Keywords
Non-traumatic acute abdomen
Abdominal pain
Triage
Medical staff
Qualitative research
Submitted : 2023-06-27
Accepted : 2023-07-12
Published : 2023-07-27
Abstract
Objective: To explore the work experience of medical staff in the emergency department of a general hospital in the triage of patients with non-traumatic acute abdomen to formulate corresponding intervention measures and branch evaluation tools. Methods: With descriptive phenomenology as the research method, semi-structured interviews were conducted with the medical staff in a tertiary hospital in Nanjing from February 1st to 10th, 2023, and Colaizzi seven-step analysis was used to analyze the data. Results: A total of 17 emergency medical staff were interviewed in this study. Four themes were derived from the analysis of the data: the etiology of acute abdomen is complex, so it is difficult to categorize them: acute abdomen requires immediate treatment, but the treat will be delayed if the categorization is inaccurate; the high pressure of nurses and the accuracy in categorizing the patients are problems that should be addressed. Conclusion: The categorization of patients with non-traumatic acute abdomen is challenging. Therefore, it is necessary to carry out corresponding intervention and formulate appropriate departmental evaluation tools to improve the accuracy of categorization of patients with acute abdomen.
References
Ma Y, Liu S, 2021, Expert Consensus on Early Analgesia for Adults with Non-Traumatic Acute Abdomen. China Emergency Medicine, 2021(01): 17–23.
Chen Z, Zhao B, 2017, Interpretation of the Basic Clinical Practice Guidelines for Acute Abdomen in 2015. China Medical Journal, 52(6):9–13.
Matz K, Britt T, Labond V, 2017, CT Ordering Patterns for Abdominal Pain by Physician in Triage. Am J Emerg Med, 35(7): 974–977.
Cervellin G, Mora R, Ticinesi A, et al., 2016, Epidemiology and Outcomes of Acute Abdominal Pain in a Large Urban Emergency Department: Retrospective Analysis of 5,340 Cases. Ann Transl Med, 4(19): 362.
Zhou J, 2017, Discussion on the Application Value of Laparoscopy in the Diagnosis and Treatment of Acute Abdomen. Clinical Medicine Research and Practice, 2(05): 145–146.
Fagerström A, Paajanen P, Saarelainen H, et al., 2017, Non-Specific Abdominal Pain Remains as the Most Common Reason for Acute Abdomen: 26-Year Retrospective Audit in One Emergency Unit. Scand J Gastroenterol, 52(10): 1072–1077.
Zaboli A, Ausserhofer D, Pfeifer N, et al., 2021, Acute Abdominal Pain in Triage: A Retrospective Observational Study of the Manchester Triage System's Validity. J Clin Nurs, 30(7–8): 942–951.
Teo A, Wang C, Wilson RB, 2019, Time is of the Essence: Evaluation of Emergency Department Triage and Time Performance in the Preoperative Management of Acute Abdomen. ANZ J Surg, 89(9): 1102–1107.
Parker R, Bedwell Gj, Hodkinson P, et al., 2021, Managing Acute Abdominal Pain in the Emergency Centre: Lessons from a Patient's Experience. African Journal of Emergency Medicine: Revue africaine de la medecine d'urgence, 11(4): 483–486.
Shi D, 2018, Expert Consensus on emergency Pre-Examination and Triage.
Li J, You Q, Yan H, 2022, Application of Behavioral Decision-Making System Model in Emergency Patients with Acute Abdomen. Qilu Journal of Nursing, 28(02): 1–3.
Sun X, Gao W, Chen T, et al., 2019, The Application of Mind Mapping in Standardizing the Emergency Pre-Examination and Triage Process of Acute Abdomen. Journal of Nurses Training, 34(24): 2244–2247.
Li H, Tang J, Wang L, 2019, Application Value of Failure Mode and Effect Analysis Model in Patients with Acute Abdomen. Laboratory Medicine and Clinic, 16(03): 417–419.
Liu M, 2019, The Application of Colaizzi's Seven Steps in the Analysis of Phenomenological Research Data. Journal of Nursing Science, 34(11): 90-2.
Abualenain J, Almarzouki A, Saimaldaher R, et al., 2018, The Effect of Point-of-Care Testing at Triage: An Observational Study in a Teaching Hospital in Saudi Arabia. West J Emerg Med, 19(5): 884–888.
Huang X, Xu H, 2021, Application Value Analysis of Emergency Pre-Examination and Triage Nursing Process in the Diagnosis and Treatment of Acute Abdomen. Health Advice, 15(25): 82–83.
Abdelwahab R, Yang H, Teka HG, 2017, A Quality Improvement Study of the Emergency Center Triage in a Tertiary Teaching Hospital in Northern Ethiopia. Afr J Emerg Med, 7(4): 160–166.
Chang W, Liu H, Goopy S, et al., 2017, Using the Five-Level Taiwan Triage and Acuity Scale Computerized System: Factors in Decision Making by Emergency Department Triage Nurses. Clin Nurs Res, 26(5): 651–666.
Ponsiglione C, Ippolito A, Primario S, et al., 2018, Configurations of Factors Affecting Triage Decision-Making. Management Decision, 56(10): 2148–2171.
Chen N, Wei W, Zhu X, et al., 2014, Research Progress on the Causes, Consequences and Mitigation Plans of Emergency Department Congestion. Chinese Journal of Nursing, 49(10): 1238–1242.
Mo Q, Lu Z, 2017, Current Situation and Countermeasures of Overcrowding in Emergency Departments of General Hospitals. Journal of Clinical Emergency Medicine, 18(01): 76–79.
Zan H, Xie X, Tan X, et al., 2020, The Application Effect of Six Sigma Management Method in Reducing the Error Rate of Emergency Abdominal Triage. Chinese Journal of Practical Nursing, 2020(10): 757-8-9- 60.
Chen P, 2019, Application of Emergency Triage System Based on TTAS Standard in Patients with Acute Abdomen. Nursing Practice and Research, 16(01): 141–142.
Shen Y, Lee HL, 2020, Improving the Wait Time to Triage at the Emergency Department. BMJ Open Qual, 9: e000708.
Shirey Mr, Ebright Pr, Mcdaniel Am, 2013, Nurse Manager Cognitive Decision-Making Amidst Stress and Work Complexity. J Nurs Manag, 21(1): 17–30.
Hatami Z, Sarkhani N, Nikpeyma N, 2022, Decision Fatigue in Nurses in the COVID-19 Pandemic: A Commentary. Nurs Open, 9(1): 4–5.
Persson E, Barrafrem K, Meunier A, et al., 2019, The Effect of Decision Fatigue on Surgeons' Clinical Decision Making. Health Econ, 28(10): 1194–1203.
Pignatiello GA, Martin RJ, Hickman Rl, Jr, 2020, Decision fatigue: A Conceptual Analysis. J Health Psychol, 25(1): 123–135.
Liu X, Hou Y, Li H, et al., 2019, Research Status of Communication Between Chinese Medicine and Nurses in Emergency Rescue Situations. Medical Theory and Practice, 32(24): 3968–3970.
Hwang S, Shin S, 2022, Factors Affecting Triage Competence Among Emergency Room Nurses: A Cross-Sectional Study. J Clin Nurs, 32(13–14): 3589–3598
Wang Y, Wan Q, Guo J, et al., 2018, The Influence of Effective Communication, Perceived Respect and Willingness to Collaborate on Nurses' Perceptions of Nurse-Physician Collaboration in China. Appl Nurs Res, 41: 73–79.
Hardy A, Calleja P, 2019, Triage Education in rural Remote Settings: A Scoping Review. Int Emerg Nurs, 43: 119–125.
Wolf LA, Delao AM, Perhats C, et al. 2018, Triaging the Emergency Department, Not the Patient: United States Emergency Nurses' Experience of the Triage Process. J Emerg Nurs, 44(3): 258–266.
Ghazali SA, Abdullah KL, Moy FM, et al., 2020, The Impact of Adult Trauma Triage Training on Decision-Making Skills and Accuracy of Triage Decision at Emergency Departments in Malaysia: A Randomized Control Trial. Int Emerg Nurs, 51: 100889.