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Triage Process (triage + process)

Distribution by Scientific Domains

Medical Sciences	75%

Selected Abstracts

An ethnographic study of three mental health triage programs

INTERNATIONAL JOURNAL OF MENTAL HEALTH NURSING, Issue 3 2004
Margaret Grigg
ABSTRACT:,,Triage processes are commonly used to manage the interface between demand for, and supply of, health services. This dimension of service provision is particularly pertinent for mental health services in Australia, where demand outweighs services available. This paper draws on the experiences of using participant observation to explore mental health triage processes. Findings highlight the complexities of the researcher role and benefits of using an ethnographic approach to explore mental health triage patterns. Insider participant observation brings many challenges but also, in this study, enabled the researcher to uncover some roles and processes underpinning triage decisions in mental health services. [source]

Overcrowding in medium-volume emergency departments: Effects of aged patients in emergency departments on wait times for non-emergent triage-level patients

INTERNATIONAL JOURNAL OF NURSING PRACTICE, Issue 3 2010
Mary Knapman MN BHScN GCEd RN
Knapman M, Bonner A. International Journal of Nursing Practice 2010; 16: 310,317 Overcrowding in medium-volume emergency departments: Effects of aged patients in emergency departments on wait times for non-emergent triage-level patients This study aims to examine patient wait times from triaging to physician assessment in the emergency department (ED) for non-emergent patients, and to see whether patient flow and process (triage) are impacted by aged patients. A retrospective study method was used to analyse 185 patients in three age groups. Key data recorded were triage level, wait time to physician assessment and ED census. Multiple linear regression analysis was used to determine the strength of association with increased wait time. A longer average wait time for all patients occurred when there was an increase in the number of patients aged , 65 years in the ED. Further analysis showed 12.1% of the variation extending ED wait time associated with the triage process was explained by the number of patients aged , 65 years. In addition, extended wait time, overcrowding and numbers of those who left without being seen were strongly associated (P < 0.05) with the number of aged patients in the ED. The effects of aged patients on ED structure and process have significant implications for nursing. Nursing process and practice sets clear responsibilities for nursing to ensure patient safety. However, the impact of factors associated with aged patients in ED, nursing's role and ED process can negatively impact performance expectations and requires further investigation. [source]

An observational cohort study of triage for critical care provision during pandemic influenza: ,clipboard physicians' or ,evidenced based medicine'?

ANAESTHESIA, Issue 11 2009
T. Guest
Summary We assessed the impact of a United Kingdom government-recommended triage process, designed to guide the decision to admit patients to intensive care during an influenza pandemic, on patients in a teaching hospital intensive care unit. We found that applying the triage criteria to a current case-mix would result in 116 of the 255 patients (46%) admitted during the study period being denied intensive care treatment they would have otherwise received, of which 45 (39%) survived to hospital discharge. In turn, 69% of those categorised as too ill to warrant admission according to the criteria survived. The sensitivity and specificity of the triage category at ICU admission predicting mortality was 0.29 and 0.84, respectively. If the need for intensive care beds is estimated to be 275 patients per week, the triage criteria would not exclude enough patients to prevent the need for further rationing. We conclude that the proposed triage tool failed adequately to prioritise patients who would benefit from intensive care. [source]

Effects of a Triage Process Conversion on the Triage of High-risk Presentations

ACADEMIC EMERGENCY MEDICINE, Issue 10 2008
Phillip V. Asaro MD
Abstract Objectives:, The objective was to determine effects of a modification in triage process on triage acuity distribution in general and among patients with conditions requiring time-sensitive therapy. Methods:, The authors retrospectively reviewed triage acuity distributions before and after modification of their triage process that entailed conversion from the Canadian Triage and Acuity Scale (CTAS) to the Emergency Severity Index (ESI). The authors calculated the ratio of the odds of being triaged to a nonemergent level (3, 4, or 5) under ESI to the odds of being triaged as nonemergent under CTAS. The authors calculated sensitivity and specificity of triage to an emergent acuity level (1 or 2) for identifying patients with common presentations who required time-sensitive care. Results:, There were shifts from higher to lower acuity levels for all subsets, with odds ratios ranging from 2.80 (95% confidence interval [CI] = 2.75 to 2.86) for all patients to 21.39 (95% CI = 14.66 to 31.21) for patients over 55 years of age with a chief complaint of chest pain. The sensitivity of triage for identifying abdominal pain patients requiring admission to an intensive care unit (ICU) or operating room (OR) or emergency department (ED) death was 80.7% (95% CI = 73.2 to 86.5) before versus 50.8% (95% CI = 43.5 to 58.1) following the transition to ESI. Specificity under CTAS, 55.2% (95% CI = 54.0 to 56.4), was significantly lower than under ESI, 83.6% (95% CI = 82.7 to 84.4). The authors found similar effects for patients presenting with chest pain. Conclusions:, Monitoring for changes in the sensitivity of the triage process for detecting patients with potentially time-sensitive conditions should be considered when modifying triage processes. Further work should be done to determine if the decreased sensitivity seen in this study occurs in other institutions converting to ESI, and potential causative factors should be explored. [source]

The Use of Biochemical and Biophysical Tools for Triage of High-Throughput Screening Hits , A Case Study with Escherichia coli Phosphopantetheine Adenylyltransferase

CHEMICAL BIOLOGY & DRUG DESIGN, Issue 5 2010
J. Richard Miller
High-throughput screening is utilized by pharmaceutical researchers and, increasingly, academic investigators to identify agents that act upon enzymes, receptors, and cellular processes. Screening hits include molecules that specifically bind the target and a greater number of non-specific compounds. It is necessary to ,triage' these hits to identify the subset worthy of further exploration. As part of our antibacterial drug discovery effort, we applied a suite of biochemical and biophysical tools to accelerate the triage process. We describe application of these tools to a series of 9-oxo-4,9-dihydropyrazolo[5,1-b]quinazoline-2-carboxylic acids (PQ) hits from a screen of Escherichia coli phosphopantetheine adenylyltransferase (PPAT). Initial confirmation of specific binding to phosphopantetheine adenylyltransferase was obtained using biochemical and biophysical tools, including a novel orthogonal assay, isothermal titration calorimetry, and saturation transfer difference NMR. To identify the phosphopantetheine adenylyltransferase sub-site bound by these inhibitors, two techniques were utilized: steady-state enzyme kinetics and a novel 19F NMR method in which fluorine-containing fragments that bind the ATP and/or phosphopantetheine sites serve as competitive reporter probes. These data are consistent with PQs binding the ATP sub-site. In addition to identification of a series of PPAT inhibitors, the described hit triage process is broadly applicable to other enzyme targets in which milligram quantities of purified target protein are available. [source]