Author: Dr. Mark Conrad Fivaz

Emergency Communication Nurses’ Ability to Correctly Select Abdominal Pain as the Appropriate Protocol in Telephonic Nurse Triage System

Download Original Paper Abdominal pain is the most common symptom with which patients present to the emergency department (ED), and overall visits to EDs in the U.S. are growing twice as fast as the overall population. Interventions that can safely mitigate such a high usage of ED resources would be a great asset in the delivery of effective and efficient ED care. One such intervention is a secondary triage of patients calling 911 for an ambulance who were subsequently triaged as a non-urgent low-acuity caller. Emergency medical services (EMS) using secondary...

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You Said It Was Quite Green This Morning….

The Health Contact Centre (HCC) in Brisbane Australia is one of the Health Support Queensland’s services that provides clinical support, either directly to the community (4.7 million Queenslanders) or in support of Hospital and Health Services (HHS) and the Department of Health. Registered nurses (RNs) use the Emergency Communication Nurse System™ (ECNS™) as Clinical Decision Software System (CDSS) to triage callers who access this service via telephone. The RN uses a set of symptom-based protocols in the ECNS to telephonically triage the caller/patient and recommends the most...

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The Distribution of Recommended Care Level Classification by Time of Day within the Emergency Communication Nurse System

Research has shown that two-thirds of emergency visits occur after business hours (weekdays 9am – 5pm). Therefore, identifying primary healthcare providers available after business hours is one strategy for improving appropriate access to healthcare services. Previous studies have also shown a high and steady volume of secondary triage-eligible calls throughout the day and into the evening. However, because the Emergency Communication Nurse (ECN) performing the secondary triage has some discretion on selecting the Recommended Care Level (RCL) based on resource...

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Assessing Call Demand and Utilization of a Secondary Triage Emergency Communication Nurse System for Low Acuity Calls Transferred from an Emergency Dispatch System

Telephone nurse triage at the 9-1-1 dispatch point is relatively new in the United States despite its ability to significantly reduce expensive and scarce Emergency Medical Services (EMS) resource use and emergency department visits. A previous study investigated the distribution of 9-1-1-triaged call incident types within the Emergency Communications Nurse System (ECNS) and found that 9-1-1 triage systems yielded a variety of low acuity complaints that were handled by the Emergency Communications Nurse (ECN). This study explored the current and potential utilization...

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The Distribution of Recommended Care Levels by Age, Gender, and Trauma vs Medical Classification within the Emergency Communication Nurse System

An examination of the Emergency Communications Nurse-determined Recommended Care Levels (RCLs), for calls transferred for secondary nurse-triage has not been performed.  The outcome of such an investigation would help to gain a more complete picture of the type of care ultimately recommended for these patients. The Emergency Communications Nurse System (ECNS) studied contained 22 RCLs, ranging from urgent levels, including a country-specific 3-digit number Emergency response (911), and Emergency care as soon as possible to less time-dependent, low priority levels, such...

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