Predictive validity of the Manchester Triage System: evaluation of outcomes of patients admitted to an emergency department

Júnior, Domingos Pinto; Salgado, Patrícia de Oliveira; Chianca, Tânia Couto Machado

doi:10.1590/s0104-11692012000600005

Cited by 34 publications

(32 citation statements)

References 11 publications

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“…This result is similar to studies carried out in Brazil (13) and in Portugal. (14) In Brazil, the mean age of the population was lower (32 years) than in Portugal (53 years).…”

Section: Discussionsupporting

confidence: 92%

“…It is reasonable to expect, thus, that the greater the severity of the patient, the greater the risk of evolving to death, showing that MTS is a good predictor of death, as it has been pointed in other studies. (11,13,15) The lack of a unified database for patients who entered the ES and were admitted to the hospitals studied represents a limitation of the study. It was necessary to resort to different databases to find the outcome of the patients.…”

Section: Discussionmentioning

confidence: 99%

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Outcome assessment of patients classified through the Manchester Triage System in emergency units in Brazil and Portugal

Guedes

Araújo²,

Júnior³

et al. 2017

Invest Educ Enferm

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“…This result is similar to studies carried out in Brazil (13) and in Portugal. (14) In Brazil, the mean age of the population was lower (32 years) than in Portugal (53 years).…”

Section: Discussionsupporting

confidence: 92%

Section: Discussionmentioning

confidence: 99%

Outcome assessment of patients classified through the Manchester Triage System in emergency units in Brazil and Portugal

Guedes

Araújo²,

Júnior³

et al. 2017

Invest Educ Enferm

Self Cite

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“…After multivariate logistic regression analysis, age, red risk rating and night admission were identified as independent predictors of mortality, which was not observed for admissions over the weekend. Thus, age is an intrinsic factor to the patient, and the severity is an intrinsic factor to the mechanism of injury 11,22,23 . On the other hand, night admission is presented, therefore, as an intrinsic factor of systemic error [22][23][24] .…”

Section: Discussion Discussion Discussion Discussion Discussionmentioning

confidence: 99%

“…Thus, age is an intrinsic factor to the patient, and the severity is an intrinsic factor to the mechanism of injury 11,22,23 . On the other hand, night admission is presented, therefore, as an intrinsic factor of systemic error [22][23][24] .Reason et al 23 proposed a model that defines the error, or an unfavorable outcome in the case of medicine, as something systematic and to avoid them, there are numerous defense barriers. These barriers act as a Swiss cheese slices, each of which has intrinsic flaws, but an error to be realized must be a confluence of failures in all the barriers.…”

mentioning

confidence: 99%

Night admission is an independent risk factor for mortality in trauma patients - a systemic error approach

Barbosa

Júnior

Chaves

et al. 2015

Rev. Col. Bras. Cir.

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Night admission is an independent risk factor for mortality in Night admission is an independent risk factor for mortality in Night admission is an independent risk factor for mortality in Night admission is an independent risk factor for mortality in Night admission is an independent risk factor for mortality in trauma patients -a systemic error approach trauma patients -a systemic error approach trauma patients -a systemic error approach trauma patients -a systemic error approach trauma patients -a systemic error approach Admissão noturna é fator de risco independente para mortalidade em pacientes Admissão noturna é fator de risco independente para mortalidade em pacientes Admissão noturna é fator de risco independente para mortalidade em pacientes Admissão noturna é fator de risco independente para mortalidade em pacientes Admissão noturna é fator de risco independente para mortalidade em pacientes vítimas de trauma -uma abordagem ao erro sistêmico vítimas de trauma -uma abordagem ao erro sistêmico vítimas de trauma -uma abordagem ao erro sistêmico vítimas de trauma -uma abordagem ao erro sistêmico vítimas de trauma -uma abordagem ao erro sistêmico LEONARDO DE [1][2][3] . Fatigue and lack of supervision to attending physicians may contribute to increased complications and hospital mortality. Such situations, also added to the circadian rhythm and dynamics of abnormal operating changes can be crucial factors for the worst performance in these periods. The cumulative presence of a number of unfavorable conditions is remarkable and very common in these periods, situations that favor and increase vulnerability to error [1][2][3][4][5][6][7][8][9][10] . Specific studies in patients with acute myocardial infarction, ischemic stroke and the Intensive Care Units showed higher rate of clinical complications and hospital mortality in the "off-hours" periods (nighttime or weekends) [4][5][6][7][8][9][10][11][12] . The volume of evidence demonstrating higher incidence of unfavorable outcomes in these adverse conditions weakens the idea of occasional errors as the cause of these events [4][5][6][7][8][9][10] . This highlights the need to analyze these situations trough of a model to interpret the error with a systemic view.Due to the lack of Brazilian studies, this study aimed to verify the impact of the shift of admission of patients who have suffered trauma, underwent surgery, in hospital mortality. According to these results, interpretation models and error correction are discussed. METHODS METHODS METHODS METHODS METHODSThis is a cohort study with retrospective collection of data, which were selected through electronic medical records, patients admitted from November 2011 to March 2012 in the emergency of Hospital do Subúrbio (HS) -a public hospital attending urgency and emergency and public-private administrative nature, in Subúrbio Ferroviá-rio, district of the city of Salvador, Bahia. The study included trauma patients admitted to the emergency HS who underwent surgery and were classified according to Internatio...

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“…This can be explained by the fact that patients who entered the adult emergency room as lesser risk (yellow, green, blue), showed a deterioration in their health after initial treatment, thereby requiring care in the emergency room due to a lack of beds in the intensive care unit. A study that evaluated the predictive validity of the Manchester risk rating compared to the TISS-28 (Therapeutic Intervention Scoring System), an instrument that measures the severity of patients, found that patients evolve in different ways between the different risk ratings so that more emergency risk ratings were related to the higher TISS-28 scores (18) .…”

Section: Discussionmentioning

confidence: 99%

Nursing staff sizing in the emergency room of a university hospital

Paixão

Campanharo

Lopes

et al. 2015

Rev. esc. enferm. USP

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Objective: To verify the adequacy of the professional nursing staff in the emergency room of a university hospital and to evaluate the association between categories of risk classification triage with the Fugulin Patient Classification System. Method: The classification of patients admitted into the emergency room was performed for 30 consecutive days through the methodology proposed by Gaidzinski for calculating nursing requirements. Results: The calculation determines the need for three registered nurses and four non-registered nursing for each six hour shift. However, only one registered nurse and four non-registered nurse were available per shift. There was no correlation between triage risk classification and classification of care by the Fugulin Patient Classification System. Conclusion: A deficit in professional staff was identified in the emergency room. The specificity of this unit made it difficult to measure. To find the best strategy to do so, further studies should be performed. Nursing staff sizing in the emergency room of a university hospital Dimensionamento de enfermagem em sala de emergência de um hospital-escola Dimensionamiento de enfermería en servicio de urgencias de un hospital escuela

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Predictive validity of the Manchester Triage System: evaluation of outcomes of patients admitted to an emergency department

Cited by 34 publications

References 11 publications

Outcome assessment of patients classified through the Manchester Triage System in emergency units in Brazil and Portugal

Outcome assessment of patients classified through the Manchester Triage System in emergency units in Brazil and Portugal

Night admission is an independent risk factor for mortality in trauma patients - a systemic error approach

Nursing staff sizing in the emergency room of a university hospital

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