REFUSING CARE TO EMERGENCY DEPARTMENT PATIENTS - EVALUATION OF PUBLISHED TRIAGE GUIDELINES
REFUSING CARE TO EMERGENCY DEPARTMENT PATIENTS - EVALUATION OF PUBLISHED TRIAGE GUIDELINES
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DOI：
10.1016/s0196-0644(94)70042-7
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发表时间：
1994-02-01
影响因子：
6.2
通讯作者：
GRUMBACH, K
中科院分区：
文献类型：
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作者：
LOWE, RA;BINDMAN, AB;GRUMBACH, K
研究目的：确定一套已发表的分诊指南是否能识别出可以安全地拒绝急诊科护理的患者。设计：历史队列研究。设置：公立医院ED。参与者类型：所有患者分流在一周内谁不是在最急性分流类别。测量值：两名艾德护士，对研究假设不知情，审查每个分诊表，以确定该病例是否符合已公布的拒绝护理指南。此外，对每个艾德记录的适当性进行了审查;只有在满足预定的明确标准并且急诊医生同意24小时的护理延迟可能会使患者的结局恶化时，才认为访视是适当的。主要结果：在106例根据分诊指南被拒绝治疗的患者中，35例（33%）进行了适当的访视。4人住院。结论：当在我们的患者人群中进行测试时，分诊指南对识别需要艾德护理的患者不够敏感。广泛应用这些指南可能会危及一些患者的健康。
Study objective: To determine whether a set of published triage guidelines identifies patients who can safely be refused emergency department care. Design: Historical cohort study. Setting: A public hospital ED. Type of participants: All patients triaged during a one-week period who were not in the most acute triage category. Measurements: Two ED nurses, blinded to the study hypothesis, reviewed each triage sheet to determine whether the case met the published guidelines for refusing care. In addition, each ED record was reviewed for appropriateness; a visit was considered appropriate only if predetermined, explicit criteria were met and an emergency physician agreed that a 24-hour delay in care might have worsened the patient's outcome. Main results: Of the 106 patients who would have been refused care according to the triage guidelines, 35 (33%) had appropriate visits. Four were hospitalized. Conclusion: When tested in our patient population, the triage guidelines were not sufficiently sensitive to identify patients who needed ED care. Broad application of these guidelines may jeopardize the health of some patients.