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Perspectives of emergency department staff on the triage of mental health‐related presentations: Implications for education, policy and practice
Author(s) -
Gerdtz Marie F,
Weiland Tracey J,
Jelinek George A,
Mackinlay Claire,
Hill Nicole
Publication year - 2012
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/j.1742-6723.2012.01592.x
Subject(s) - medicine , triage , mental health , thematic analysis , emergency department , scale (ratio) , nursing , perception , qualitative research , medical emergency , psychiatry , psychology , social science , physics , quantum mechanics , sociology , neuroscience
Objective To explore ED staff perceptions of the factors that influence accuracy of triage for people with mental health problems. Methods This qualitative learning needs analysis used a descriptive exploratory design. Participants were A ustralian emergency nurses and doctors. We used a criterion‐based sampling approach. Recruitment was facilitated by the C ollege of E mergency N ursing A ustralasia and the A ustralasian C ollege for E mergency M edicine. A semi‐structured interview schedule was developed. Telephone interviews were conducted, audio recorded and transcribed verbatim. Thematic analysis was used to identify factors perceived to affect triage outcomes and to explore strategies to optimise the accuracy of triage assessments. Results Thirty‐six staff participated (16 nurses and 20 doctors). Four major factors were perceived to influence accuracy. These were: environmental factors (physical structure, time pressures, activity levels, and interruptions), policy and education (guidelines, training and resources), staff factors (knowledge, experience, attitudes) and patient factors (police presence, patient behaviour, clinical condition). Differences of opinion were expressed by emergency doctors about the validity of the time to treatment objectives included in the A ustralasian T riage S cale for mental health presentations, and the utility of the scale to differentiate urgency for psychiatric conditions. Conclusion Clinical guidelines and training have been developed to support the use of the A ustralasian T riage S cale. Further evaluation of the application of this scale to assess mental health problems is indicated. Additional work is also required to reduce variance in urgency assignment based on staff knowledge and attitudes about the causes, assessment and early management of psychiatric disorders.