The State, Implementation, and Spread of a Nurse Triage SystemSpecialized in Stroke

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In 2010, we performed a nationwide questionnaire survey of facilities with experience in acute stroke treatment regarding the nurse triage system specialized in stroke (hereafter, stroke nurse triage system) to better understand the state of the system. Issues raised during the survey included manuals, education systems, and the triage nurse follow-up system.Next, in 2011, we interviewed a total of 13 triage nurses from four hospitals in Japan inorder to examine the effects of the stroke nurse triage system and required abilities, roles, and functions of triage nurses, and to identify specific issues regarding the system. We also attended and observed a stroke triaging scene, and conducted qualitative and inductive analysis. Implementation of the stroke triage nurse system improved the assessment abilities of staff, manuals and educational systems, and staff morale. In other words, the secondary effects of implementing the stroke nurse triage system became evident through intervews.In … More light of the 2012 revision of the medical payment system that made it possible to charge a “hospital triage fee”, we conducted a questionnaire survey of hospitals with experience in hyper acute stroke treatment. We compared facilities that newly implemented a nurse triage system after establishment of the hospital triage fee (new group) with facilities that originally had such a system (existing group) to examine the characteristics of the stroke triage system. The existing group had significantly higher supplementary hospital charges for special care, more personnel specialized in emergency care, a larger medical practice, and more nurse specialists compared to the new group.Compared to hospitals in the newly-introduced group, hospitals in the existing group had significantly greater reimbursement of specified hospitalization fees, full-time personnel systems, medical care systems, and deployment of specialized nurses, and thus the stroke triage system was likely more fully developed at these hospitalsFor this reason, it is possible that hospitals in the newly-introduced group have introduced triage nurses without an adequate system in place.If the assessment of triage is inadequate, early treatment may be delayed, worsening patient prognosis. Therefore, it is necessary to examine what kind of system will lead to improvements in the quality of triage nurses and the provision of better care to patients. Less