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Barkensjö, My, and Therese Tikka. "Patientupplevelse av triage." Thesis, Högskolan i Borås, Institutionen för Vårdvetenskap, 2011. http://urn.kb.se/resolve?urn=urn:nbn:se:hb:diva-20376.
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Tidigare studier har visat vad patienten anser vara tillfredställande i samband med triage. Där framkommer att i mötet med vårdpersonalen vill patienten känna sig värdig, sedd och bekräftad. Detta ställer krav på vårdpersonalen och den kompetens de besitter. En förutsättning för patienttillfredsställelse är information om väntetider, patienternas medicinska tillstånd och en god vårdrelation. I mötet med patienten krävs kunskap om vad dessa tycker är viktigt och betydelsefullt i samband med triage. Kunskapen om vad som är viktigt är fortfarande inte tillräckligt belyst, ur ett patientperspektiv. Syfte var att beskriva patientens upplevelse av vad som var betydelsefullt för denne i samband med triage. En kvalitativ forskningsansats med en påföljande innehållsanalys valdes. 11 stycken intervjuer genomfördes på en mindre akutmottagning i väst Sverige.Informanterna som valdes ut var patienter på denna akutmottagning. I resultatet framträdde två domäner, bemötande och information. Kategorierna som följde var omvårdnad, trygghet, delaktighet, kompetens, omhändertagande, integritet, tid och kommunikation. Informanterna ansåg det vara betydelsefullt att bli bemötta på ett individuellt plan, detta innefattade allt från basal omvårdnad till att informanterna litade på triageteamets goda kompetens. Sanningsenlig information kring väntetider och prioriteringssystemet visade sig ha betydelse. Tidigare studier har visat att vården upplevdes som god om vårdpersonalen hade ett öppet förhållningssätt, visade hänsynsfullhet och lugn. Detta bekräftas i vårt resultat. Triageteamet skulle kunna tillgodose detta genom att våga uppskatta väntetiden, men också genom att vara tydliga i att informationen kan komma att förändras.Program: Magisterprogram i vårdvetenskap med inriktning mot akutsjukvård
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Vassallo, James M. A. "Major incident triage: development and validation of a modified primary triage tool." Doctoral thesis, University of Cape Town, 2018. http://hdl.handle.net/11427/29232.
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Introduction
A key principle in the effective management of a major incident is triage, prioritising patients on the basis of their clinical acuity. However, existing methods of primary major incident triage demonstrate poor performance at identifying the Priority One patient in need of a life-saving intervention. The aim of this thesis was to derive an improved triage tool.
Methods
The first part of the thesis defined what constitutes a life-saving intervention. Then using a retrospective military cohort, the optimum physiological thresholds for identifying the need for life-saving intervention were determined; the combination of which was used to define the Modified Physiological Triage Tool (MPTT). The MPTT was validated using a large civilian trauma database and a prospective military cohort. Subsequently, to describe the safety profile of the MPTT, an analysis of the implications of under-triage was undertaken. Finally, pragmatic changes were made to the MPTT (MPTT-24) - in order to provide a more useable method of primary triage. Statistical analysis was conducted using sensitivities and specificities, with triage tool performance compared using a McNemar test.
Results
32 interventions were considered life-saving and the optimum physiological thresholds to identify these were a GCS <14, 12 < RR <22 and a HR < 100. Within both the military and civilian populations, the MPTT outperformed all existing methods of triage with the greatest sensitivity and lowest rates of under-triage, but at the expense of over-triage. Applying pragmatic changes, the MPTT-24 had comparable performance to the MPTT and continued to outperform existing methods.
Conclusion
The priority of primary major incident triage is to identify patients in need of life-saving intervention and to minimise under-triage. Fulfilling these priorities, the MPTT-24 outperforms existing methods of triage and its use is recommended as an alternative to existing methods of primary major incident triage. The MPTT-24 also offers a theoretical reduction in time required to triage and uses a simplified conscious level assessment, thus allowing it to be used by less experienced providers.
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Esteves, Ana Luísa Roque de Andrade. "Implementação de um sistema de triagem no hospital escolar da Faculdade de Medicina Veterinária." Bachelor's thesis, Universidade Técnica de Lisboa. Faculdade de Medicina Veterinária, 2010. http://hdl.handle.net/10400.5/2667.
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Dissertação de Mestrado Integrado em Medicina VeterináriaA triagem surgiu associada à actividade militar, com o principal objectivo de salvar o maior número de soldados, de forma a manter o poderio militar. No final da década de 1980 surgiu o 1º sistema de triagem civil, o Ipswich Triage Scale, com boas indicações de performance e de aceitação pela comunidade de emergência médica. Assim, durante as décadas de 1990 e 2000 surgiram outros sistemas de triagem: o Canadian Triage and Acuity Scale, o Manchester Triage System, o Emergency Severity Index e o Cape Triage Score. A triagem está, actualmente, distribuída um pouco por todo o mundo ocidental, sendo um tema bastante comum e com o qual a maioria da população está familiarizada, incluindo Portugal. No campo veterinário, a triagem aparece ligada aos casos de pacientes politraumatizados, apesar de não existir um verdadeiro sistema de triagem padronizado, como ocorre na medicina humana. A presente dissertação de mestrado procurou testar o efeito da implementação de um sistema de triagem no Hospital Escolar da Faculdade de Medicina Veterinária da Universidade Técnica de Lisboa (HEFMV), à semelhança dos que foram desenvolvidos para aplicação nos serviços de urgência dos hospitais civis. Para tal, foram feitos 2 estudos no HEFMV: o 1º para estudar os tempos de espera e distribuição dos casos nas diferentes categorias, com o actual sistema em vigor no hospital (por ordem de chegada), e o 2º estudo, já com a aplicação do sistema de triagem previamente desenvolvido, estudando também os mesmos parâmetros, de forma a poder comparar os 2 estudos. Apesar do esforço em padronizar os 2 estudos, há que ter sempre em conta os factores variáveis e que, neste caso, tiveram grande influência: o número de clientes que se dirigiram à consulta e o próprio número de médicos veterinários em serviço, que foram diferentes em ambos os estudos. Assim, não foi possível concluir qual o verdadeiro efeito da triagem nos tempos de espera dos pacientes mais urgentes. Há, contudo, que salientar os efeitos positivos da triagem no funcionamento do HEFMV: redução do tempo de consulta, ou pelo menos, um melhor encaminhamento da mesma, e a atenção dada a cada cliente, logo após a sua entrada no HEFMV, demonstrando preocupação pelos mesmos.
ABSTRACT - IMPLEMENTATION OF A TRIAGE SYSTEM IN THE TEACHING HOSPITAL OF FACULDADE DE MEDICINA VETERINÁRIA – UTL - Triage appeared linked to military activity, with the main goal of saving the highest number of soldiers, in order to keep the military power. With the end of the 1980s came the 1st civil triage system, Ipswich Triage Scale, with good performance indicators and acceptance by the medical emergency community. Thus, in the 1990 and 2000 other triage systems have emerged: Canadian Triage and Acuity Scale, Manchester Triage System, Emergency Severity Index and Cape Triage Score. Triage is now spread throughout the Western world, being a fairly common theme and with whom most of the world population are familiar with, including the portuguese. In the veterinary field, triage appears linked to cases of polytraumatized patients and there is no real standardized triage system, as occurs in human medicine. The present dissertation tried to test the effect of implementing a triage system in the Teaching Hospital of Faculdade de Medicina Veterinária of Universidade Técnica de Lisboa (HEFMV), similar to those that have been developed for application in the emergency services of civilian hospitals. For that purpose the author made 2 studies in HEFMV: the first one to study the distribution of patients and waiting times in the different triage categories, with the current system at the Hospital (in order of arrival), and the second study, already implementing the previously developed triage scale, studying the same parameters, in order to being able to compare the 2 studies. Despite the effort to standardize the 2 studies, it’s always necessary to count with variables and factors that, in this case, had great influence: the number of customers who went to the consultations and the actual number of veterinarians in service, that were different in both studies. Thus, it was not possible to conclude what is the true effect of triage in waiting times for patients with more urgency. Despite it all, there are, however, positive effects of triage on the functioning of HEFMV: there was a consultation time reduction, or at least a better routing of it, and the attention given to every customer, shortly after arriving at HEFMV, showing concern by them.
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Oscarsson, Susanne. "Triage av barn på akutmottagning." Thesis, Högskolan i Halmstad, Sektionen för hälsa och samhälle (HOS), 2011. http://urn.kb.se/resolve?urn=urn:nbn:se:hh:diva-16474.
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Beslutsprocessen vid triage är komplex och triageprocessen bör utföras noggrant. Vid akuta situationer måste snabba beslut tas, oftast med lite information. Det ska under kort tid samlas in data genom observation, frågor och kontroll av vitalparametrar. Syftet med studien var att belysa faktorer som påverkar sjuksköterskans triagering av barn på akutmottagning. Studien genomfördes som en litteraturstudie där 13 vetenskapliga artiklar analyserades. I resultatet framkom fyra kategorier: kompetens och erfarenhet hos sjuksköterskan vid triagering av barn, faktorer relaterat till barn och vitalparametrar vid triagering av barn, sjusköterskans kommunikation med barn och närstående vid triagering och beslutsstöd i form av triagesystem. Kontrollen av vitalparametrarna är en grund i triagering men den kan utgöra en otillförlitlig bas för en korrekt triagebedömning. Stor utmaning är i att identifiera avvikande vitalparametrar och ha kunskap om utveckling och beteende relaterat till barnets utvecklingsnivå. Triagering av barn ställer speciella krav på triagesjuksköterskan och på de triagesystem som används. Genom att tydliggöra sjuksköterskans kunskap och skapa en förståelse kring triagering av barn uppmärksammas barnets behov. Vårdverksamheten behöver satsa på utbildning och utveckling av ett triagesystem för barn för att öka patientsäkerheten. Ytterligare forskning behövs om vilka faktorer som påverkar sjuksköterskan i bedömningen av det sjuka barnet.To make a triage decision is a complex process that should be conducted carefully. In emergency situations quick decisions must be made, often with little information about the patient. In a short time information about the patient should be collected through observation, questioning and monitoring of vital parameters. The purpose of this study was to elucidate factors that influence the nurse in the triage process of children in the emergency department. The study was conducted as a literature study in which 13 scientific articles were analyzed. The result revealed four categories: skills and experience of the nurse in triaging children, factors related to children and vital parameters in triaging children, the communication between the nurse and the child and relatives during triaging, decision support in form of a triage system. Monitoring of vital parameters sets the ground to the triage decision but it can be an unreliable basis for an accurate triage assessment. A major challenge is to identify abnormal vital parameters and to understand the development and behavior related to the child’s level of development. Triaging of children puts special demands on the triage nurse and the triage system that is used. By elucidating the nurse’s knowledge and by creating an understanding of triaging of children, more attention is drawn to the needs of the child. Health care institutions need to invest in education and development of triage systems for children to improve patient safety. Further research is needed on which factors that affect the nurse in the assessment of the sick child.
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Charles-Hanmer, Mary-Margaret. "ED Triage Chest Pain Protocol." Mount St. Joseph University Dept. of Nursing / OhioLINK, 2021. http://rave.ohiolink.edu/etdc/view?acc_num=msjdn1619697945080865.
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Göransson, Katarina. "Registered nurse-led emergency department triage : organisation, allocation of acuity ratings and triage decision making." Doctoral thesis, Örebro University, Department of Health Sciences, 2006. http://urn.kb.se/resolve?urn=urn:nbn:se:oru:diva-732.
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Successful triage is the basis for sound emergency department (ED) care, whereas unsuccessful triage could result in adverse outcomes. ED triage is a rather unexplored area in the Swedish health care system. This thesis contributes to our understanding of this complex nursing task. The main focus of this study has been on the organisation, performance, and decision making in Swedish ED triage. Specific aims were to describe the Swedish ED triage context, describe and compare registered nurses’ (RNs) allocation of acuity ratings, use of thinking strategies and the way they structure the ED triage process.
In this descriptive, comparative, and correlative research project quantitative and qualitative data were collected using telephone interviews, patient scenarios and think aloud method. Both convenience and purposeful sampling were used when identifying the participating 69 nurse managers and 423 RNs from various types of hospital-based EDs throughout the country.
The results showed national variation, both in the way triage was organised and in the way it was conducted. From an organisational perspective, the variation emerged in several areas: the use of various triageurs, designated triage nurses, and triage scales. Variation was also noted in the accuracy and concordance of allocated acuity ratings. Statistical methods provided limited explanations for these variations, suggesting that RNs’ clinical experience might have some affect on the RNs’ triage accuracy. The project identified several thinking strategies used by the RNs, indicating that the RNs, amongst other things, searched for additional information, generated hypotheses about the fictitious patients and provided explanations for the interventions chosen. The RNs formed relationships between their interventions and the fictitious patients’ symptoms. The RNs structured the triage process in several ways, beginning the process by searching for information, generating hypotheses, or allocating acuity ratings. Comparison of RNs’ use of thinking strategies and the structure of the triage process based on triage accuracy revealed only slight differences.
The findings in this dissertation indicate that the way a patient is triaged, and by whom, depends upon the particular organisation of the ED. Moreover, the large variation in RNs triage accuracy and the inter-rater agreement and concordance of the allocated acuity ratings suggest that the acuity rating allocated to a patient may vary considerably, depending on who does the allocation. That neither clinical experience nor the RNs’ decision-making processes alone can explain the variations in the RNs triage accuracy indicates that accuracy might be influenced by individual and contextual factors. Future studies investigating triage accuracy are recommended to be carried out in natural settings.
In conclusion, Swedish ED triage is permeated by diversity, both in its organisation and in its performance. The reasons for these variations are not well understood.
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Göransson, Katarina. "Registered nurse-led emergency department triage : organisation, allocation of acuity ratings and triage decision making /." Örebro : Hälsovetenskapliga institutionen, Örebro universitet, 2006. http://urn.kb.se/resolve?urn=urn:nbn:se:oru:diva-732.
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Andersson, Christin, Maria Meister, and Helena Olofsson. "Triage på akutmottagning ur ett omvårdnadsperspektiv." Thesis, Halmstad University, School of Social and Health Sciences (HOS), 2009. http://urn.kb.se/resolve?urn=urn:nbn:se:hh:diva-2378.
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I dagsläget finns inget enhetligt prioriteringssystem för att möta det ökade patientflödet till akutmottagningar. Ordet triage står för en snabb förstahandsbedöming av medicinskt sjuka, vilket innebär att den med störst behov tas omhand först. Triagesystem har utvecklats genom växande behov av struktur och mindre individuella variationer i den medicinska bedömningen. Studien genomfördes som en litteraturstudie med syfte att belysa triageverksamheten på akutmottagningar ur ett omvårdnadsperspektiv. Faktorer som visade sig ha betydelse när sjuksköterskan fattade beslut angående prioritering var kunskap, erfarenhet, samt intuition. Hur och vem som gör triageringen skiljer sig mellan akutmottagningarna i Sverige. Patienternas kunskaper var bristfälliga angående hur arbetet organiserades på akutmottagningen. Ett bra bemötande från personalen visade sig ha stor betydelse för patienten. De önskade att bli mer informerade om väntetider samt vilka rutiner som tillämpades. Fortsatt forskning behövs för att utreda de faktorer som har betydelse då sjuksköterskan gör sina bedömningar.
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Lang, Ursula Friederike. "Oktoberfest-Triage-Evaluationsstudie 1998 (OTES ’98)." Diss., lmu, 2001. http://nbn-resolving.de/urn:nbn:de:bvb:19-3638.
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Veeramachaneni, Ramya Chowdary, and Niroopa Uppalapati. "A Framework for Requirements Triage Process." Thesis, Blekinge Tekniska Högskola, Sektionen för datavetenskap och kommunikation, 2011. http://urn.kb.se/resolve?urn=urn:nbn:se:bth-2451.
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ABSTRACT Context: Requirements triage is a crucial activity in requirements engineering process for market-driven products. Triage deals with selection of appropriate requirements from large number of requirements for particular release plan. If triage is not performed initially, selection and management of a large number of requirements would be difficult in requirements engineering process. In market-driven product development triage is followed by estimation and prioritization of requirements to be selected for a particular release plan, also termed as requirements selection. Product development is done based on the set of requirements selected in requirements selection process. Objectives: The objective of the thesis is to find whether there is a need to improve existing requirements triage process or not, identify the challenges and shortcomings of the existing requirements triage and selection solutions and suggest improvements to address identified challenges and shortcomings. Methods: In order to identify existing requirements triage and selection solutions (method, model, tool, technique, process, and others), challenges addressed by existing requirements triage and selection solutions, and the shortcomings faced while implementing them, a systematic literature review has been done. A list of challenges and shortcomings, identified through the analysis of systematic literature review results, was used as an input to industrial survey to confirm most applicable (relevant) challenges and shortcomings and to identify possibilities to address those challenges and shortcomings. Results: A process framework for requirements triage has been proposed to address the challenges faced by practitioners during triage. The steps and solutions proposed within the framework also enable to alleviate the shortcomings of the existing requirements triage solutions. Conclusions: The results of the survey have been analyzed from different perspectives: size of organization, number of requirements handled per month and experience of professional doing triage. Therefore, the proposed process framework is usable and useful for both small-scale and large-scale organizations. The initial effort required to put framework process steps in place would be high, however, later the effort will reduce not only for requirements triage but also for later phases in requirements engineering. As a spin off effect the quality of triage decision is increased.
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Holmberg, Maria, and Susanne Alvunger. "Triage inom hospital akutsjukvård : - ur sjuksköterskeperspektiv." Thesis, Linnéuniversitetet, Institutionen för hälso- och vårdvetenskap (HV), 2017. http://urn.kb.se/resolve?urn=urn:nbn:se:lnu:diva-69918.
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Bakgrund: Begreppet triage betyder “välja ut”. I triagen delas patienter in i olika kategorier utifrån hur snabbt de behöver tas om hand. Den patient som har störst behov av sjukvård ska ges företräde. Som teoretisk referensram till uppsatsen har Patricia Benners teori ”Från novis till expert” använts. Syfte: Att belysa sjuksköterskors upplevelse av att triagera inom hospital akutsjukvård. Metod: Litteraturöversikt. Vetenskapliga artiklar kvalitetsgranskades och analyserades. I resultatet inkluderades sex kvalitativa artiklar samt en kvantitativ artikel. Resultat: Anlysen ledde fram till tre kategorier: utsatthet i triagen, kunskap och erfarenheter samt helhetsperspektiv – att se ”hela” människan. Utsatthet i triagen delades in i två subkategorier: tidsbrist och stress samt rädsla och brist på förståelse. Resultatet visade att sjuksköterskor upplever en utsatthet i triagen där sjuksköterskors upplevelse av stress dominerade. Resultatet visade också att kunskap och erfarenhet har betydelse för sjuksköterskors upplevelse av triagering samt att det är viktigt att som sjuksköterska se helhetsperspektivet kring varje patient vid triagering. Slutsats: Nyutexaminerade sjuksköterskor, i synnerhet, anses riskera att uppleva stress på grund av bristande erfarenhet. Vid praktiskt omvårdnadsarbete i samband med triagering anser författarna att sjuksköterskor bör ha några års erfarenhet av sjuksköterskeyrket. Detta för att utföra ett så patientsäkert arbete som möjligt i triagen. För att utföra optimalt omvårdnadsarbete vid triagering kan stresstålighet ses som en viktig egenskap att ha som sjuksköterska.
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Anvik, John. "Assisting bug report triage through recommendation." Thesis, University of British Columbia, 2007. http://hdl.handle.net/2429/265.
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A key collaborative hub for many software development projects is the issue tracking system, or bug repository. The use of a bug repository can improve the software development process in a number of ways including allowing developers who are geographically distributed to communicate about project development. However, reports added to the repository need to be triaged by a human, called the triager, to determine if reports are meaningful. If a report is meaningful, the triager decides how to organize the report for integration into the project's development process. We call triager decisions with the goal of determining if a report is meaningful, repository-oriented decisions, and triager decisions that organize reports for the development process, development-oriented decisions.
Triagers can become overwhelmed by the number of reports added to the repository. Time spent triaging also typically diverts valuable resources away from the improvement of the product to the managing of the development process. To assist triagers, this dissertation presents a machine learning approach to create recommenders that assist with a variety of development-oriented decisions. In this way, we strive to reduce human involvement in triage by moving the triager's role from having to gather information to make a decision to that of confirming a suggestion.
This dissertation introduces a triage-assisting recommender creation process that can create a variety of different development-oriented decision recommenders for a range of projects. The recommenders created with this approach are accurate: recommenders for which developer to assign a report have a precision of 70% to 98% over five open source projects, recommenders for which product component the report is for have a recall of 72% to 92%, and recommenders for who to add to the cc: list of a report that have a recall of 46% to 72%. We have evaluated recommenders created with our triage-assisting recommender creation process using both an analytic evaluation and a field study. In addition, we present in this dissertation an approach to assist project members to specify the project-specific values for the triage-assisting recommender creation process, and show that such recommenders can be created with a subset of the repository data.
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Forsberg, Lenny, and Gunnar Engblom. "Ambulanssjuksköterskors upplevelser av att använda triage." Thesis, Örebro universitet, Institutionen för hälsovetenskap och medicin, 2013. http://urn.kb.se/resolve?urn=urn:nbn:se:oru:diva-29798.
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Henderson, Glenn. "Triage visualization for digital media exploitation." Thesis, Monterey, California: Naval Postgraduate School, 2013. http://hdl.handle.net/10945/37636.
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Approved for public release; distribution is unlimitedDigital forensic examiners are overwhelmed by case loads and data volumes and must prioritize their work. This thesis hypothesis that digital forensic examiners can employ triage visualizations to prioritize work loads. This thesis presents a simple one page visualization of disk activity for Windows FAT and NTFS filesystems. The visualization is constructed from filesystem meta data carved by the open source bulk_extractor digital forensics application. The visualization does not require further examination or reconstruction of file system metadata. The visualization is able to detect minor obfuscation or modification and overwriting of file system timestamps.
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Taguchi, James K. "Optimal sector sampling for drive triage." Monterey, California: Naval Postgraduate School, 2013. http://hdl.handle.net/10945/34750.
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Approved for public release; distribution is unlimitedWith digital storage becoming cheaper, bigger, and more prevalent, finding evidence from the hard drives collected for a case is too difficult and time consuming. Simply reading an entire drive takes hours and it takes even longer to analyze the drive for deleted files and data fragments. Investigations frequently involve multiple drives, and this traditional method of reading entire drives for analysis simply cannot keep up in modern cases. Furthermore, investigators often search drives only for known files, which we call target data, that could help identify a drive holding evidence such as child pornography or malware. Triage is needed to sift through drives to quickly identify drives containing target data. One way is by randomly sampling drive data to find known files or to give a confidence that less than some small amount is present. We determine the optimal sampling strategy bypassing the file system to find even deleted files and fragments in minimum time with maximum confidence. With 15 minutes of sampling we can give a 90% confidence that less than 10MiB of target data is present on a 500GB hard disk drive. By using statistical sampling in combination with sector hashing, our software forms an efficient triage tool for digital forensics.
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Lampi, Maria. "TRIAGE : Management of the trauma patient." Doctoral thesis, Linköpings universitet, Avdelningen för kliniska vetenskaper, 2017. http://urn.kb.se/resolve?urn=urn:nbn:se:liu:diva-134595.
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Triage, derived from the French word for sorting, aims to assess and prioritize injured patients, regardless of whether the injuries are sustained from everyday road traffic accident with few injured or a mass casualty incident. Triage seeks to provide the greatest benefit to the largest number of casualties in order to minimize morbidity and mortality. Triage in a pre-hospital setting entails management and sorting of patients according to an assessment of medical need, prioritization, and evacuation. In-hospital triage aims to rapidly identify the most injured and ensure timely and appropriate treatment according to the patient’s clinical urgency. A number of different systems for performing triage have been established and implemented globally. The methodology is recognized and utilized but there is still a need for an evidence-based strategy to optimize training and the efficacy of the different systems. The main aim of this thesis was to determine triage performance among prehospital personnel and investigate the potential advantage of a triage system for trauma patients. The papers included in this thesis evaluated the triage skills of physicians, pre-hospital personnel, and rescue services personnel by testing their performance before and after an educational intervention. The last paper evaluated potential benefits of using a triage system for trauma patients admitted to the emergency department at MOI Teaching and Referral Hospital in Eldoret, Kenya. The results presented in this thesis illustrate that triage skills are lacking among physicians. Experienced pre-hospital personnel are more skilled in performing triage than physicians. The triage skills of the rescue services personnel improved significantly after the educational intervention. Moreover, the potential benefit to trauma patients of implementing an in-hospital triage system in a resource-poor environment was shown. In conclusion, health care personnel, especially physicians without experience but highly involved in trauma patient management, seem to be in need of triage training. How to train, how to implement, and how to evaluate triage skills must be considered in order to develop effective training.
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Eriksson, Fredrik, and Elin Jingström. "Patienters erfarenheter av triage : en litteraturstudie." Thesis, Ersta Sköndal Bräcke högskola, Institutionen för vårdvetenskap, 2021. http://urn.kb.se/resolve?urn=urn:nbn:se:esh:diva-8800.
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Bakgrund: Akut sjuka/skadade personer känner ofta att de tappar kontroll över sin kropp och situation, dessa känslor kan förvärras i en okänd miljö och kan i samband med brist på information vara överväldigande. Den första patienten ofta kommer i kontakt vid en akut situation är sjuksköterskan. I detta skede behöver den akut sjuka/skadade lämna över ansvaret till hälso- och sjukvården. Sjuksköterskan ska då med sin omvårdnadsvetenskapliga- och medicinska kunskap med hjälp av bedömningsverktyget triage, kategorisera och prioritera patienten utifrån dennes symtom och anamnes. Triage används brett i världen just för detta ändamål men är för många okänt både varför och hur det används. Syfte: Syftet var att beskriva patienters erfarenheter av triageprocessen. Metod: Metoden var en litteraturöversikt som baserades på kvalitativa samt kvantitativa vetenskapliga artiklar gällande det valda syftet. Sökningarna gjordes på de bibliografiska sökmotorerna Cinahl complete och PubMed. Artiklarna granskades och analyserades med hjälp av Friberg (2017). Resultat: Litteraturöversikten resulterade i 10 stycken artiklar med fyra teman: Väntetid, Bemötande, Information & Miljö Slutsats: De sjuksköterskor som utför triage sågs ofta som kunniga inom sitt område men patienter saknade informationsutdelning både kring väntetid och triage. Patienterna saknade även ett mer holistiskt bemötande där sjuksköterskor fokuserade mer på det psykiska måendet utöver det medicinska.Background: Acutely ill / injured people often feel that they are losing control of their body and the situation, these feelings can be intensified in an unfamiliar environment. And can be overwhelming in the absence of information. The first encounter is often with a nurse. At this stage, the acutely ill/injured person needs to hand over the responsibility to the healthcare service. The nurse must then use their nursing- and medical knowledge with the help of triage, categorizes and prioritizes the patient based on the patient´s symptoms and anamnesis. Triage is used a lot all over the world but is for many unknown, both how it works and why it´s used. Aim: The aim was to describe patients' experiences of the triage process Method: The method was a literature review based on qualitative and quantitative scientific articles regarding the chosen purpose. The searching was made on the bibliographic search engines Cinahl complete and PubMed. The articles were reviewed and analyzed with the help of Friberg (2017) Results: The literature review resulted in Four themes: Wait time, treatment, information & environment Conclusion: The nurses who performed triage was often seen as knowledgeable in their field, but the patients lack information on both waiting time and triage. The patients also wished for a more holistic approach where nurses focused more on the mental state in addition to the medical one.
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Fredrik, Eriksson, and Elin Jingström. "Patienters erfarenheter av triage : en litteraturstudie." Thesis, Ersta Sköndal Bräcke högskola, Institutionen för vårdvetenskap, 2021. http://urn.kb.se/resolve?urn=urn:nbn:se:esh:diva-8800.
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Bakgrund: Akut sjuka/skadade personer känner ofta att de tappar kontroll över sin kropp och situation, dessa känslor kan förvärras i en okänd miljö och kan i samband med brist på information vara överväldigande. Den första patienten ofta kommer i kontakt vid en akut situation är sjuksköterskan. I detta skede behöver den akut sjuka/skadade lämna över ansvaret till hälso- och sjukvården. Sjuksköterskan ska då med sin omvårdnadsvetenskapliga- och medicinska kunskap med hjälp av bedömningsverktyget triage, kategorisera och prioritera patienten utifrån dennes symtom och anamnes. Triage används brett i världen just för detta ändamål men är för många okänt både varför och hur det används. Syfte: Syftet var att beskriva patienters erfarenheter av triageprocessen. Metod: Metoden var en litteraturöversikt som baserades på kvalitativa samt kvantitativa vetenskapliga artiklar gällande det valda syftet. Sökningarna gjordes på de bibliografiska sökmotorerna Cinahl complete och PubMed. Artiklarna granskades och analyserades med hjälp av Friberg (2017). Resultat: Litteraturöversikten resulterade i 10 stycken artiklar med fyra teman: Väntetid, Bemötande, Information & Miljö Slutsats: De sjuksköterskor som utför triage sågs ofta som kunniga inom sitt område men patienter saknade informationsutdelning både kring väntetid och triage. Patienterna saknade även ett mer holistiskt bemötande där sjuksköterskor fokuserade mer på det psykiska måendet utöver det medicinska.Background: Acutely ill / injured people often feel that they are losing control of their body and the situation, these feelings can be intensified in an unfamiliar environment. And can be overwhelming in the absence of information. The first encounter is often with a nurse. At this stage, the acutely ill/injured person needs to hand over the responsibility to the healthcare service. The nurse must then use their nursing- and medical knowledge with the help of triage, categorizes and prioritizes the patient based on the patient´s symptoms and anamnesis. Triage is used a lot all over the world but is for many unknown, both how it works and why it´s used. Aim: The aim was to describe patients' experiences of the triage process Method: The method was a literature review based on qualitative and quantitative scientific articles regarding the chosen purpose. The searching was made on the bibliographic search engines Cinahl complete and PubMed. The articles were reviewed and analyzed with the help of Friberg (2017) Results: The literature review resulted in Four themes: Wait time, treatment, information & environment Conclusion: The nurses who performed triage was often seen as knowledgeable in their field, but the patients lack information on both waiting time and triage. The patients also wished for a more holistic approach where nurses focused more on the mental state in addition to the medical one.
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Sands, Natisha. "Psychiatric triage nursing : the new frontier." Thesis, The Author [Mt. Helen, Vic.] :, 2002. http://researchonline.federation.edu.au/vital/access/HandleResolver/1959.17/67855.
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MARTURANA, FABIO. "Device classification in digital forensics triage." Doctoral thesis, Università degli Studi di Roma "Tor Vergata", 2014. http://hdl.handle.net/2108/214142.
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Internet’s pervasiveness and the large availability of multimedia devices with networking
capability have contributed to the global diffusion of cyber threats and cybercrimes,
causing serious challenges from the digital forensic perspective. As a consequence, the
potential amount of data which requires analysis is increasing, causing an urgent need
for new forensic techniques and tools. Those currently in use, indeed, being more
focused on full device extraction for some basic statistics than reducing and correlating
data for case-relevant device identification, tend to be outdated. In this situation,
which may be referred to as data rich but information poor, a practical solution is
represented by Digital Forensics Triage, a promising new branch of the Digital Forensics
science whose aim is to extract evidence and provide vital intelligence in a timely
manner. Digital Forensics Triage, or simply Digital Triage, is generally referred to as
a framework that could be adopted in time-critical situations to assign a higher priority
to certain digital devices with regards to others, according to their relevance to
the criminal case. Digital Triage has been characterized by the development of rapid
data extraction techniques and tools whereas, despite some categorisation functions,
determining the relevance of a digital device to a criminal case, also known as classification,
tend to be a mostly manual process. Based on substantial research carried
out to establish current methodologies in the field of Digital Triage and their potential
use, this thesis describes an original methodology for digital device pre-examination
and classification either on the crime scene or at Digital Forensic Laboratories (DFLs).
The intended aim of the methodology is to automate the identification of relevant devices
in criminal cases where time, huge backlogs, and suspect’s privacy protection
are deemed critical factors. As a result of the merge of Digital Forensics best practices
and Machine Learning supervised classification, the novel approach described
hereafter presents several advantages with respect to other techniques currently in use. Selective device pre-examination on the crime scene or at DFLs, indeed, allows the
timely identification of case-relevant devices while reducing the volume of data that
need to be exhaustively examined. Experimental results of the criminal case studies of
child pornography exchange and copyright infringement, suggest that the methodology
described in this thesis is effective and viable, and can provide a basis for an automated
digital devices classification tool for use in real-life criminal cases
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Lattimer, Valerie Ann. "A randomised controlled triage of nurse telephone trials in out of hours primary care." Thesis, University of Southampton, 1998. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.262872.
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Kanegane, Kazue. "Tradução para o português e validação de instrumento para triagem de pacientes \"Manchester Triage System\" (MTS) e adaptação para o Setor de Urgência Odontológica." Universidade de São Paulo, 2012. http://www.teses.usp.br/teses/disponiveis/23/23147/tde-06032012-163954/.
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A triagem de emergência tem como objetivo dar prioridade aos pacientes mais graves e melhorar a prestação do serviço de emergência, garantindo atendimento no momento adequado, melhor fluxo e segurança. Os objetivos deste trabalho foram traduzir e validar a parte referente às emergências odontológicas do instrumento para triagem de emergência Manchester Triage System (MTS) na língua portuguesa, avaliar a confiabilidade interobservadores e o impacto da aplicação do MTS no Setor de Urgência Odontológica da Faculdade de Odontologia da Universidade de São Paulo. O MTS foi traduzido através do método padrão de tradução/ retrotradução. A versão foi submetida à validação semântica e idiomática e também conceitual e cultural, feita por um comitê de juízes. Em ambas, a concordância final observada após os ajustes realizados foi superior a 80%. Na concordância interobservadores, 200 pacientes participaram das entrevistas realizadas por 2 voluntários independentes com conhecimentos em odontologia e a pesquisadora. Os coeficientes kappa foram de 0.58 e 0.60. Inicialmente foram entrevistados 120 pacientes sem a aplicação do MTS e em seguida 139 pacientes categorizados de acordo com a prioridade clínica. Houve diminuição no tempo médio de espera para atendimento, de 79.96 min para 36.86 min (Mann-Whitney (MW), p=0.00) e aumento do tempo médio de duração do atendimento, de 29.11 min para 34.78 min (MW, p=0.05). Dentre os pacientes categorizados segundo o MTS, os não-urgentes eram mais velhos (MW, p=0.01), tiveram menor duração de atendimento (MW, p=0.00) e menor intensidade de dor (MW, p=0.00). A versão traduzida e validada do MTS mostrou-se adequada e sua aplicação e útil no atendimento de pacientes do Setor.The emergency triage aims to assign clinical priority to the patients and to improve emergency services, ensuring attendance at the right time, better patient flow and safety. The objectives of this study were to translate and validate part of the Manchester Triage System (MTS) related to dental emergency in Portuguese, to assess the inter-rater reliability and to evaluate the impact of implementation of triage at Setor de Urgência Odontológica of Faculdade da Odontologia of Universidade de São Paulo. The MTS was translated using the standard translation/ back-translation method. The instrument was then submitted to semantic and idiomatic validation, as well as conceptual and cultural validation by a committee of judges. In both, the final concordance after the adjustments was higher than 80%. In the inter-rater agreement, 200 patients were interviewed by two independent volunteers with some knowledge of dentistry and the researcher. The kappa coefficients were 0.58 and 0.60. Then 120 patients were interviewed without the application of the MTS and 139 patients were categorized according to their clinical priority. There was a reduction in the mean waiting time, from 79.96 min to 36.86 min (Mann-Whitney test (MW), p=0.00) and an increase in the mean of treatment duration, from 29.11 min to 34.78 min (MW, p=0.05). Among triaged patients, the non-urgent were older (MW, p=0.01), had shorter duration of treatment (MW, p=0.00) and lower pain intensity (MW, p=0.00). The translated and validated version of the MTS showed to be appropriate and useful in categorization of patients with dental emergencies in this setting.
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Jansson, Pravitz Elin. "Betydelsen av triagesjuksköterskans kliniska erfarenhet i triagebedömningen på akutmottagning : En kvantitativ sekundäranalys." Thesis, Linnéuniversitetet, Institutionen för hälso- och vårdvetenskap (HV), 2019. http://urn.kb.se/resolve?urn=urn:nbn:se:lnu:diva-82620.
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Bakgrund: Triage är numera en viktig del i den moderna sjukvården och innebär prioritering och sortering av patienter. Triagebedömningen utförs oftast av en triagesjuksköterska och då med hjälp av en triageskala som till stor del är avgörande för hur länge patienten bedöms kunna vänta på läkarbedömning. I Sverige är den mest frekvent använda triageskalan RETTS. Dock har studier visat på olikheter i triagenivåer och att triagebedömningen skulle påverkas av triagesjuksköterskans erfarenhet. Syfte: Syftet var att undersöka om det i triagebedömningar på akutmottagning fanns skillnader som berodde på triagesjuksköterskans kliniska erfarenhet sett utifrån triagenivå och ESS-algoritm vid användandet av triageskalan RETTS. Metod: Studien hade en kvantitativ metod och en sekundäranalys av rådata från 2014 genomfördes. Rådatan bestod av enkäter utformade som patientfall vilka hade fyllts i av triagesjuksköterskor från två akutmottagningar i södra Sverige. Dataanalysen gjordes med deskriptiv analys samt med jämförande statistik, Chi2-test. Resultat: Resultaten redovisades utifrån triagenivå, ESS-algoritm samt kommentarer. Skillnaderna mellan de olika erfarenheterna presenterades i tre olika erfarenhetskategorier. I resultatet framkom att det fanns skillnader i triagenivå, ESS-algoritm samt antal kommentarer. Enbart i en analys förekom en signifikant skillnad mellan de olika erfarenhetsgrupperna. Slutsats: Resultatet visade på skillnader i triagenivåer och ESS-algoritmer men däremot visade inte resultatet i tillräckligt hög utsträckning vad dessa berodde på. Då skillnader i triagebedömningen utgör en patientsäkerhetsrisk samt ökar kostnaden för vården behövs vidare forskning för att försöka ta reda på anledningen till skillnaderna.Background: Triage has now become an important part of modern health care and involves prioritizing and sorting of patients. It is usually performed by a nurse and with the help of a triage scale. The triage scale is critical for how long the patient can wait to see the doctor. In Sweden the most common triage scale is RETTS. However, studies have shown differences in the triage level and that the triage assessment could be affected by the experience of the triage nurse. Aim: The aim of the study was to investigate if there were any differences in the triage assessment at emergency departments depending on the clinical experience of the triage nurse in reference to the triage level and ESS-algorithm when using the triage scale RETTS. Method: A quantitative study and a secondary analysis was carried out based on data from 2014. The collection of the data has been carried out in two different emergency departments in the South of Sweden through written patient scenarios. Data were analyzed with descriptive statistics and The Chi-square Test. Result: The results was shown in the categories triage level, ESS-algorithm and comments. The differences between experiences was displayed in three different categories. The result showed differences in triage levels, ESS-algorithms and in the number of comments. However, only in one analysis was there a significant difference between the different groups of experiences. Conclusion: The result has shown that there were differences in the triage levels and ESS-algorithms but the result has not sufficiently given an explanation as to why these differences occur. As the differences in the triage assessments constitutes a risk for the patients and increases costs for the health care further research need to be done to try to find out the reason for the differences.
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Martín, Campillo Abraham. "Triage applications and communications in emergency scenarios." Doctoral thesis, Universitat Autònoma de Barcelona, 2012. http://hdl.handle.net/10803/117616.
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El triatge de víctimes és una de les primeres i més importants tasques a realitzar en arribar a un escenari d'emergència. Aquest procés prioritza l'atenció mèdica a les víctima en base al nivell de les seves lesions. Aquest procés és molt important per a una assignació de recursos eficient i eficaç, sobretot en emergències de gran abast amb un gran nombre de víctimes. El procés de classificació de víctimes tradicional utilitza etiquetes de triatge com a indicador de l'estat de la víctima, una solució que comporta alguns inconvenients: Els metges han d'acostar-se a la víctima per veure el seu estat en l'etiqueta de paper, la pèrdua de l'etiqueta de triatge, etc. Avui dia, la informatització de les etiquetes de classificació és essencial per a una coordinació i atenció a les víctimes més ràpida. No obstant això, els escenaris d'emergència usualment es caracteritzen per la falta de xarxes sense fils disponibles per al seu ús. Xarxes sense fils basades en infraestructura com les xarxes de telefonia mòbil o les xarxes Wi-Fi solen destruir-se o saturar-se a causa d'un gran intent d'utilització o per la mateixa naturalesa de l'emergència. Algunes solucions proposen l'ús de sensors i la creació d'una xarxa de sensors sense fils per transmetre l'estat i la posició de les víctimes o el desplegament de repetidors per crear una MANET completament connectada. No obstant això, en grans emergències, això pot no ser possible a causa de l'extensió d'aquesta o pot no ser viable a causa del temps requerit per desplegar els repetidors. Aquesta tesi analitza les situacions d'emergència des del punt de vista de xarxes i comunicacions. Es proposa un sistema per a la classificació electrònica de víctimes fins i tot en casos sense cap tipus de xarxa disponible gràcies a la utilització de xarxes oportunistes i agents mòbils. També s'analitza el rendiment dels protocols de forwarding a les zones de desastre i es proposen algunes millores per reduir el consum d'energia.El triaje de víctimas es una de las primeras y más importantes tareas al llegar a un escenario de emergencia. Este proceso prioriza la atención médica a las víctima en base al nivel de sus lesiones. Este proceso es muy importante para una asignación de recursos eficiente y eficaz, sobretodo en emergencias de gran abasto con un gran número de víctimas. El proceso de clasificación de víctimas tradicional utiliza etiquetas de triaje como indicador del estado de la víctima, una solución que con algunos inconvenientes: Los médicos tienen que acercarse a la víctima para ver su estado en la etiqueta de papel, la pérdida de la etiqueta de triaje, etc. Hoy en día, la informatización de las etiquetas de clasificación es esencial para una coordinación y atención a las víctimas más rápida. Sin embargo, los escenarios de emergencia usualmente se caracterizan por la falta de redes inalámbricas disponibles para su uso. Redes inalámbricas basadas en infraestructura como las redes de telefonía móvil o las redes Wi-Fi suelen destruirse o saturarse debido un gran intento de utilización o a la misma naturaleza de la emergencia. Algunas soluciones proponen el uso de sensores y la creación de una red de sensores inalámbricos para transmitir el estado y la posición de las víctimas o el despliegue de repetidores para crear una MANET completamente conectada. Sin embargo, en grandes emergencias, esto puede no ser posible debido a la extensión de esta o puede no ser viable debido al tiempo requerido para desplegar los repetidores. Esta tesis analiza las situaciones de emergencia desde el punto de vista de redes y comunicaciones. Se propone un sistema para la clasificación electrónica de víctimas incluso en casos sin ningún tipo de red disponible gracias a la utilización de redes oportunistas y agentes móviles. También se analiza el rendimiento de los protocolos de forwarding en las zonas de desastre y se proponen algunas mejoras para reducir el consumo de energía.
Triaging victims is the first and foremost task in an emergency scenario. This process priorizes victim's attention based on their injuries, very important for an efficient and effective resource allocation in mass casualty incidents which large amount of victims. Traditional triage process used paper triage tags as victim's injury level indicator, a solution that had some drawbacks: first responder had to go to the each victim to see their injury level on the paper triage tag, loss of the triage tag, etc. On today emergencies, an electronic triage tag is essential for a faster coordination and attention to victims. However, emergency scenarios are usually characterized by the lack of wireless networks to rely on. Infrastructure based wireless networks as mobile phone networks or Wi-Fi networks are usually destroyed or overused due to the very nature of the emergency. Some solutions propose the use of sensors, creating a wireless sensor networks to transmit the injury level and position of the victim or deploying repeaters to create a fully connected MANET. However, in large emergencies this may not be possible and the time required to deploy all the repeaters could be not worth. This thesis analyses emergencies from the communication point of view. It proposes a system for the electronic triage of victims and emergency management to work even in worst cases scenarios from the network communications perspective thanks to the use of opportunistic networks and mobile agents. It also analyses the performance of several forwarding protocols in disaster areas and proposes some improvements to reduce energy consumption.
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Alm, Lena, and Andreas Enarsson. "Triage på akutmottagning : -vad påverkar sjuksköterskans arbete?" Thesis, Mittuniversitetet, Institutionen för hälsovetenskap, 2011. http://urn.kb.se/resolve?urn=urn:nbn:se:miun:diva-13734.
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Bakgrund: Triagesystem användes för att identifiera allvarligt sjuka från mindre sjuka på akutmottagningar. En snabb och adekvat behandling var viktig för en god patientsäkerhet. En sjuksköterskas felbedömning kunde ge allvarliga konsekvenser för en patient och andra vårdsökande. Syfte: Att belysa faktorer som påverkar sjuksköterskan i sitt triagearbete på akutmottagning. Metod: En litteraturöversikt gjordes och 18 resultatartiklar inkluderades. Analysarbetet inspirerades av kvalitativ innehållsanalys och resulterade i 4 kategorier och 13 underkategorier. Resultat: Sjuksköterskans triagearbete påverkades av färdigheter, personliga egenskaper, organisation och tillgång till information. Diskussion: Få sjuksköterskor hade utbildning i triage vilket borde uppmärksammas mer med tanke på att ett stort antal patienter söker till akutmottagningar varje dag. Sjuksköterskor borde utgå ifrån gemensamma riktlinjer för att patienter skall behandlas lika oberoende vilken akutmottagning de söker vård på. Slutsats: Erfarenhet, utbildning, kommunikation, intuition, självtillit, arbetsbelastning, arbetsteam, arbetsuppgift, triageskala, helhetsbedömning, initial bedömning, objektiv- samt subjektiv data påverkade triagebedömningen. Troligen förekom en samverkan mellan dem vilket gjorde området komplext.
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Allard, Cecilia, and Anna Ögnelod. "Triage på en akutmottagningen ur sjuksköterskors perspektiv." Thesis, Högskolan i Skövde, Institutionen för hälsa och lärande, 2017. http://urn.kb.se/resolve?urn=urn:nbn:se:his:diva-14536.
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Wagner, Wolfgang. "Implementierung einer "Triage und Ersteinschätzung von Patienten"." Bachelor's thesis, Dresden International University, 2013. http://nbn-resolving.de/urn:nbn:de:bsz:14-qucosa-130625.
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Hintergrund: Triage und Ersteinschätzung von Patienten in der Krankenhaus-Notaufnahme als Instrument der Prozeßgestaltung. Übersicht: In den vergangenen Jahren zeigte sich deutschlandweit ein Trend. Die Versorgung von Patienten in den Notaufnahmen der Krankenhäuser erlangt eine immer größere Bedeutung. Bedeutendste Ressource in der Notaufnahme ist die ärztliche Arbeit. Diagnosestellung und Festlegung der Therapie sind die wesentlichen Leistungen. Es ist entscheidend, die Prozessqualität am Punkt des Erstkontaktes des Notfallpatienten mit dem Krankenhaus zu verbessern. Das Universitätsklinikum Dresden eröffnete 2012 mit der Konservativen Notaufnahme (KNA-S1) eine neue, interdisziplinäre Funktionsstelle. Organisatorische Intervention war die Entlastung und Steuerung der Ressource „Arbeitszeit Arzt“. Es wurde das Manchester Triage System als Steuerungsinstrument implementiert mit den Zielen: • Optimale Nutzung der Infrastruktur • Neu definierter und verbesserter Ablauf der Integration von Notfallpatienten in den Behandlungsprozeß und den Geschäftsprozeß des UKD. • Entwicklung von Handlungsempfehlungen für das Pflegepersonal für Maßnahmen am Patienten vor Arztkontakt Schlussfolgerungen: Die strukturierte Ersteinschätzung von Patienten ist ein zielführendes Instrument, um den organisatorischen Reifegrad des Workflows in der Notaufnahme zu erhöhen. Auf dieser Grundlage entwickelte Handlungsempfehlungen für das Pflegepersonal schaffen für Patienten, Ärzte und Pflegepersonal ein optimiertes, Risiko-reduziertes UmfeldBackground: Triage and initial assessment of patients in Emergency Departments as organizational tool for process improvement. Summary: A trend occurred throughout Germany during the past years. Hospital Emergency Departments achieve increasing importance in patient care. Crucial resource in the ED is physician´s work and authority for diagnosis and therapy. It is important to improve process quality at the point of emergency patient´s first contact to hospital. In 2012 University Hospital Dresden established a new interdisciplinary infrastructure in emergency care for medical and neurological patients (KNA-S1). Organizational intervention has been to relieve and control workload and schedule of the physicians. The Manchester Triage System was implemented as instrument for process control aiming: • Optimized utilization of resources • improved workflow of how emergency patients are introduced into treatment and hospital workflow • Development of guidelines for nursing staff to accomplish appropriate procedures on patients before seeing the physician first Conclusion: Operating an initial assessment on emergency patients leads to improvement of quality and proficiency throughout the operating procedures of an Emergency Department. Guidelines for nursing staff on this foundation will create an optimized and risk reduced environment for patients, physicians and all medical professionals in the ED
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Paulenich, John, Chukwuemeka Agbedo, and Kenneth Rea. "Identification and triage of compromised virtual machines." Thesis, Monterey, California: Naval Postgraduate School, 2014. http://hdl.handle.net/10945/43975.
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Approved for public release; distribution is unlimitedThe increasing volume and sophistication of cyber-attacks, the adoption of virtualization technology, and the slow incorporation of new software on Navy networks has created a unique situation. The status quo has left those responsible for administering and defending Navy networks at a distinct disadvantage. They are unable to leverage current triage tools available to assist in the identification, classification, and recovery aspects of incident response on a computer network. At the same time, their adversaries have no such limitations. This capstone report explores the use of native operating system tools along with mirrored domains in a virtualized environment as a possible strategy to provide these capabilities. For this project, we created a generalized virtual network with mirrored domains. In this environment, we developed a toolkit, comprised of software already available to administrators, and a method for deploying it. We then demonstrated its efficacy in detecting a compromise by inserting malware into a computer in the environment. Finally, we used the mirrored domains within the environment to provide a means for an accelerated recovery. Used together, this native toolset and recovery strategy provide a possible solution for the detection of and response to incidents on a network.
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Carson, C. "Telephone street triage : a service user perspective." Thesis, University of Salford, 2018. http://usir.salford.ac.uk/48859/.
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In the last fifteen years Accident and Emergency (A & E) departments have become the default environment for service users seeking help during a mental health crisis. Simultaneously, the Police have reported concerns about the expectations placed on their officers in dealing with the rising numbers of people experiencing a mental health crisis. In 2014 the Home Office launched The Crisis Care Concordat requiring statutory and non-statutory organisations to make a commitment to work together to ensure a seamless pathway for anyone who experiences a mental health crisis, regardless of their first contact with services. To facilitate this many new initiatives were developed, Street Triage being one. This allows the police immediate access to a mental health professional when they find themselves attending an incident or event that has a mental health component. Whilst there is an emerging body of research focusing on the organisational and financial benefits to such services, there is limited research regarding the experience of the service user utilising such services. The aim of this study was to explore and understand the experiences of service users, who when experiencing a mental health crisis were treated by the Street Triage Service. Qualitative research, using a narrative approach was used to address this aim. Data were collected through one to one narrative interviews with three service users. Interview transcripts were initially analysed as individual stories, and then as a collective, recognising the nuances of each narrative and also exploring the cross commonalities. While each narrative had its own unique themes some, shared commonalities were also identified. These included; (1) Learning from their own experiences, (2) Perceiving and interacting with blue light services and (3) Interacting with the Street Triage team. Individuals who have experienced a mental health crisis and used the Street Triage service offer a wealth of knowledge that not only contributes to the emerging body of research in this area, but also enables the development of such services in better meeting the needs of those who may require such services in the future.
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Holt, Steven. "Using urban triage to plan for walkability." Kansas State University, 2015. http://hdl.handle.net/2097/19051.
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Master of Landscape ArchitectureLandscape Architecture/Regional and Community Planning
Mary C. Kingery-Page
Literature shows that walkable neighborhoods have the potential to significantly decrease the carbon footprint of cities by lessening the need to drive, as well as providing many health, economic, and social benefits to society. The goal of this research, therefore, was to devise a practical strategy to create walkable places in the car-oriented city of Wichita, Kansas. A necessary component of this strategy is an “urban triage,” described by Jeff Speck in Walkable City as identifying streets with the most existing potential and concentrating limited resources to their improvement (2012, 254). This report employed an urban triage of Wichita at two scales based on three central characteristics of walkability: urban fabric, dense street network and connectivity. Comparing block length and link to node ratio, I built a case for downtown, which is organized on a traditional grid of streets, over a typical shopping district organized around the more modern hierarchical pattern of streets. Within downtown, I further narrowed the study area primarily based on urban fabric, the degree to which streets are enclosed by buildings. I created a method to measure urban fabric, using aerial imagery and street views, taking into account the consistency of the street wall, height of buildings and foreground. The strongest complete corridor, in terms of urban fabric, and three potential links between that corridor and downtown’s largest event space, became the study area for further analysis. A rubric, based on characteristics of walkability extrapolated from literature, served as the instrument to measure the attributes of each block in the study area. Each attribute, as well as the characteristics that they create, yielded a map, contrasting strong and weak blocks. This analysis provided the detailed information necessary to create an informed conceptual strategy to resolve these weaknesses. Selective building infill resolved gaps in the urban fabric, road diets and improved crossings restored modal balance to the street, and a new pedestrian corridor completed a broken street and activated an existing park.
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Ziabari, Mir Kamyar. "Mobile Self-Triage Applications: A Usability Perspective." Thesis, Université d'Ottawa / University of Ottawa, 2018. http://hdl.handle.net/10393/37971.
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Each person faces a health problem differently. Many people tend to visit an emergency department immediately without any regards to the scale of acuity of their disorder. Some of these visits are not necessary and hence lead to overcrowding of emergency de-partments, increase patients’ waiting time, and ultimately lead to overutilization of healthcare resources. At the other end of the spectrum, some people do not visit their physician when they should. One solution to this problem is to provide a reliable source of information that would allow people to assess their health condition (self-triage) in a way that helps reduce the number of inappropriate visits and promote warranted visits to emergency departments.
This research proposes a new and user-friendly self-triage mobile application called Symptoms Pal, which allows lay people to use their health data to assess the pres-ence of potential health concerns. Using diagnostic algorithms developed by physicians on the basis of medical evidence, the application requires users to answer a short series of questions about their symptoms. Symptoms Pal then provides some basic information about the possible problem and aims to inform users about whether they should seek im-mediate medical attention such as visiting an emergency department, or see a family doc-tor, or do self-care. The usability of Symptoms Pal was evaluated by conducting a study involving 34 participants. Several strengths and weaknesses of the usability and perceived usefulness of the application were identified and led to a revised version and additional recommendations.
The thesis contributes 25 reusable requirements and validated user interface de-sign artefacts for self-triage mobile applications.
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Wilson, Merna Akram. "Triage Template to Improve Emergency Department Flow." Kent State University / OhioLINK, 2021. http://rave.ohiolink.edu/etdc/view?acc_num=kent1622280768033809.
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Riska, Kristal M., Faith W. Akin, Laura Williams, Stephanie B. Rouse, and Owen D. Murnane. "A Benign Paroxysmal Positional Vertigo Triage Clinic." Digital Commons @ East Tennessee State University, 2017. https://dc.etsu.edu/etsu-works/1779.
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Purpose: The purpose of this study was to evaluate the effectiveness of triaging patients with motion-provoked dizziness into a benign paroxysmal positional vertigo (BPPV) clinic.
Method: A retrospective chart review was performed of veterans who were tested and treated for BPPV in a triaged BPPV clinic and veterans who were tested and treated for BPPV in a traditional vestibular clinic.
Results: The BPPV triage clinic had a hit rate of 39%. On average, the triaged BPPV clinic reduced patient wait times by 23 days relative to the wait times for the traditional vestibular clinic while also reducing patient costs.
Conclusion: Triaging patients with BPPV is one method to improve access to evaluation and treatment and a mechanism for the effective use of clinic time and resources.
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Zhao, Lijuan. "Advanced Triage Protocols in the Emergency Department." ScholarWorks, 2017. https://scholarworks.waldenu.edu/dissertations/3649.
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Overcrowded emergency departments (EDs) are a major problem in the United States resulting in inefficiency in operation and performance. A Southern California hospital ED was the site for this project because it had operated over its maximum capacity during the last decade. Advanced triage protocols integrating standard order sets were implemented to improve quality of care; however, no evaluation of the protocols had been done. The purpose of this project was to evaluate the effect of the advanced triage protocols. Two project questions determined whether advanced triage protocols reduced ED length of stay (LOS), number of patients who left without being seen (LWBS), and improved patient experience. The Lean Principles and the Plan-Do-Study-Act Model for Improvement were used to guide the project. A pre- and post-implementation design found that ED LOS had a significant 17-minute decrease for ESI Level 3 patients (225.7 -± 8.6 minutes vs. 208.8 -± 6.9 minutes, p = .002), and significant 13- minute decrease for ESI Level 4 patients (146.5 -± 1.6 minutes vs. 133.5 -± 1.5 minutes, p =.001). For the ED rate of patients who LWBS, no statistically significant difference was seen between pre- and post- implementation (41/575, 7.13% vs. 46/611, 7.52%). Satisfaction scores were improved by more than 10% after implementation. The advanced triage protocols enhanced front-end throughput operations and patient experience within the ED by allowing triage nurses to initiate orders and begin pain medication. Delivering timely and efficient care to meet various patients' needs has the potential for a positive social change through improved health care outcomes; perception of care; and trust between patients, providers, and the health care system.
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Sprivulis, Peter Carl. "Evaluation of the prehospital utilisation of the Australasian Triage Scale /." Connect to this title, 2003. http://theses.library.uwa.edu.au/adt-WU2004.0055.
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Fredriksson, Lisette, and Annika Hemström. "Triageprocessen på akutmottagning : en enkätstudie om sjuksköterskors och läkares uppfattningar kring utbildning, förtroende och följsamhet." Thesis, Sophiahemmet Högskola, 2019. http://urn.kb.se/resolve?urn=urn:nbn:se:shh:diva-3337.
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Patientflöden till Sveriges akutmottagningar ökar varje år. För att ta emot och bedöma patienter på ett patientsäkert sätt används triage. En välfungerande triageprocess är en förutsättning för ett patientsäkert arbete på akutmottagning. Syftet med denna studie var att göra en granskning av triageprocessen på akutmottagning, utifrån sjuksköterskors och läkares uppfattningar kring utbildning, förtroende och följsamhet. Metoden var en deskriptiv tvärsnittsstudie baserad på en webbaserad enkätundersökning ställd till sjuksköterskor och läkare som arbetade inom triageprocessen på två sjukhus i Mellansverige. Inkluderade respondenter uppgick till n=191. Data har analyserats med hjälp av kvantitativ- och kvalitativ metod. Enkätfrågor med slutna svarsalternativ har analyserats kvantitativt med Chi-2-test [Χ2] och presenteras med deskriptiv statistik. Fritextsvar i enkäten har analyserats kvalitativt med manifest innehållsanalys. Resultatet visar att det finns brister i triageutbildningen på akutmottagningarna som deltog i studien. Framförallt uppger läkarna att de saknar utbildning i triageverktyg och triageprocessens rutiner. Respondenternas svar visar att det finns brister i hur väl innehållet i utbildningen stämmer överens med hur arbetssättet tillämpas i den kliniska verksamheten och att respondenterna inte känner sig väl förberedda inför att börja arbeta med triage i klinisk verksamhet. Patienternas sjukdomstillstånd anses inte identifieras adekvat av triageverktyg eller under triageprocess. Utifrån aspekter kring övertriagering samt identifiering av omvårdnadsbehov och medicinska behov har SATS högre förtroende hos sjuksköterskorna än DPT. Dock uppger respondenterna på båda akutmottagningarna att omvårdnadsbehov och medicinska behov inte fullt ut identifieras av triageverktyg eller under triageprocessen. Få respondenter uppger att informationsöverföring i triageprocessen fungerar väl på deras arbetsplatser. Det förekommer att respondenterna avviker från triageverktyget, triageprocessens rutiner samt prioriteringsordning. Respondenternas uppfattningar är att läkare frångår oftare än sjuksköterskor. Sjuksköterskor som arbetar med sjuksköterskeledd triage anser i högre grad än övriga respondenter att bristande följsamhet till triageprocessens rutiner påverkar patientsäkerheten på deras arbetsplats. Slutsatsen är att det finns brister i triageprocessen på akutmottagningarna i studien som skulle kunna inverka negativt på patientsäkerheten.Inflow of patients to Sweden’s emergency departments are increasing every year. In order to receive and assess patients in a patient-safe manner, triage is used. A well-functioning triage process is a prerequisite for patient-safe work at the emergency department. The aim of this review was to study the triage process in the emergency department based on nurses’ and physicians’ perceptions of education, confidence and compliance. The method was a descriptive cross-sectional study, based on a web-based survey sent to nurses and physicians active in the triage process in two hospitals in Sweden. Respondents included amounted to n=191. Data have been analyzed using quantitative and qualitative methods. Survey questions with closed answer options have been analyzed quantitatively with Chi-squared test [Χ2] and is presented using descriptive statistics. Free text replies have been analyzed qualitatively with manifest content analysis. The results show that there are shortcomings concerning the triage education at the emergency departments participating in this study. Especially physicians state that they lack education regarding the triage tool and in the triage process procedures. Respondents’ answers show that there are deficiencies regarding how well education content is consistent with how it is applied in the clinical activity and that respondents do not feel well prepared before starting triage in clinical activities. Patients’ disease states are not regarded to be adequately identified by the triage tool or during the triage process. Based on aspects of over triage and identification of care and medical needs nurses show higher confidence in SATS than DPT. However, respondents at both emergency departments state that care and medical needs are not fully identified by the triage tool or during the triage process. Few respondents state that information transfer in the triage process works well in their workplaces. The respondents may deviate from the triage tool, the triage process procedures and priority order. Perceptions of respondents are that physicians more frequently deviate than nurses. Nurses who work with nursing led triage consider in higher degree, than other respondents, that lack of compliance to triage process procedures affects patient safety at their place of work. The conclusion is that there are shortcomings regarding the triage process in the emergency departments included in this study that could adversely affect patient safety.
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Dalwai, Mohammed K. "Reliability and validity of the South African Triage Scale in low-resource settings." Thesis, University of Cape Town, 2018. http://hdl.handle.net/11427/28428.
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Emergency medical care (EMC) is proposed by the World Health Organization (WHO) as being one of the core components of a horizontal approach to improving population health in low-resource settings; triage is considered to be a fundamental part of this field. Most studies exploring triage have focused on high-income countries. In 2004, the Cape Triage Group (CTG) developed the South African Triage Scale (SATS) a scale that uses a physiologically based scoring system together with a list of discriminators - designed to triage patients into one of four priority groups for medical attention. The SATS was designed for use in the South African context to mitigate the limited numbers of doctors and professional nurses. The SATS has been implemented and assessed extensively in South Africa, but its performance across a spectrum of different low-resource settings, particularly non-sub-Saharan African and trauma-only settings, has not been adequately assessed. Médecins Sans Frontières (MSF), an international humanitarian organisation, introduced EMC in 2006 into low-resource settings. In 2011, MSF began introducing the SATS in various projects where it was providing EMC. Methodology: This was a multi-site retrospective cohort study which sought to assess the reliability and validity of the SATS in different low-resource settings. Aim 1: To implement and evaluate the SATS in Northern Pakistan by describing the steps of implementation and how accurate nurses were in using the triage scale. After one month of implementation, 370 triage forms from a one-week period were evaluated. Aim 2: To assess the inter- and intra-rater reliability and accuracy of nurse triage ratings when using the SATS in an emergency centre (EC) in Timergara, Pakistan. Fifteen EC nurses assigned triage ratings to a set of 42 reference vignettes (written case reports of EC patients) under classroom conditions. Inter-rater reliability was assessed by comparing these triage ratings; intra-rater reliability was assessed by asking the nurses to re-triage ten 12 random vignettes from the original set of 42 vignettes and comparing the duplicate ratings. Accuracy of the nurse ratings was measured against the reference standard. Aim 3: To improve the ability to measure reliability and validity in paediatric settings by developing a set of paediatric paper-based vignettes using the Delphi methodology. In a two-round consensus building process, a panel of EC experts were asked to independently triage 50 clinical vignettes using one of four acuity levels: emergency (patient to be seen immediately), very urgent (patient to be seen within 10 min), urgent (patient to be seen within 60 min), or routine (patient to be seen within four hours). The vignettes were based on real paediatric EC cases in South Africa. Vignettes that reached a minimum of 80% group consensus for acuity ratings on either round one or two were included in the final set of reference vignettes. Aim 4: To further assess the reliability of the SATS across MSF-supported hospitals using paper-based vignettes in Afghanistan, Haiti and Sierra Leone. Applying the same methodology as in Northern Pakistan, we assessed reliability under classroom conditions between December 2013 and February 2014. Aim 5: To assess the validity of the SATS across MSF-supported hospitals between June 2013 and June 2014. Validity was assessed by comparing patients’ SATS ratings with their final EC outcomes (i.e., hospital admission, death or discharge) across four sites in Afghanistan, Haiti and Sierra Leone. Findings The SATS was able to be easily implemented and accurately completed in a low-resource setting of Northern Pakistan. We recommended further implementation and assessment of reliability and validity in low-resource settings. Across six sites with a total of 87 nurses, including two trauma-only hospitals in Afghanistan and Haiti, a paediatric-only hospital in Sierra Leone and three mixed medical settings in Afghanistan, Pakistan and Haiti, the SATS demonstrated moderate to substantial reliability. Across all settings in which we measured validity using outcome markers, SATS predicted an increase in the likelihood of admission/death when moving from low- to high-triage acuity. In trauma-only settings of Afghanistan and Haiti, the SATS showed a 1-9% under-triage and 13 a 2-16% over-triage rate. In mixed medical and paediatric settings, under-triage ranged from 0-76% while over-triage ranged from 2-88%. A more logical standardised approach to assessing validity was put forward when using outcome markers that would allow easier comparisons to be done across validity studies irrespective of the number of levels the triage scale had. We developed a set of paediatric vignettes for use in low-resource settings but cautioned against its use after measuring reliability using adult reference vignettes. We found that generic vignettes were poor substitutes in a variety of settings based on a lack of contextualisation and understanding by local nurses. Conclusion: The SATS has reasonable reliability with good validity across different ECs in various lower-source settings. The SATS is a valid triage tool for prioritisation of patients with trauma in low-resource settings. Its use in mixed EC settings seems justified, but in paediatric settings context-specific adjustments and assessments of its performance would be prudent.
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Sprivulis, Peter Carl. "Evaluation of the prehospital utilisation of the Australasian Triage Scale." University of Western Australia. Emergency Medicine Discipline Group, 2004. http://theses.library.uwa.edu.au/adt-WU2004.0055.
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[Truncated abstract] Background : Triage systems have evolved from battlefield casualty prioritisation tools to integral components of civilian emergency care systems over the last 50 years. There is significant variation in prehospital triage practices in Australia and little research has been undertaken to validate the triage systems used. There is considerable evidence to support the use of the Australasian Triage Scale (ATS) for triage in the emergency department setting and the ATS is used ubiquitously for emergency department triage in Australasia ... Conclusions : The findings of this thesis support integrating prehospital ATS allocations with emergency department triage processes. It is concluded that Paramedics apply the ATS similarly to nurses ... Allocations to ATS 1, 2 and 3 and most ATS 4 allocations by paramedics are valid when compared to nurse ATS allocations. Australasian Triage Scale category 5 is used inappropriately by paramedics and should be used rarely, if at all, by paramedics. The reliability of paramedic and nurse ATS allocations is sufficient to warrant a trial of the omission of retriage of ambulance presentations at Perth metropolitan emergency departments. However, early nursing assessment of a small proportion of ATS 3 patients may be required to ensure timely assessment for some mistriaged bone fide ATS 2 patients. Paramedic ATS allocations appear sufficiently reliable and valid to warrant a trial of their use as part of a two-tier trauma team activation system ... The implementation of standardised training between paramedics and nurses based on current Australasian College for Emergency Medicine guidelines is recommended. The implementation of paramedic triage audit, including comparison of paramedic ATS allocations with nurse ATS allocations may improve reliability between paramedics and nurses, and particularly the reliability of ATS 4 and ATS 5 allocations. Prehospital ATS allocations may prove useful in prehospital casemix analysis, the evaluation of prehospital service delivery and for prehospital research. Research opportunities include actual trials of the integration of prehospital use of ATS with emergency department triage and trauma system activation, and the evaluation of the ATS as a prehospital casemix and performance evaluation tool. Research into alternative triage tools to the ATS for use in the prehospital environment and into the impact of standardised triage training is also suggested.
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Östlund, Charlotte, and Ida Åhlin. "Triage på akutmottagning : Sjuksköterskors upplevelser av nuvarande triagemodell." Thesis, Uppsala University, Department of Public Health and Caring Sciences, 2009. http://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-112464.
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To sort, is the meaning of the word “triage”. Triage is used at emergency departments to facilitate prioritization of patients according to the urgency of the chief complaint. The aim of this study was to investigate how the nurses experience the triage model at the emergency department at Uppsala university hospital.
Twelve nurses were interviewed. The mean age was 40 years and the mean work experience was three years and four months. An interview guide was used, consisting of questions about triage, collaboration and work situation.
The nurses perceived that triage supports assessment and prioritization of patients. Different triage models were used depending on the nurses’ level of triage-education, which was perceived as problematic. The nurses perceived safety when triage was performed together with the physician. The level of collaboration, between the nurses and the physicians, was experienced to be person-dependent. The importance of good communication between nurses and physicians were highlighted.
Triage supports the assessment and prioritization of patients. A standardized triage model would increase the quality of care. The collaboration between nurses and physicians could be improved if they receive the same information and education about triage. Improved communication will facilitate the collaboration. Physicians should participate in the triage process.
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Bengtsson, Jonny, and Alexander Löfman. "Patientens upplevelse av triage och vård på akutmottagning." Thesis, Mittuniversitetet, 2011. http://urn.kb.se/resolve?urn=urn:nbn:se:miun:diva-13507.
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Bakgrund: Akutsjukvård sker i första hand via en akutmottagning. Vid ett akut omhändertagande på en akutmottagning är det ytterst viktigt att patienten får den vård som krävs så fort som möjligt, därför används triagering så att den som är i mest behov skall gå först, oavsett belastning. Syfte: Syftet med denna litteratur studie var att belysa patientens upplevelse av att bli omhändertagen och triagerad av sjuksköterskan på akutmottagningen. Metod: Litteraturstudien har genomförts genom att granska och klassificera 14 artiklar som både är kvantitativa och kvalitativa. Resultat: Patienter som inte har livshotande symtom får ofta vänta länge på vård. Den långa väntan leder till att patienterna får en lägre grad av tillfredsställelse av sitt besök på akutmottagningen. Att ge patienten information om hur lång eventuell väntan kan bli och varför de får vänta upplever patienten som positivt och får därigenom en högre grad av tillfredsställelse av sitt besök på akutmottagningen. Diskussion: Efter triageringen är det viktigt att informera angående hur lång väntetiden kan räknas bli. Även om patienten inte har livshotande symtom måste sjuksköterskan skapa trygghet hos dem då de ofta känner mycket oro och ovisshet. Slutsats: Att bemöta patienten korrekt samt ge information angående triagen, eventuell väntetid, vart de kan köpa mat och dryck skapar en högre grad av tillfredsställelse hos patienten.
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Gossas, Håkan, and Liselotte Berg. "Hur ambulanspersonalens rapport och triage används på akuten." Thesis, Karlstads universitet, Fakulteten för hälsa, natur- och teknikvetenskap (from 2013), 2018. http://urn.kb.se/resolve?urn=urn:nbn:se:kau:diva-67122.
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Introduktion: En viktig del i vårdprocessen är kommunikation. Därför är det viktigt att den fungerar tillfredställande. En mycket bra och beprövad kommunikationsmodell är SBAR. Ambulanssjuksköterskan ska kunna överrapportera på ett adekvat och patientsäkert sätt. Triage används för att få ett bra flöde på akutmottagningen och patientsäker vård. Syfte: Att kartlägga hur ambulanspersonalen överrapporterar patienten till akutens personal. Samt hur ambulanspersonalens triage används av akutens personal. Metod: En observationsstudie med kvantitativ design samt kompletterande enkät av kvalitativ karaktär där personalen med fritext kunde beskriva vad som var positivt samt negativt med överrapporteringen den hade en kvalitativ karaktär. Resultat: i resultatet framkom det i samtliga observationerna att det finns en klar och tydligfältdiagnos samt att bakgrund finns med. Vitalparametrar som rapporteras varierar från inga alls till korrekt rapporterat. Att ge en rekommendation till mottagande enhet sker sällan. När det gäller ESS så rapporterades det i mindre än hälften av fallen. Arbetets betydelse: Det finns en ganska stor förbättringspotential när det gäller överrapportering från ambulanspersonal vad gällande SBAR och hur den ska användas. Samtidigt en förbättringspotential från akutens personal gällande att vara intresserad av vad ambulanspersonalen överrapporterar.
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Alm, Jan-Ove, and Mikael Öström. "Triage i primärvården : Ett sätt att uppfylla behovsprincipen." Thesis, Högskolan i Borås, Akademin för vård, arbetsliv och välfärd, 2018. http://urn.kb.se/resolve?urn=urn:nbn:se:hb:diva-14634.
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Sverige har valt att ha en första linjens sjukvård som är tänkt att fånga upp invånarna och remittera vidare i systemet om det behövs, det som idag kallar primärvården eller Närhälsan. I Sverige finns det cirka 1100 vårdcentraler varav 40% bedrivs i privat regi. Det finns även en väl utvecklad egenvårdsrådgivning och sjukvårdsupplysning via web och telefon. Många vårdcentraler erbjuder också telefonrådgivning eller tidsbokning via telefon. Där ses ett problem då de vårdsökande kanske inte kommer fram via telefon och att det inte alltid är de med mest behov som får en tid bokad? Syftet med denna studie är att försöka hitta strategier vilka inte bryter mot behovsprincipen och som ger de vårdsökande en lättillgänglig första kontakt med vården. En litteraturstudie har genomförts och 12 artiklar har granskats och analyserats. Resultatet av denna studie visar på vissa faktorer vilka kan påverka primärvården: (1) öka patientflödet, (2) öka resurserna och tillgängligheten, samt (3) öka råd och vård via media. Det finns ett stort behov av att utveckla vårdcentralernas tillgänglighet, både från patienter och närstående men även från andra vårdinrättningar vilka blir överbelastade på grund av att första linjen inte klarar av sitt uppdrag fullt ut. Genom en ökad insikt i hur första linjens flöde kan optimeras för att tillgodose de vårdsökandes behov och hur sjukhusen kan avlastas går det att effektivisera primärvården.
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Soteriou, Sofia, and Johanna Frid. "Sjuksköterskors upplevelser av triage på akutmottagningen : en litteraturöversikt." Thesis, Sophiahemmet Högskola, 2020. http://urn.kb.se/resolve?urn=urn:nbn:se:shh:diva-3643.
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SAMMANFATTNING Bakgrund På en akutmottagning råder ett högt patientflöde vilket kräver någon form av turordningssystem. På de flesta akutmottagningar har således triage implementerats för att underlätta denna turordning. Syftet med triage är att bedöma och turordna patienter utefter medicinsk angelägenhetsgrad. I de flesta fall är det en sjuksköterska som utför denna bedömning vilket ställer krav på egenskaper som kritiskt tänkande, kunskap och erfarenhet. Att utföra triage på akutmottagningen kan vara utmanande till följd av högt patientflöde, hög arbetsbelastning och resursbrist vilket kan äventyra patientsäkerheten. Syfte Syftet var att beskriva sjuksköterskors upplevelser av triage på akutmottagningen. Metod Designen som valdes var en litteraturöversikt som omfattar vetenskapliga originalartiklar. Designen möjliggjorde sammanställning av en betydande del av det befintliga forskningsläget inom ämnesområdet. Datainsamlingen genomfördes i februari år 2020 i databaserna PubMed och CINAHL. En kvalitetsgranskning och integrerad analys genomfördes i syfte att sammanställa de 18 artiklar som slutligen ingick i resultatet. Resultat Resultatet utgjordes av sex kategorier bestående av sjuksköterskors övergripande upplevelser av triage på akutmottagningen. Dessa kategorier var patientflöde, akutmottagningens miljö, tidsaspekter, samarbete med kollegor, triageskalor samt yrkeserfarenheter och utbildning. Slutsats Tydlig kommunikation, samarbete med kollegor och ett konkret beslutsunderlag är essentiella aspekter för att främja sjuksköterskors förmåga att utföra triage. Resultatet illustrerar behovet av en adekvat utbildning och förberedelse inför triage samt att yrkeserfarenhet och en klinisk blick är av stor betydelse för att kunna utföra en korrekt bedömning och således leverera en patientsäker vård av hög kvalitet. Nyckelord: Akutmottagning, Patientsäkerhet, Sjuksköterskor, Triage, Upplevelser.ABSTRACT Background At the emergency department, there is a high flow of patients, thus some form of priority system is required. Therefore, most emergency departments have implemented the concept of triage in order to facilitate this priority system. The purpose of triage is to assess and prioritize between patients according to medical urgency. In most cases, a nurse is the one to perform this assessment, which requires characteristics such as critical thinking, knowledge and experience. Due to high flow of patients, heavy workload and lack of resources, it can be challenging to perform triage which may jeopardize patient safety. Aim The aim was to describe nurses’ experiences of triage at the emergency department. Method The design chosen was a literature review consisting of original research articles. The design made it possible to compile a significant amount of existing research within the current topic. The data collection took place in February 2020 via PubMed and CINAHL. Quality control and integrated analysis were conducted in order to present the 18 articles finally included in the results. Results The results consisted of six categories consisting of nurses’ overall experiences of triage at the emergency department. These categories were flow of patients, the emergency department environment, time-aspects, collaboration with colleagues, triage scales and experiences and education. Conclusions Distinct communication, collaboration with colleagues and concrete basis for decisions areessential aspects to promote nurses’ abilities in triage. The results illustrate the need of education and preparation for triage as well as professional and clinical experience in order to assess correctly, thus delivering patient-safe and high-quality care. Keywords: Emergency department, Experiences, Nurses, Patient safety, Perceptions
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Benner, Myron, and L. Lee Glenn. "Measurement Validity of Pediatric Emergency Department Rapid Triage." Digital Commons @ East Tennessee State University, 2012. https://dc.etsu.edu/etsu-works/7481.
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Excerpt: The study by Doyle et al1 concluded that “Implementing rapid triage and fast track guidelines can affect nurse-sensitive patient outcomes related to safety and care delivery in a pediatric emergency department,” but the support for the conclusions was weak because of 2 shortcomings: (1) the authors did not use a side-by-side control group, and (2) the findings can be explained by the Hawthorne effect.
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Richter, Rebecka, and Jim Stein. "Kommunikation vid triage och på akutmottagning : En litteraturstudie." Thesis, Röda Korsets Högskola, 2012. http://urn.kb.se/resolve?urn=urn:nbn:se:rkh:diva-461.
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Bakgrund: Syftet med triage på akutmottagningen är att säkerställa att patienter med störst behov av vård får det inom rimlig tid och på ett korrekt sätt. Triageprocessen inleds med att skapa en första kontakt mellan sjuksköterska och patient där kommunikationen är av stor betydelse. Att kunna delge andra människor information och dessutom kunna tolka och läsa av meddelanden är en del av kommunikationen samt att lyssna och ge svar på andra personers uttryck. Även icke-verbal kommunikation är en stor del av det som kommuniceras. Akutmottagningen är en stressig miljö och det finns mycket att lära angående vad som kan förbättra kommunikationen mellan sjuksköterska och patienter. Syfte: Att belysa hinder och befrämjande av kommunikation mellan sjuksköterska och patient vid triage och på akutmottagning. Metod: En allmän litteraturstudie baserad på tio kvalitativa artiklar. Resultat: Två huvudteman med sju underrubriker identifierades. Huvudtemana var: Befrämjande av kommunikation och Hinder för kommunikation. Underrubrikerna var: Verbal kommunikation, Icke-verbal kommunikation, Delaktighet i vård, Icke-delaktighet, Bristande individfokus, Tidsbrist och Informationsbrist. Slutsats: Av resultatet framgår att fler faktorer inom triage och akutsjukvård utgör hinder för kommunikation. Resultatet tyder på att patienterna saknar information om rutinerna på akutmottagningen samtidigt som sjuksköterskorna inte alltid anser sig ha tid för att ge informationen till patienterna. De faktorer som påverkar befrämjandet av kommunikationen stämmer överens med Habermas (1981/1990) teori där kommunikation baseras på öppenhjärtig grund, ärlighet och samförstånd. Klinisk betydelse: En mer patientcentrerad kommunikation och bättre information kan behövas på akutmottagningarna för att patienterna ska få bra vård och för att arbetet ska bli enklare för sjuksköterskorna.Background: The purpose of triage in the emergency department is to ensure that patients with the greatest need of care receive it within a reasonable time and in a proper manner. The triage process starts by creating an initial contact between nurse and patient, where communication is a vital part. Being able to communicate information to other people and to interpret messages is a part of the communication and also to listen and provide answers to other people's expressions. Non-verbal communication is also a great part of what is communicated. The emergency room is a stressful environment and there is much to learn in what can make communication between nurses and patients better. Aim: To highlight what hinders and promotes communication between nurses and patients in triage and at the emergency department. Method: A general literature study based on ten qualitative articles. Results: Two main themes and seven subthemes were identified. Main themes were: Promoting communication and Obstacles for communication. Subthemes were: Verbal communication, Non-verbal communication, Participation in care, Non-participation, Lack of individual focus, Lack of time and Lack of information. Conclusion: The results of the study show that more factors in triage and emergency care became hindrance of communication. The patients lack information about the routines in the emergency department and the nurses do not have enough time to inform the patients. The factors that affect promotion of communication consist with Habermas (1981/1990) theory where communication is based on open-hearted grounds, honesty and understanding. Clinical implication: A more patient-centered communication and better information may be needed at the emergency departments to secure good care of the patients and thereby facilitate the nurses work.
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Lee, Teng-Yok. "Data Triage and Visual Analytics for Scientific Visualization." The Ohio State University, 2011. http://rave.ohiolink.edu/etdc/view?acc_num=osu1321889683.
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Kamali, Behrooz. "Decision Support for Casualty Triage in Emergency Response." Diss., Virginia Tech, 2016. http://hdl.handle.net/10919/79817.
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Mass-casualty incidents (MCI) cause a sudden increase in demand of medical resources in a region. The most important and challenging task in addressing an MCI is managing overwhelmed resources with the goal of increasing total number of survivors. Currently, most of the decisions following an MCI are made in an ad-hoc manner or by following static guidelines that do not account for amount of available resources and number of the casualties. The purpose of this dissertation is to introduce and analyze sophisticated service prioritization and resource allocation tools. These tools can be used to produce service order strategies that increase the overall number of survivors. There are several models proposed that account for number and mix of the casualties, and amount and type of the resources available. Large number of the elements involved in this problem makes the model very complex, and thus, in order to gain some insights into the structure of the optimal solutions, some of the proposed models are developed under simplifying assumptions. These assumptions include limitations on the number of casualty types, handling of deaths, servers, and types of resources. Under these assumptions several characteristics of the optimal policies are identified, and optimal algorithms for various scenarios are developed. We also develop an integrated model that addresses service order, transportation, and hospital selection. A comprehensive set of computational results and comparison with the related works in the literature are provided in order to demonstrate the efficacy of the proposed methodologies.Ph. D.
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SEYDEL, ANKE. "Etude du triage des lipoproteines chez escherichia coli." Paris 7, 1999. http://www.theses.fr/1999PA077228.
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Nous etudions la mise en place des lipoproteines dans l'enveloppe d'escherichia coli, une bacterie a gram negatif. Grace a un peptide signal n-terminal, les lipoproteines traversent la membrane cytoplasmique par la voie d'exportation sec. Apres clivage par la lipoproteine signal peptidase, trois acides gras attaches a la cysteine n-terminale permettent l'ancrage de la lipoproteine dans la membrane externe en general, mais parfois dans la membrane cytoplasmique. La localisation des lipoproteines serait determinee par un signal de triage constitue par l'acide amine en position +2 de la proteine mature. Les lipoproteines n'ayant pas d'aspartate en position +2 (d+2) seraient localisees dans la membrane externe par une machinerie de triage composee de lola et lolb. Afin d'identifier d'autres facteurs impliques dans le triage des lipoproteines, nous avons mis au point un systeme genetique pour selectionner les mutations affectant le triage des lipoproteines vers la membrane externe en utilisant la proteine periplasmique affine du maltose, male. Nous avons construit des lipoproteines modeles composees d'un peptide signal d'une lipoproteine, d'un signal de triage pour la membrane externe (s+2) ou cytoplsmique (d+2) et de male comme rapporteur. Les souches exprimant lipomale avec (d+2) poussent sur maltose, tandis que celles avec (s+2) non. Une mutagenese chimique suivie d'une selection des mutants capables d'utiliser le maltose nous a permis d'identifier deux classes de mutants : un seul mutant de classe i, portant une mutation remplacant la serine +2 par une phenylalanine. Une mutagenese systematique de l'acide amine en position +2 de lipomale revele que des variants avec des acides amines tryptophane, tyrosine, glycine ou proline restent aussi dans la membrane cytoplasmique. L'analyse du genome d'e. Coli k-12 indique que ces acides amines sont rarement utilises en position +2 des lipoproteines. Les mutants de la classe ii ont des mutations chromosomiques causant une delocalisation partielle de lipomale. Par complementation, nous avons montre pour des mutants differents que la mutation n'est ni dans lola ni dans lolb, ce qui suggere que d'autres proteines pourraient etre impliquees dans le triage.
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Bae, Soon Il. "Balancing human and system visualization during document triage." [College Station, Tex. : Texas A&M University, 2008. http://hdl.handle.net/1969.1/ETD-TAMU-2330.
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Persson, Anna, and Sara Persson. "Prehospital triage : Faktorer som har betydelse för bedömning och beslut." Thesis, Högskolan i Gävle, Akademin för hälsa och arbetsliv, 2013. http://urn.kb.se/resolve?urn=urn:nbn:se:hig:diva-14889.
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Sammanfattning Syftet var att beskriva skillnader i triagebeslut som förekommer bland olika personalkategorier samt att beskriva olika vitalparametrars betydelser för triage. En ökad belastning finns idag på den prehospitala akutsjukvården. För att fördela resurserna på bästa sätt, att ge vård inom rimlig tid som är nödvändig för patientens tillstånd, har triage införts. Triage innebär att bedöma och prioritera hur snabbt patienten behöver vård. Litteraturstudien hade en deskriptiv design. Vetenskapliga artiklar söktes i PubMed och Cinahl samt utifrån funna artiklars referenslistor. Tio artiklar inkluderades i studien. Det har visat sig att triage har viktig inverkan på patientens fortsatta vård. Det förekom skillnader i beslut beroende på vilken personalkategori som utförde triage. De med högre utbildning triagerade patienterna oftare till rätt avancerad vårdnivå. Ålder och vitalparametrarna andningsfrekvens, saturation och medvetandegrad hade inverkan på triagebeslutet. De patienter som undertriagerades visade på högre mortalitet. För att patientsäkerhet skall uppnås måste all sjukvårdspersonal bedöma patienten till rätt triagenivå för att minska lidande och mortalitet. Det finns en uppenbar vinst i att tidigt upptäcka sviktande vitala organfunktioner och följa hur detta utvecklas. All akutsjukvård, både prehospital och hospital vore förtjänt av ett gemensamt och standardiserat triageinstrument.