Emergency departments are "hospital departments that provide care for unscheduled visits, in a public or private healthcare facility, 24 hours a day, every day of the year, to any person without selection, presenting in an emergency situation, including psychiatric"* according to the French National Authority for Health.
These services are one of the main entry points into the healthcare system; moreover, the number of visits to this entry point is constantly increasing. For example, in 2017, in metropolitan France and the overseas departments and regions (DROM), 713 emergency structures located in 637 hospitals treated 21.4 million visits.*
During the health crisis, emergency departments also played a crucial role in managing COVID-19 cases, whether for screening or care.
In order to guarantee the rapid care of medically urgent or unstable patients and to ensure reliable care in the emergency department, strategies should be implemented to respond effectively to patient needs in the event of a crisis or health emergency.
The Admissions, Transfers and Orientation (IOA) nurse, ensuring a secure reception for patients in the emergency department
The Emergency Department Triage Nurse, formerly known as the Reception and Orientation Nurse, is one of the first caregivers to take care of a patient arriving in the emergency room.
According to the Agence Nationale de la performance sanitaire et médico-sociale (ANAP), the Emergency Department Triage Nurse plays a key role in ensuring the reliability of care.
For the French Emergency Medicine Society (SFMU), the general mission of the Reception Organizing Nurse is "to personally welcome the patient and their companions upon arrival, define care priorities based on expressed and/or observed needs, and, based on these, decide on the appropriate place of care. These actions aim to improve the quality of care for patients and their companions from the moment they arrive. They are carried out in constant connection with the referring physician responsible for supervising the operation of the service and the management of flows."
To this end, it is recommended that the IOA adopt best practices in order to know the essential points in terms of identitovigilance, to be able to assess the clinical condition of a patient and guide them, but also to secure transmissions between caregivers.
Proper patient identification is indeed the first step in a process that extends throughout their care by the various healthcare professionals involved. Therefore, from the moment of arrival in the emergency room, it is essential to employ robust identification practices to secure the sharing of health information and to guarantee patient safety. To learn more about best practices in identity vigilance, read our article.
One of the missions of the emergency department is to rapidly detect urgent patients. Triage is an activity that has been used for many years in war and disaster medicine, and consists in efficiently directing a patient to a care area adapted to his or her needs. This care area can range from discharge to resuscitation.
Triage of patients consulting in the emergency department is necessary when the flow exceeds the capacity for immediate care outside of vital emergencies. This triage must be carried out from the first moments of the patients' arrival in the emergency department in order to guarantee the safety of patient care, which is organized according to the severity of their state of health and not according to their order of arrival at the emergency reception service.
The mission of the Admissions, Transfers and Orientation (IOA) nurse is to assess the degree of urgency of patients' health conditions. If necessary, they administer first aid and direct patients to an examination room or the waiting room appropriate to their health condition.
To be able to assess a patient's clinical condition and direct them, especially when the flow of passage is significant, it is recommended to use scales that would distinguish priority patients in terms of health status while reducing the waiting time for initial care.
Several scales exist and deserve to be considered. Take the example of the "Emergency Severity Index" scale.
Another major role played by the IOA in improving the reliability of care is to ensure secure communications between caregivers.
Transmissions encompass all means of conveying information between members of a care team to ensure continuity of care. This involves enabling the passage of information and acting as an intermediary. For more information on transmissions between caregivers, see our article.
SafeTeamAcademy and welcoming a patient in the emergency department
Applying best practices when welcoming a patient to the emergency department is a key moment to secure care for the subsequent stages of the care process. To support healthcare professionals in this process, SafeTeam Academy has developed a module dedicated to welcoming a patient to the emergency department.
Through an immersive video, caregivers are immersed in an emergency reception department to care for a patient with a respiratory emergency.
In this module, healthcare professionals consider several points: the practices to be implemented, the application of non-technical skills for robust identity vigilance, information gathering, and the assessment of the degree of urgency of medical advice.
If you too would like to play your part in improving the reliability of care within your facilities, SafeTeam Academy training courses are for you! To find out more, write to: contact@safeteam.academy
