Triage Under Fire: How to decrease the flames Cheryl A. Tull, RN University of Wisconsin Green Bay
"Does communication and patient education in Emergency Room triage play a significant role in patient satisfaction and quality of care?"
Citation (APA) Purpose Sample Design Theory Measurement Results/ Conclusion Ranking Raper, J., Davis, B.A., & Scott, L. (1999). Patient satisfaction with emergency department triage nursing care: A multicenter study. Journal of Nursing Care Quality, 13(6), 11-24 Examine relationship between patients’ and nurses’ characteristics and how these relate to patient satisfaction with triage nurse and the emergency room N=378 Phase I- power analysis of staff nurses from 3 participating hospitals Phase II- Convenience sample from an urban academic medical center, a small public hospital and a Catholic hospital Descriptive Correlational study The Strasser Patient Satisfaction Model Caring subscale of the Consumer Emergency Care Satisfaction Scale (CECSS), 12 question, 5 point Likert-type scale IV Summary of Evidence
Chau, J. & Nga Han Chan, J. (2005). Patient satisfaction with triage nursing care in Hong Kong. Journal of Advanced Nursing , 50 (5), 498-507 Examines the relationship between patient satisfaction and triage nursing care Systematic sampling of 56 urgent, semi-urgent and non-urgent triaged patients, random sampling using table of random numbers, 18 years old, English or Chinese reading, writing, speaking Descriptive, correlational study N/A Consumer Emergency Care Satisfaction Scale, patient and nurse demographic data IV Citation (APA) Purpose Sample Design Theory Measurement Results/ Conclusions Ranking Summary cont....
Citation (APA) Purpose Sample Design Theory Measurement Results/ Conclusions Ranking Centers for Disease Control and Prevention-Federal Government Agency [US]. (2009). Guidelines for field triage of injured patients. Recommendations of the National Expert Panel on Field Triage A clinical algorithm devised by the CDC from evidence based practice research to implement clinical guidelines N/A N/A N/A N/A N/A Syntheses: practice guidelines Davis, B.A., Bush, H.A., Thomas, Jr., S.W. (1997). Measuring consumer satisfaction with emergency department nursing care. Journal of Nursing Science , 2(1-6), 35-47 A journal abstract using the CECSS (Consumer Emergency Care Satisfaction Scale) implementing patient preference with nursing care in the ED N/A N/A N/A N/A N/A Synopses Summary cont....
Innovation to be implemented: Create a practice for frequent communication and education with patients in triage and the emergency waiting room. Stakeholders identified: Nurses, Registrars, Support staff, patients and families. Policy and procedures identified as needed or updated: Add to Triage Policy and Procedures: Triage nurse, registrars and/or nursing support staff will communicate with patients and there families at least every 60 minutes while in waiting. The triage nurse will educate patients and families on process and disease/injury when appropriate. Nursing staff will reassess vital signs every 60 minutes on patients waiting 60 minutes or longer to be seen. A goal of 90% patient satisfaction rate using the CECSS (Consumer Emergency Care Satisfaction Scale) will be obtained each month. “ Kotter’s Phases of Change Model”
Project Name Establish Urgency Create Coalition Develop Vision Communicate Vision Empower Action Generate Short-term Wins Consolidate Gains/Produce More Anchor Approaches Creating improved communication and education with patients in triage-Increasing customer satisfaction Develop Power Point Presentation- #1 reason for patient dissatisfaction is lack of communication. Include surveys from our hospital and research data. Coalition Team-Nurse manager, triage nurses, registrars and lead support staff Create vision statement How will improved communication affect staff, patients, family and overall patient quotas? Develop a power point presentation showing the process of integrating communication and education in to triage hourly rounding. A team member will work 1:1 with the front staff the first week of implementation. Design a binder where staff can anonymously write their concerns or suggestions to the team. Compile monthly CECSS Comments and statistics at Unit Conference. Publish article in hospital “High Points” magazine with special recognition with in the department for those that reinforce the practice. Expand idea into the main Emergency Department after 2 months. Present statistics at monthly Unit Conferences for 6 months. Team member will directly observe communication and education in triage and waiting room and report at team meeting.