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Aurelie Pison, Ciara Bergin, Christina Gianniou, Aurélie Martin, Alejandra Daruich, Yan Guex-Crosier, Jean-Louis Bourges, Francine Behar-Cohen; Evaluation of the efficacy of the nurse triage at the ophthalmic emergencies of the Jules Gonin Ophthalmic Hospital (HOJG), Lausanne, Switzerland. Invest. Ophthalmol. Vis. Sci. 2016;57(12):5550.
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© ARVO (1962-2015); The Authors (2016-present)
The urgency of an ophthalmic condition determines the delay and the means undertaken to its management. Very few nurse triage systems have been developed in the field of ophthalmology. A local nurse triage system has been developed at the ophthalmic emergency room of the Jules Gonin Ophthalmic Hospital (HOJG). The purpose of the study was to determine the efficacy of this triage system.
This retrospective study included 1133 consecutive patients that showed up at the emergency room of the HOJG, Lausanne, Switzerland from the 17th november 2014 to the 19th december 2014.The patients were evaluated by the nurse using a questionnaire to classify patients into four degrees of emergency (white, yellow, violet, and red : increasing degree of urgency) according to the symptomatology described by the patient.The patients were then examined by the doctor, who evaluated also the degree of emergency (according to a scale).The arrival time of the patient, the time of the nurse triage, and the time of examination by the doctor were also recorded.
1269 patients were recruted in one month, and 1133 finally included in the analysis. 64% of the patients were evaluated as « violet » according to the nurses (725/1133). 43% of the patients were evaluated as « white » according to the doctors (485/1133).There had been an agreement between the nurse and the doctor for 23% of the patients (261/1133). 76% of the patients (857/1133) had been overvalued during the nurse triage.1% of the patients (15/1133) had been undervalued by the nurse triage. Among those 15 patients, ten were evaluated as « red » by the doctor.The mean waiting time for the patients evaluated as « red » by the nurse was 60 minutes; for the « violet » patients it was 93 minutes; for the « yellow » patients 102 minutes; and for the « white » patients, 291 minutes. The distribution of the waiting time during the day showed an increase in the waiting times for patients who arrived at lunch hours (between noon and 2pm).
This nurse triage system showed overvaluation for 76% of the patients, underevaluation for 1% but 67% of those undervalued patients were evaluated as « red » by the doctor. A new optimized system is presented and discussed.
This is an abstract that was submitted for the 2016 ARVO Annual Meeting, held in Seattle, Wash., May 1-5, 2016.
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