Premium
Evaluation of a multifaceted intervention on documentation of vital signs at triage: A before‐and‐after study
Author(s) -
Gerdtz Marie F,
Waite Rebbecca,
Vassiliou Theresa,
Garbutt Bruce,
Prematunga Roshani,
Virtue Elizabeth
Publication year - 2013
Publication title -
emergency medicine australasia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.602
H-Index - 52
eISSN - 1742-6723
pISSN - 1742-6731
DOI - 10.1111/1742-6723.12153
Subject(s) - medicine , triage , vital signs , guideline , referral , checklist , early warning score , emergency medicine , medical emergency , intervention (counseling) , physical therapy , nursing , surgery , psychology , pathology , cognitive psychology
Background Triage systems provide a centralised safety mechanism where all patients are assessed for clinical urgency at point of entry to the ED . Objective The present study aims to evaluate the effect of a multifaceted intervention on triage documentation rates and guideline adherence. Methods A before‐and‐after design was used. The intervention involved restructuring the computerised interface, regular audit and feedback and education sessions. The setting was one adult tertiary referral hospital and major trauma centre located in M elbourne, A ustralia. Participants were triage nurses. Data were collected at five time points for a consecutive sample of one month of presentations. Results Over a 15 month period, we sampled 35.8% (24 862/69 395) episodes of triage performed by 122 nurses. Documentation rates for all vital signs progressively increased from baseline. There were significant increases in the proportion of episodes of triage where any vital sign was documented (32.2% vs 82.6%), and where pair and triplet combinations of vital signs were recorded in the triage field (heart rate and respiratory rate: 17.9% vs 64.6%; heart rate, respiratory rate and temperature: 7.0% vs 30.4%). No significant change in guideline adherence was observed after the intervention. Conclusion Progressive sustained improvements in vital sign documentation were observed over the study period; however, no such increases were noted in guideline adherence. To facilitate evaluation of guideline adherence, we recommend specific vital sign parameters be included in the A ustralasian T riage S cale G uideline for all levels of urgency.