Implementation of a new pediatric emergency nursing triage procedure significantly reduces arrival-to-triage times to less than 10 minutes for most patients, according to a study published in the January issue of the Journal of Emergency Nursing.
Stacy L. Doyle, M.B.A., R.N., of the Children's Mercy Hospital in Kansas City, Mo., and colleagues implemented a rapid triage assessment process into their pediatric emergency department that integrated fast-track guidelines and the five-level Emergency Severity Index (ESI). Arrival-to-triage times were tracked in 13,910 patient visits during a month before and after the intervention. Fast-track utilization and left-without-being-seen (LWBS) rates were assessed over a 10-month period for 60,373 patients prior to implementation of the new triage system and 67,939 patients following its implementation.
The investigators found a significant decrease in the arrival-to-triage times post-intervention, with 88.3 percent of patients triaged in less than 10 minutes. Compared with pre-intervention, patients were 14 percent more likely to receive fast-track status following implementation of fast-track guidelines, and those patients with the lowest acuity were almost 50 percent more likely to be triaged to fast track. LWBS rates were insignificant, but in the post-intervention group, the overall acuity level was lower.
"Implementation of the new triage process, which included the use of the ESI scale and rapid triage, significantly decreased arrival-to-triage time for patients entering our pediatric emergency department," the authors write.
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