Hospital and Telephone Triage

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How do we triage correctly

Video 8 of 89
3 min 52 sec
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So Mark, can you explain to me how we triage correctly and the importance of it?

Okay, so this triage being an initial assessment to get the patient on the right pathway to as quickly as possible to get an intervention quick and for definitive care. So along with that is putting the vital signs on to the computer system. This will then compute a National Early Warning Score, which is... It is a scoring system based on blood pressure, pulse, temperature, pain score and oxygen saturations, that sort of thing, which will give you a score, a number. And usually patients with a low score are not so sick, patients with a high score are the sicker patients. And with that score, that... Say a patient with a NEWS score of four and above, they would probably go to a major illness area, major injuries area, if they were not for resus.

So if I got a patient who decided to... My observations were not quite what I thought they were or... And I put my own figures in here and changed it, is that acceptable? Can we deviate or is it important that we stick to exactly the figures and exactly the system? Is there any leeway in it or does it have to be followed correctly?

Okay, so really the pathways are there for us to follow. The department is set up to accommodate those pathways and really your triage should follow those pathways. However, there are times when everything does not add up and you feel a patient needs to be seen sooner based on your observations, your assessment of the patient, this quick triage of the patient. And that is okay to do, but usually your triage matches the NEWS score and they follow a pathway.

If that does happen, have you got to put any safeguards in place, have you got to put any markers in place? If you do have somebody that you are concerned that this is not working for, what would you do then?

Okay, there is a function on the system that we use, and it is to highlight a patient for priority care. And you click this icon, I think it is a stethoscope, but it alerts the doctor and the nurses that in your opinion, the triage has picked something up that means this patient needs to be seen quicker. It could be a higher NEWS score, it could be just part of the assessment. What is important is that you triage to the patient. Each patient is an individual, and you do not triage to the needs of the department or the needs of the hospital. It has to be patient-centered.

So Mark, if there is anything that we are really concerned about, are there any other options for us?

Okay, so as well as there is the button on the triage system that we use that alerts the doctor, a small icon that will show up next to the patient's name, that means you are prioritising this patient in terms of what you found out about the patient. There is also a narrative screen that each patient has a narrative screen, free text, and you can put in what your findings are, your prioritised findings are and of course, there is always face-to-face. You can always talk to a fellow healthcare professional. You can find a doctor, ask them what they think. You can go to the department you are thinking of sending them to, you can call. You can always speak to a doctor or a nurse. The important thing is to make a safe decision and consult the right people.