Triage Assessment

klone, MSN, RN · Jan 13, 2015

For a labor check, I would ask them when ctx started, pain scale, any VB or fluid, any recent intercourse. If it's preterm, I would ask them about hx risk, any s/sx of UTI/pyelo, when is the last time they ate or drank anything.

With all OB patients, regardless of why they're there, I would ask about fetal movement and pre-eclampsia s/sx (headache, blurry vision, scotoma).

And then depending on their answers or presenting complaint, I would tailor it.

What questions do you ask that you think is too much?

fearthefork · Jan 13, 2015

Our nurses are doing DVT risk assessments, domestic violence screening, depression screening, and a fall risk assessment on every patient. I just feel like this is more appropriate to if the patient is being admitted?

klone, MSN, RN · Jan 14, 2015

I agree with the domestic violence screening. As far as DVT, fall risk, depression - do you have access to the patient's prenatal chart?

spider woman · Jan 14, 2015

I always start with the pertinent questions, but we're required to ask about every single thing you could imagine every time. Doesn't matter why they are there.

klone, MSN, RN · Jan 14, 2015

I agree with the domestic violence screening. As far as DVT, fall risk, depression - do you have access to the patient's prenatal chart?

Another thought....what do you do with that information if they are triaged and sent home? If the woman indicates she's struggling with depression, for instance....do you intervene in any way? Contact her primary provider?

USA987, MSN, RN, NP · Jan 16, 2015

Is it part of Meaningful Use maybe?

cayenne06, MSN, CNM · Jan 16, 2015

And don't forget to screen everyone for ebola!

ScrappytheCoco · Jan 23, 2015

ER nurse here (I hope to end up in l&d so I lurk) all that stuff is JCAHO required for everyone at triage into the hospital.