The use of scripting at triage and its impact on elopements.
The use of scripting at triage and its impact on elopements.
复制标题
分诊时脚本的使用及其对私奔的影响。
DOI：
10.1111/j.1553-2712.2010.00721.x
复制
发表时间：
2010
期刊：
影响因子：
--
通讯作者：
K. John McConnell
中科院分区：
文献类型：
--
作者：
D. Handel;R. Fu;M. Daya;J. York;E. Larson;K. John McConnell
目标
这项研究的目的是测量分诊时脚本语言对私奔可能性的影响，控制患者数量和其他潜在的混杂变量。
方法
这是一项干预前和干预后的队列研究，使用了相同的5个月期间(分别为2007年11月至2008年3月和2008年11月至2009年3月)，分析中包括了所有21岁及以上的患者，他们在急诊科(ED)候诊室的分诊窗口(而不是救护车)就诊。作为脚本的一部分，分流护士告知病人任何仍在等待从候诊室被带回急诊室的病人的最长等待时间(当时)。比较了接受和没有接受脚本的患者的私奔比率，控制了个体和日常ED变量。
结果
这项分析包括24,390次急诊科就诊。在处方期间，ED患者的私奔发生率为4.4%，而在脚本后时期为2.3%。在多变量Logistic回归模型中，与非脚本组相比，使用脚本组私奔的几率显著降低(优势比[OR]=0.61，95%可信区间[CI]=0.46-0.80)。
结论
研究发现，即使在控制了其他混杂变量后，使用分诊脚本也能显著降低急诊室候诊室患者的私奔发生率。脚本编写是一种简单且未得到充分利用的技术，可以对患者和急诊室产生积极影响。
OBJECTIVES
The objective of this study was to measure the effect of scripting language at triage on the likelihood of elopements, controlling for patient volume and other potential confounding variables.
METHODS
This was a pre- and postintervention cohort study using the same 5-month period (November 2007-March 2008 and November 2008-March 2009, respectively) that included in the analysis all patients 21 years of age and older, who presented to the triage window in the emergency department (ED) waiting room (not by ambulance). As part of the scripting, triage nurses informed patients of the longest waiting time (at that point in time) for any patients still waiting to be brought back from the waiting room into the ED. Rates of elopement were compared between patients who did and did not receive the scripting, controlling for individual and daily ED variables.
RESULTS
A total of 24,390 ED visits were included in this analysis. The elopement rate was 4.4% among ED patients in the prescripting period, compared to 2.3% in the postscripting period. In a multivariate logistic regression model, the use of scripting was significantly associated with decreased odds of elopement, compared to the nonscripting group (odds ratio [OR] = 0.61, 95% confidence interval [CI] = 0.46 to 0.80).
CONCLUSIONS
The use of triage scripting was found to significantly reduce elopement rates in patients placed in the ED waiting room, even after controlling for other confounding variables. Scripting is a simple and underutilized technique that can have a positive effect for patients and the ED.