid=21102441817401
The Merriam Webster Dictionary. Definition of Triage. Retrieved from http://www.merriam-webster.com/dictionary/triage
