Triage is easy, said no triage nurse ever

Abstract

Triage is not a new concept. The historic principle of triage is associated with the French physician, Baron Dominique Jean Larrey, who served as Napoleon's Chief Surgeon after joining the Army of the Rhine in 1792. Larrey prioritised the medical needs of military casualties by using his own conceptual sorting system. This sorting system was described in his report during the Russian campaign: "Those who are dangerously wounded must be attended to first, entirely without regard to rank or distinction. Those less severely injured must wait until the gravely wounded have been operated on and dressed. The slightly wounded may go to the hospital line; especially officers, since they have horses and therefore have transport." [1, p. 27]. The object of triage at the time was firstly to conserve manpower, and secondly, to conserve the interest of the sick and wounded [2]. The 21st century definition of triage has not changed much since, however, the process has been redefined from the battlefield into modern emergency departments. There are various definitions of triage presented throughout modern literature, mostly dependant on where triage is applied and what outcomes are expected. In essence, sorting is based around the severity of patients' illness or injury, also called acuity. Triage can thus be interpreted as the identification of acuity through clinical assessment; classification of acuity from injury or illness; and the prioritisation of acuity, based on appropriate treatment and medical care required.

Factors contributing to patient safety during triage process in the emergency department: A systematic review

“…Moreover, triage performance is directly related to the appropriate response of the triage staff and the triage system (Burgess et al, 2019). The triage system must guide the nurses to ensure the most accurate and precise triage priority is obtained from a patient's acuity (Dippenaar & Bruijns, 2016). Studies (Hitchcock et al, 2014; Reblora et al, 2020) emphasise that continuous education and mentorship programs are essential for novice nurses in the emergency department to learn about triage, use triage guidelines and perform it effectively.…”

“…Therefore, according to evidence from summarised studies, we can conclude that patient safety relies upon emergency triage nurses' experience, education and training. In addition, triage is a very person‐dependent process (Wolf et al, 2018), and the usage of triage systems reduces subjectivity and provides a valid and reliable system (Dippenaar & Bruijns, 2016; Hammad et al, 2017; Hitchcock et al, 2014; McMahon et al, 2017; Reay et al, 2020). The applied triage system must distinguish between a stable and an unstable patient, as the inability to do so may lead to severe consequences for the patient (Wireklint et al, 2018).…”

The Reliability and Accuracy of International Triage Scale in the Emergency Department (ED): A Literature Review

“…The triage system was first introduced by Dominique Jean Larrey, a French doctor in 1792 who tried to prioritize the medical needs of military victims during the first World War (Yuksen, Sawatmongkornkul, Suttabuth, Sawanyawisuth, & Sittichanbuncha, 2016;Fry & Burr, 2002;Dippenaar & Bruijns, 2016). This system eventually became the concern of civil health care providers to be employed in civil hospital EDs.…”

Perceção dos enfermeiros das competências de tomada de decisão na triagem de Manchester

“…A enfermagem, na realidade portuguesa, assume um papel fundamental na medida em que o enfermeiro tem sido o profissional responsável por efetuar a triagem dos doentes, através de uma avaliação inicial rápida e tomada de decisão sobre a prioridade clínica. A tomada de decisão do enfermeiro na triagem é basilar para a admissão de doentes no SU, condicionando todo o processo de cuidados, pelo que os mesmos devem possuir competências necessárias a uma tomada de decisão adequada (Dippenaar & Bruijns, 2016). Face ao exposto, o estudo tem por objetivo analisar relações entre as características socioprofissionais dos enfermeiros de um SU e a perceção das competências de tomada de decisão na triagem.…”