• Title/Summary/Keyword: triage

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Thinking Strategies of Triage Nurses' Decision Making in the Emergency Department: Think Aloud Study (응급실 중증도 분류 간호사의 의사결정과정에 나타난 사고전략: 소리내어 생각하기)

  • Moon, Sun Hee;Park, Yeon Hwan
    • Journal of Korean Critical Care Nursing
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    • v.9 no.1
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    • pp.15-26
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    • 2016
  • Purpose: The aim of this study was to identify thinking strategies in the complicated decision-making process based on real patient-based data of triage nurses in the emergency department (ED). Methods: This study used the 'think aloud' method to collect data from 8 triage nurses from one general hospital ED in South Korea. The data were analyzed with protocol analysis using thinking strategies. Results: The triage process was divided into three stages. The first stage consisted of 8 thinking strategies, including searching for information. They used intuition based on directly observed concepts for identifying a crisis. The second stage consisted of 17 thinking strategies related to the decision-making process. They assessed patients and generated a hypothesis to try to understand their health problems through analytic thinking. The third stage consisted of 10 thinking strategies, including qualifying. They considered the situation of the ED and properly triaged the patients. During the triage process, they frequently used judging the value and searching for information on 17 thinking strategies. Conclusions: Triage nurses demonstrated various connected thinking strategies for each stage. Based on our results, further studies should be done to develop a triage education program.

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Healthcare Process Pattern Analysis with Triage in the Emergency Department (환자의 중증도 분류를 고려한 응급실의 진료 프로세스 패턴 분석)

  • Sim, Seungbae;Choi, Jaehyung;Kim, Bosung;Oh, Jisoo;Kim, Seungho;Park, Yooseok;Park, Incheol;Chung, Taenyoung;Oh, Kyounghwan;Jeong, Bongju;Lee, Young Hoon
    • Journal of the Korean Operations Research and Management Science Society
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    • v.37 no.4
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    • pp.111-124
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    • 2012
  • Emergency room process is very important in the whole hospital processes because it is first diagnosis for patient. Above all, triage is important activity which quickly diagnose the status of emergency patient and sets the priority for treatment. This paper analyzes the treatment process pattern by triage type. The results show that the treatment process after triage such as residence time, diagnosis and checkup type, and joint treatment are dependent on triage types. We can use these analysis results for improving the current triage system and developing the new triage system considering a domestic emergency medical service environment.

Factors Influencing Professional Competencies in Triage Nurses Working in Emergency Departments (응급실 간호사의 중증도분류 전문역량에 영향을 미치는 요인)

  • Kim, Myoung Soo;Kang, Minkyeong;Park, Keun Hee
    • Journal of Korean Biological Nursing Science
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    • v.24 no.2
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    • pp.122-130
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    • 2022
  • Purpose: This study was conducted to identify the professional competency of nurses working in emergency medical institutions that use the Korean Triage Acuity Scale (KTAS), and to identify factors that affect them. Methods: This study collected data from 105 nurses working in emergency medical institutions from June to August 2020. For data analysis, descriptive analysis, t-test, ANOVA, Pearson's correlation coefficient, and multiple regression were performed using the SPSS 25.0 program. Results: As for the professional competency in triage, the higher the self-efficacy (β= 0.58, p< .001), the more experience they have in triage-related education (β= 0.30, p< .001), 2-4 years of clinical experience in emergency department (β= 0.19, p= .002), in case of triage alone (β= 0.24, p< .001), the higher the level of education a nurse has (β= 0.19, p= .003), the higher the professional competency in triage. These variables explained professional competency in a total of 64.2% of the participants (F = 38.30, p< .001). Conclusion: To improve nurses' professional competence in triage, introducing manpower expansion, financial support, and the provision of appropriate places is suggested. In addition, it is necessary to repeatedly provide educational opportunities in an environment similar to actual clinical practice by developing various scenarios and introducing simulations and web-based formats.

Emergency Nurses' Critical Thinking Disposition, Problem Solving Ability, and Triage Competency (중증도 분류간호사의 비판적 사고성향, 문제해결능력과 중증도 분류역량)

  • Park, Jae Hyung;Bae, Sun Hyoung
    • Journal of muscle and joint health
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    • v.29 no.2
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    • pp.124-132
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    • 2022
  • Purpose: The purpose of this study was to investigate the relationships among critical thinking disposition, problem solving ability, and triage competency in nurses working in Emergency Rooms (ERs). Methods: This cross-sectional study, conducted in August and September 2021, involved 118 ER nurses from three hospitals in the Gyeonggi-do metropolitan area. The data were analyzed using t-test, ANOVA, Scheffé test, Pearson correlation coefficients, and multiple linear regression analysis using SPSS for Windows version 25.0. Results: The mean score of triage competency among ER nurses was 87.63±15.65. In the regression model, age, ER experience, triage experience, critical thinking disposition, and problem solving ability predicted 52% of the triage competency. Both critical thinking disposition and problem-solving ability were noted to be significant (β=.32, p<.001; β=.36, p<.001, respectively). Conclusion: Critical thinking disposition and problem solving ability of ER nurses were identified as major factors in triage competency. To improve ER nurses' triage competency and enhance critical thinking disposition and problem solving ability, a systematic and ongoing program should be developed and implemented.

Reliability of the Emergency Severity Index Version 4 Performed by Trained Triage Nurse (중증도 분류 간호사에 의한 응급환자 중증도 분류 신뢰도 측정 연구: Emergency Severity Index Version 4를 중심으로)

  • Choi, Hee Kang;Choi, Min Jin;Kim, Ju Won;Lee, Ji Yeon;Shin, Sun Hwa;Lee, Hyun Jung
    • Journal of Korean Critical Care Nursing
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    • v.5 no.2
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    • pp.61-71
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    • 2012
  • Purpose: The aim of this study was to measure the inter-rater reliability of Emergency severity index (ESI) version 4 among triage nurse. Methods: This study was carried out from August 11, 2010 to September 7, 2010 in a regional emergency department. Data collection was done by ten triage nurses who trained ESI v.4. Two research nurses and ten triage nurses scored the ESI version 4 to the patients as references, independently. We calculated the weighted kappa between the triage nurses and research nurses to evaluate the consistency of the ESI v.4. Results: A total of 233 patients were enrolled in this study. Classification of ESI level was as follows - level 1 (0.4%), level 2 (21.0%), level 3 (67.8%), level 4 (9.4%), and level 5 (1.3%). Inter-rater reliability by weighted kappa was 0.79 (95% Confidence Interval= 0.74-0.83) and agreement rate was 87.1%. Under-triage rate by triage nurse was 6.0% and over-triage rate was 6.9%. Conclusion: For this study, inter-rater reliability was measured good level between triage nurses and research nurses in Korean single ED.

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Comparison with in-hospital Korean Triage and Acuity Scale (KTAS) and prehospital triage system in a metropolitan city (일개 대도시의 병원전 단계와 병원 단계의 중증도 분류체계 간의 결과 분석)

  • Choi, Hyo Jeong;Kim, Ho Jung;Lee, Hyo Ju;Lee, Bo Ra
    • Journal of The Korean Society of Emergency Medicine
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    • v.29 no.5
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    • pp.391-398
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    • 2018
  • Objective: This study was conducted to analyze and compare the classifications of a prehospital triage system and an in-hospital triage system. Methods: The records of patients transferred from the '119' emergency service for 5 months (from January 1 to May 31, 2016) were collected and records of first aid activities were assessed. We examined cases classified as four (urgent, semi-urgent, potentially urgent, and non-urgent) of five stages, excluding death. In the hospital, data were collected from medical records and classifications made using the five Korean Triage and Acuity Scale (KTAS) stages (1, resuscitation; 2, emergency; 3, urgent; 4, less urgent; and 5, non-urgent) were analyzed. Results: The number of patients enrolled in the study was 3,457. Of them, 2,301 were discharged after treatment and 1,156 were hospitalized. According to the prehospital triage classification, 726 of the 3,457 cases were urgent, 593 were semi-urgent, 1,944 were potentially urgent, and 194 were non-urgent. The results of the in-hospital triage were as follows: 114 KTAS 1 (3.3%), 491 KTAS 2 (14.2%), 1,345 KTAS 3 (38.9%), 1,227 KTAS 4 (35.5%), and 280 KTAS 5 (8.1%). The odds ratio trend for hospitalization showed a larger decrease according to in-hospital staging (95% CI, 0.32-0.39) than according to prehospital staging (95% CI, 0.50-0.60). The odds ratio trend for intensive care unit (ICU) admission also showed a larger decrease according to in-hospital staging (95% CI, 0.16-0.22) than according to prehospital staging (95% CI, 0.37-0.48). Conclusion: We found little correspondence in classifications made according to the KTAS and prehospital triage systems. However, the tendencies toward decreases in the hospitalization and ICU admission rates were similar.

Development of a Computerized Telephone Triage and Consultation System for Patients Discharged with Ophthalmic Disease (눈질환자의 퇴원 후 증상관리를 위한 전화상담 전산 Triage 시스템 개발)

  • Lee, Hyun Jung
    • Journal of East-West Nursing Research
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    • v.18 no.2
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    • pp.95-103
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    • 2012
  • Purpose: This methodological study was done to develop a computerized telephone triage and consultation system for patients discharged with ophthalmic disease in order to provide more efficient practice guidelines for nurses, and evaluate the usability of the system. Methods: Development of the system consisted of six phases: strategic planning, analysis, design, implementation, evaluation, modification, and maintenance. Results: In the strategic planning phase, ophthalmic problems and nursing interventions of triage algorithms and practice guidelines were cross-mapped with the Omaha system. In the analysis phase, users requirements were identified. Then infrastructure including database, nursing knowledge base, and user interface were designed in the implementation phase. Usability and satisfaction of the system presented as very positive. Telephone consultation took about 2 minutes less than time in the previous system. The system was modified based on users' comments during the evaluation phase. Conclusion: This study was the first attempt in Korea to develop computerized triage system to prompt the quality of telephone consultation. It is suggestive that the computerized triage system may improve the quality of nursing.

Investigating Factors Affecting Automated Question Triage for Social Reference: A Study of Adopting Decision Factors from Digital Reference

  • Park, Jong Do
    • Journal of the Korean Society for Library and Information Science
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    • v.49 no.1
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    • pp.483-511
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    • 2015
  • The efficiency and quality of the social reference sites are being challenged because a large quantity of the questions have not been answered or satisfied for quite a long time. Main goal of this study is to investigate important factors that affect the performance of question triage to relevant answerers in the context of social reference. To achieve the goal, expert finding techniques were used to construct an automated question triage approach to resolve this problem. Furthermore, important factors affecting triage decisions in digital reference were first examined, and extended them to the social reference setting by investigating important factors affecting the performance of automated question triage in the social reference setting. The study was conducted using question-answer pairs collected from Ask Metafilter. For the evaluation, logistic regression analyses were conducted to examine which factors would significantly affect the performance of predicting relevant answerers to questions. The results of the current study have important implications for research and practice in automated question triage for social reference. Furthermore, the results will offer insights into designing user-participatory digital reference systems.

Study on Automatic Bug Triage using Deep Learning (딥 러닝을 이용한 버그 담당자 자동 배정 연구)

  • Lee, Sun-Ro;Kim, Hye-Min;Lee, Chan-Gun;Lee, Ki-Seong
    • Journal of KIISE
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    • v.44 no.11
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    • pp.1156-1164
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    • 2017
  • Existing studies on automatic bug triage were mostly used the method of designing the prediction system based on the machine learning algorithm. Therefore, it can be said that applying a high-performance machine learning model is the core of the performance of the automatic bug triage system. In the related research, machine learning models that have high performance are mainly used, such as SVM and Naïve Bayes. In this paper, we apply Deep Learning, which has recently shown good performance in the field of machine learning, to automatic bug triage and evaluate its performance. Experimental results show that the Deep Learning based Bug Triage system achieves 48% accuracy in active developer experiments, un improvement of up to 69% over than conventional machine learning techniques.

Triage Nurses' Work Experiences in Emergency Department: A Qualitative Research (응급실 중증도 분류 간호사의 업무 경험: 질적 연구)

  • Park, Yu Jin;Kong, Eun-Hi;Park, Young A
    • Journal of muscle and joint health
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    • v.25 no.3
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    • pp.176-186
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    • 2018
  • Purpose: The purpose of the study was to describe work experiences of triage nurses working at emergency departments in Korea. Methods: A qualitative descriptive research method was used. Twenty-one nurses of emergency department participated in the first interview and 16 of them participated in the second interview. Data were collected through in-depth interviews and field notes. Qualitative content analysis was utilized to analyze the data. Results: Forty-eight codes, 12 categories, and six themes emerged from the data analysis: caring on the frontline, burden as an initial evaluator, handling things alone, lack of others' understanding, becoming an expert, and needs for improvement. Participating triage nurses faced many challenges and difficult situations in emergency departments. They felt burden and loneliness as initial evaluator. Also, they felt pride in their work and struggled to become a professional. Conclusion: This study is the first qualitative study that has focused on exploring the experiences of triage nurses in emergency departments in Korea. The results provide description and in-depth understanding of working experiences of triage nurses. The results provide valuable fundamental data for regulation, clinical practice, education, and research for triage nurses in Korean emergency departments.