An effective triage system and patient reception combine detailed nurse assessment with a definitive

approach. Careful consideration should be given to observantions, intuitive reactions and concise but
accurate documentation. Priorities are then established effectively and the information can be
interpreted and synthesized to enhance and balance patient care

PRIORITIES AND RESPONSIBILITIES

When making an assessment the triage nurse must remain aware of his/her priorities, conscious that
the main objective is the rapid assessment of whether the patient has an obvious need for resuscitation
indicated by impairment or potential impairment to his/her airway, breathing or circulation. The
provision of first aid measures and then immediate delegation of care for priority patients to other
team members must take precedence unless triage responsibilities have been allocated to individuals.

Ensuring that priorities are met is a responsibility of the triage nurse but this does not mean that
he/she necessarily has to perfom these tasks him/herself as acknowledging limitations, acting as
medicator and delegating these tasks is essential for the triage system to function effectively. Once
patients with immediate needs have received attention, those patients who do not need urgent
assistance and can wait for further assessment or treatments are prioritized.

Having ascertained that the patient is a designated non-urgent category, the triage nurse has to
decide whether it is appropriate to continue with a fuller assessment. This is not appropriate to continue
with a fuller assessment. This is not appropriate if there is an excess of patients or if the next patient has
been waiting longer than agreed local Charter times for assessment. The triage nurse’s responsibility is
to perform only mandatory investigasions for a more thorough investigation when time allows. If it is
not appropriate to proceed with a full assessment and the delay may be detrimental to the patient, the
triage nurse should delegate this care. The role of the triage nurse involves provision of care the role of
the triage nurse involves provision of care for patient in the waiting room, the continual reassessment of
waiting patients and apprpiate communication and actions.

patient charter standart 8(DoH, 1992) can be related to triage as the named nurse is a possible
focus for the development of the
389 Relationship between patient and triage nurse. A named nurse is a qualified nurse allocated to a
patient and three therefore the triage nurse can be the named nurse for patients in the waiting room,
with subsequent responsibility for providing care and monitoring reassessment. The working of most
A&E departments does not allow the same nurse to provide all care to the patient and communication
between nursing colleagues with appropriate delegation of responsibilities is essential.

During the initial assessment, and suring patient privacy by avoiding interruption and by using a
dedicated triage facility will help to develop an understanding and tacktful approach. The triage nurse
should affer credible explanations for his/her actions and triage decisions made, remaining observant of
isues such as parental consent and special needs of the patient. These can be a complex and axtanded
process and should not affect patient assessment times. The triage nurse should identify practices that
cause delay in triage assessment such as extensive waits for patient registration or multiple telephone
enquiries and subsequently rectify these problems before they affect the assessment times. He/she
must remaind aware of the department and personal workloads, so that information can be given
accordingly as to the affects on waiting times. To affer a supportive and attentive afroach to patients can
limit the degree of isolation they feel at being asked to wait, and maintaing open communication link
between triage nurse and patient reassures them and reduces the risk of physical or verbal aggression.

No categorization made the triage nurse should be final and priorities may be changed taking
into consideration additional information or changes in patient condition.

HEALTH PROMOTION AND HEALTH EDUCATION

If workload allows , another role of thr triage nurse can be to advocate appropriate health
promotion and health education. The triage nurse role is now well established and the general public
will reabily accept advice from a nurse. In this advantageous position the nurse must consider his/her
responsibility toward health promosion and health education and incorporate this issues into the role.

Walsh (1985) claimed that A&E nurses should use opportunities that present themselves daily to
practice health education as patients will tend to be motivated by the fact that they have just had a.