Location
Virtual
Start Date
1-3-2024 8:00 AM
End Date
1-3-2024 3:30 PM
Keywords:
california; orange
Description
Background:
Triage is the process of sorting and prioritizing patients requiring medical treatment. A primary goal is to identify high-risk or life-threatening situations. Emergency Severity Index (ESI) is a validated method to assign an acuity level from Level 1 (emergent) to Level 5 (non-urgent). ESI handbook states competency is vital to the success and accuracy of the ESI tool & requires periodic assessment of RNs participating in triage. The Emergency Nurses Association (ENA) reports only 60% accuracy in assigning acuity.
Aim:
The aim of this evidence-based practice project was to determine compliance with triage standards and provision of initial care before and after an educational update.
Approach:
Audited EHR for ESI Level 4 patients who required admission to hospital to identify accuracy of assigned acuity and provision of immediate care. Audits completed monthly for September 2022 –December 2022. Focused on over/under triaged and implementation of Triage Standardized Procedure. Audits compiled January 2023. Intervention: Results of audit data shared with staff in February 2023. Provided additional education on ESI acuity assignment in February 2023 to improve acuity accuracy and encourage use of nurse-initiated orders (NIOs). Continued audits post intervention monthly for March 2023 –June 2023.
Results:
SJO ECC baseline acuity accuracy of ESI Level 4 patients who required admission was 44%. 100% of inaccurate ESI Level 4 patients who required admission were ‘under-triaged’. 4-month post education saw increase to 60% average accuracy of identifying ESI Level 4 patients who required admission, with highest accuracy in June 2023 at 80%.
Conclusion:
Education and feedback from audits lead to improvement in ESI accuracy. Provider in Triage during high census times may reduce use of NIOs.
Implications for practice:
New RNs need support to ensure accurate acuity assignment and use of NIOs. Periodic re-education for triage is necessary for ensuring high accuracy and implementation of care.
Recommended Citation
Rowen, Alexandra, "Triage Re-Education: Impact on Accuracy of Acuity and Care Provision" (2024). Providence Nursing Research Conference 2023 – Present. 11.
https://digitalcommons.providence.org/prov_rn_conf_annual/2024/posters/11
Specialty/Research Institute
Nursing
Included in
Triage Re-Education: Impact on Accuracy of Acuity and Care Provision
Virtual
Background:
Triage is the process of sorting and prioritizing patients requiring medical treatment. A primary goal is to identify high-risk or life-threatening situations. Emergency Severity Index (ESI) is a validated method to assign an acuity level from Level 1 (emergent) to Level 5 (non-urgent). ESI handbook states competency is vital to the success and accuracy of the ESI tool & requires periodic assessment of RNs participating in triage. The Emergency Nurses Association (ENA) reports only 60% accuracy in assigning acuity.
Aim:
The aim of this evidence-based practice project was to determine compliance with triage standards and provision of initial care before and after an educational update.
Approach:
Audited EHR for ESI Level 4 patients who required admission to hospital to identify accuracy of assigned acuity and provision of immediate care. Audits completed monthly for September 2022 –December 2022. Focused on over/under triaged and implementation of Triage Standardized Procedure. Audits compiled January 2023. Intervention: Results of audit data shared with staff in February 2023. Provided additional education on ESI acuity assignment in February 2023 to improve acuity accuracy and encourage use of nurse-initiated orders (NIOs). Continued audits post intervention monthly for March 2023 –June 2023.
Results:
SJO ECC baseline acuity accuracy of ESI Level 4 patients who required admission was 44%. 100% of inaccurate ESI Level 4 patients who required admission were ‘under-triaged’. 4-month post education saw increase to 60% average accuracy of identifying ESI Level 4 patients who required admission, with highest accuracy in June 2023 at 80%.
Conclusion:
Education and feedback from audits lead to improvement in ESI accuracy. Provider in Triage during high census times may reduce use of NIOs.
Implications for practice:
New RNs need support to ensure accurate acuity assignment and use of NIOs. Periodic re-education for triage is necessary for ensuring high accuracy and implementation of care.
