Emergency department triage performance timing. A regional multicenter descriptive study in Italy

Bambi, Stefano; Ruggeri, Marco; Sansolino, Sandra; Gabellieri, M.; Tellini, Sabrina; Giusti, Monica; Ciulli, Elisa; Franchi, Federica; Petrocchi, Laura; Olivi, Mauro; Gravili, Raffaele Carlo; Biancalana, Paola; Millanti, Andrea; Martini, L.; Sgrevi, Paola

doi:10.1016/j.ienj.2015.10.005

Cited by 19 publications

(14 citation statements)

References 24 publications

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“…An improvement in the situation could be produced by entrusting the evaluation of triage. Currently, this is delegated to the nursing staff in Italy and to doctors able to grasp the symptomatic subtleties [41,42].…”

Section: Discussionmentioning

confidence: 99%

Fear of the COVID-19 and medical liability. Insights from a series of 130 consecutives medico-legal claims evaluated in a single institution during SARS-CoV-2-related pandemic

2021

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Objectives: The aim of the current work was to evaluate the frequency and the type of cases of medical liability from a single center in the first ten months of the pandemic as well as to identify critical issues associated with the organization of public health during the coronavirus disease 2019 pandemic. Methods: We compared 130 cases evaluated for medical liability from March 2020 to January 2021 and compared with 159 cases from March 2019 to January 2020. The cases were divided in four pre-established groups: surgical error, diagnostic/therapeutic errors and nosocomial diseases, delays, and problems related to assistance. Results: Analysis showed a significant increase in cases due to delay in treat-ment/hospitalization and shortages in health care of non-autonomous patients [χ2 (1, N = 289) = 5.6746, p = 0.02]. Conclusions: The work showed an increase in medical/legal cases regarding non-COVID-19 emergencies in which the outcome is related to the time of treatment and/or arrival at the hospital. There was also a rise in complaints of deficits in supervision and care for non-autonomous patients. Despite the persistence of preventive measures for the current pandemic, measures should be taken to improve health care in these categories of patients.

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Section: Discussionmentioning

confidence: 99%

Fear of the COVID-19 and medical liability. Insights from a series of 130 consecutives medico-legal claims evaluated in a single institution during SARS-CoV-2-related pandemic

2021

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“…Nurse triage guidelines mention constraints that bear upon the task, especially limited time (61,62). Two studies (49,63) carried out in European ED have demonstrated the mean duration of nurse triage to be four minutes. In our study, the time required by the nurses to determine the triage score for each clinical vignette will be measured and the variable will be considered in the analyses.…”

Section: Theoretical Frameworkmentioning

confidence: 99%

Effects of environmental distractors on nurse emergency triage accuracy: a pilot study protocol

Delmas

Fiorentino

Antonini

et al. 2020

Preprint

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Background: The clinical decisions of emergency department triage nurses need to be of the highest accuracy. However, studies have found repeatedly that these nurses over- or underestimate the severity of patient health conditions. This has major consequences for patient safety and patient flow management. Workplace distractors such as noise and task interruptions have been pointed to as factors that might explain this inaccuracy. The use of a serious game reproducing the work environment during triage affords the opportunity to explore the impact of these distractors on nurse emergency triage accuracy, in a safe setting. Methods/Design: A pilot study with a factorial design will be carried out to test the acceptability and feasibility of a serious game developed specifically to simulate the triage process in emergency departments and to explore the primary effects of distractors on nurse emergency triage accuracy. Eighty emergency nurses will be randomized into four groups: three groups exposed to different distractors (A: noise, B: task interruptions, C: noise and task interruptions) and one control group. All nurses will have to complete 20 clinical vignettes within two hours. For each vignette, a gold standard assessment will be determined by experts. Pre-tests will be conducted with clinicians and certified emergency nurses to evaluate the appeal of the serious game. Discussion: Study results will inform the design of large-scale investigations and will help identify teaching, training and research areas that require further development.

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“…Nurse triage guidelines mention constraints that bear upon the task, especially limited time (18,73). Two studies (60,74) carried out in European ED have demonstrated that the mean duration of nurse triage was four minutes. In our study, the time required by the nurses to determine the triage score for each clinical vignette will be measured and the variable will be taken into account in the analyses.…”

Section: Theoretical Frameworkmentioning

confidence: 99%

Effects of environmental distractors on nurse emergency triage accuracy: a pilot study

Delmas

Fiorentino

Antonini

et al. 2020

Preprint

View full text Add to dashboard Cite

Background: Patient safety is a top priority of the health professions. In emergency departments, the clinical decision making of triage nurses must be of the highest reliability. However, studies have repeatedly found that nurses over- or undertriage a considerable portion of cases, which can have major consequences for patient management. Among the factors that might explain this inaccuracy, workplace distractors have been pointed to without ever being the focus of specific investigation, owing in particular to the challenge of assessing them in care settings. Consequently, the use of a serious game reproducing a work environment comprising distractors would afford a unique opportunity to explore their impact on the quality of nurse emergency triage. Methods/Design : A factorial design will be used to test the acceptability and feasibility of a serious game created to explore the primary effects of distractors on emergency nurse triage accuracy. A sample of 80 emergency nurses will be randomised across three experimental groups exposed to different distractor conditions and one control group not exposed to distractors. Specifically, experimental group A will be exposed to noise distractors only; experimental group B to task interruptions only; and experimental group C to both types combined. Each group will engage in the serious game to complete 20 clinical vignettes in two hours. For each clinical vignette, a gold standard will be determined by experts. Pre-tests will be planned with clinicians and specialised emergency nurses to examine their interaction with the first version of the serious game. Discussion : This study will shed light on the acceptability and feasibility of a serious game in the field of emergency triage. It will also advance knowledge of the possible effects of exposure to common environmental distractors on nurse triage accuracy. Finally, this pilot study will inform planned large-scale studies of emergency nurse practice using serious games.

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Emergency department triage performance timing. A regional multicenter descriptive study in Italy

Cited by 19 publications

References 24 publications

Fear of the COVID-19 and medical liability. Insights from a series of 130 consecutives medico-legal claims evaluated in a single institution during SARS-CoV-2-related pandemic

Fear of the COVID-19 and medical liability. Insights from a series of 130 consecutives medico-legal claims evaluated in a single institution during SARS-CoV-2-related pandemic

Effects of environmental distractors on nurse emergency triage accuracy: a pilot study protocol

Effects of environmental distractors on nurse emergency triage accuracy: a pilot study

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