We are trialing a new triage system to hopefully improve flow that has the triage RN do a portion of the patient registration, apply the ID bracelet, do the triage assessment, and then place them in a room after triage(if available) and the registration process is completed by clerical staff.
Do any of your triage procedures involve the triage RN doing patient registration, or is that done solely by the ER registration clerks? The triage RN feels it slows down their clinical assessment and it would work more efficiently if the ER registration clerk did a "mini" registration for arm band, stickers, and a face sheet with demograpics, simultaneously while the RN was triaging the patient.
The biggest sacred cow in our triage is that an RN has to be the first to talk to a pt. So, one nurse sits at the window, has the pt fill out a slip with name, dob and complaint, puts the stuff into the computer for a quick reg, prints the labels and band, and then either goes on to triage (assess) the pt or pass them to another nurse for triage. We do bypass some of it for chest pain or severe distress, and the quick reg stuff follows them down the hall on the way to a bed.
This cow is in our triage as well... There is also the argument that insurance information ought to be obtained after completion of MSE.
Do you, as an RN, have to enter the patient name, DOB, ER doctor, and print out an ID bracelet & stickers as part of triage as part of your electronic triage?
Yep. We do the quick registration ("quick reg") in triage, and that software piece communicates with our electronic medical record/tracking board (PICIS/ED Pulsecheck). Then we pull them down into the EMR and complete the triage. But as part of the quick reg, a page with the bracelet and stickers is generated.
No. After we triage, our clerks enter their hospital (health card) information, changes in address, insurance, etc, and they put the id. bracelet on the pt. (yellow = no allergies), (red = allergies). There name, DOB, HCN, address, FMD (all this information is on their bracelet.
We have an RN at the front window along with a Registration Clerk.
The RN does a quick assessment to assign level of care needed and a quick, instant triage into the computer, with an ED Tech getting the first set of vitals immediately.
Level 1 or 2 and they are put in order to quickly see a PA.
Level 3, 4, or 5 and they are put in order to be taken back to the main ED area. The ED Techs do most of the room assignments and take the pts to the rooms, based on which Doc has the least amount of pts.
When someone critical comes in (SOB, Chest Px, etc), the RN at the front window asks the Charge Nurse which room would be best and the pt goes right back.
Our facility is making RN's register pts on night shift. We have to ask for insurance info , I'd cards and have them sign consent forms. Feels like this is a conflict of interest and unethical as a nurse. They are "cutting costs" by making us do it. How does everyone else feel about this ?
thmpr
116 Posts
This cow is in our triage as well... There is also the argument that insurance information ought to be obtained after completion of MSE.