Results of the Patient Screening According to Emergency Severity Index of Nurses accident and emergency unit at Naphalai Hospital

Abstract

The objective of this cross-sectional research was to study the screening results of accident and emergency patients according to 3 level of severity and emergency severity index (ESI), duration of service receiving at accident and emergency unit, compare with waiting period for medical examination by physician according to ESI criteria, satisfaction of service receivers, and problems of applying patients screening according to ESI by accident and emergency nurses at Naphalai Hospital. The samples consisted of 13 accident and emergency nurses and 400 patients who got medical care at accident and emergency room. Data was collected by questionnaire and screening record form during May to September 2017, and analyzed by descriptive statistics and analysis statistics such as Paired t-test and One sample t-test. The study found the followings: 3 level of severity screening had a good effect at 15.4%, for ESI had a good effect at 84.6%. When comparing the applied results between 3 level severity screening with ESI, found that the applying result of the ESI screening was better than the 3 level of severity screening by statistical significance (P-value <0.001). According to ESI; nurses performed patients illness screening as followings, resuscitation patients were conducted screening immediately, followed by patients with emergency, urgency, semi-urgency and non-urgency were conducted screening averagely at 1 minute, 3 minutes, 3 minutes and 10 minutes respectively. When were refer patients to doctors after screening, resuscitation patients took an average of 1 minute waiting for doctor, followed by patients with emergency, urgency, semi-urgency and non-urgency took an average of 2 minutes, 7 minutes, 6 minutes and 6 minutes waiting for doctor, respectively. When comparing waiting time for medical examination with patient screening criteria based on ESI of patients in each category, showed that each category of patients spent waiting time for medical examination less than screening criteria, especially, emergency, urgency and semi-urgency patients less than screening criteria by statistical significance (P-value <0.001). Satisfaction for whole services at accident and emergency unit; there were 94.8% at high level. Problems of screening patients based on the ESI, found that lack of knowledge about the screening of patients according to ESI at 15.4%. Thus, there should be use ESI and develop the screening methods to identify patients with fewer errors, as well as, make the patients see the doctor faster.