L&D triage staffing/hours

LoveANurse09 · Feb 15, 2010

The hospital I work at has a 2 bed triage area open 24/7.Pt's walk in anytime like the ER.They usually gain some info on the pt first then decide if they need to be out in a triage bed or into a room. Any RN will pick up the pt, usually if a RN has 1 early labor pt, or 1 or 2 antepartum pts.it works pretty well. We are also a teaching hospital, so usually there is a resident around to do a exam, check for rupture of membranes,ultrasound and quickly send them home if need be.

debbiernbsn · Feb 15, 2010

A little more info on the new triage area, it will have to be staffed separately from L&D because it is physically separated from it by a long hallway. Thanks for any and all input!

klone, MSN, RN · Feb 15, 2010

Our setup sounds like yours. We do about 1200-1400 births a year, and our unit didn't have a separate triage area until about 2-3 years ago. It's separated from the unit by a hallway and two double doors. It's a 4-bed setup.

The triage unit is open all the time, there aren't "hours". When the charge nurse does assignments at the beginning of the shift, one of the L&D nurses gets assigned to triage. When a patient walks in, she comes to the L&D secretary's desk at the nurse's station, gives the unit secretary her info, and then the secretary or a nurse will walk the patient back to triage. There are lots of times when there aren't any patients in triage, and then that nurse will just hang out at the nurse's station, help catch babies, maybe do vitals for the floor (we don't have CNAs), help out wherever needed. When a triage patient comes in, she goes over there with the patient and hangs out at the triage nursing desk by herself.

The triage nurse might have 2-3 patients at a time, but usually if there are more than two patients in triage, and staffing allows, the charge nurse will send another nurse over to triage to help out.

We are not allowed to AROM a patient in triage (doctors will try), nor are we allowed to start any inductions there. Triage is considered "outpatient" for billing purposes, and it technically has a 4-hour limit, and if the patient is there longer than 4 hours, she's supposed to be moved over to "observation" over in L&D.

Sometimes we will get scheduled C/S ready in triage (if we're waiting for a bed to open up in postpartum). We do all procedures like NSTs and amnios in triage.

klone, MSN, RN · Feb 15, 2010

Also, if your unit is planning on having it open only specific hours, I'd probably recommend 7a-7p. During the day is when our triage is most busy, and especially between 3-6pm.

Elvish, BSN, DNP, RN, NP · Feb 17, 2010

Our triage area is open 24/7. It's part of L&D for staffing purposes but separated from the actual labor and delivery beds. There are usually 2 RNs, a secretary, and a CNM who evaluates for the residents. Private docs evaluate their own pts.

Everybody over 20 weeks who comes in w/ a pregnancy-related concern bypasses the ED and goes straight to L&D triage.

I believe our policies regarding charges and admits etc. are about the same as klone's.

debbiernbsn · Feb 17, 2010

Thank you for your input. Our minimum staffing for L&D is 2 RNs, so I feel that we cannot keep the triage open 24/7 because we can't have 1 RN in L&D and 1 RN clear on the other end in triage. That leads me to think that there should be designated hours like 7A-7P, or even 9A-9P. Our busiest triage times are from 2-9 or 10ish. I have made some calls to hospitals within the state and most all of them say that the triage area is within L&D. I think ours is slightly different as it is set apart from L&D. I am gathering my info in order to write a proposal, any suggestions on what to include in that would be helpful also!!