The Research On Clinical Application Effect Of "Three-district And Four-level" Triage Method In Emergency Triage

objective:To study the clinical application effect of " three-district and four-level " triage method in emergency triage and to explore the triage method which is appropriate for emergency department in our hospital.Methods:106533 patients registered in emergency department and treated in emergency area in 2016,116866 patients registered in emergency department and treated in emergency area in 2017,In order to avoid epidemics affected by seasonal factors,Separate random sampling 500 patients who accord with the inclusion criteria in 2016 from October 1st to December 31 st and 2017 from October 1st to December 31 st were selected as the research object.The " department of disease" triage method was divided into group A In 2016,the triage method was that the triage personnel assigned the emergency patients to the corresponding consulting room according to the symptoms and main complaints of the emergency patient.In addition to the immediate rescue of the endangered patients,the other patients visited in the order of registration.The "three-district and four-level" triage method was divided into group B in 2017,it was that triage personnel determine the priority of treatment area and treatment according to the severity of the patient's condition,the emergency department was divided into red,yellow,and green "three areas" in space,and the patient's condition was classified into a grade 1 endangered,a grade 2 critical,a grade 3 emergency,and a grade 4 non-urgent "four levers".By inquiring the hospital information platform,"Emergency Room Nursing Record Sheet","Medical Dispute Record Book","The Emergency Triage Criteria","The Patients' Registration Form of Emergency Triage","Normative Appendix of Medical Resources for The Disease Grading of Emergency Patients" and other research tools to collect information,such as patients' name,gender,age,registration number,disease type of patients,register time,consultation time,the right patients' number of the triage,the number and causes of medical disputes,etc.Input the information of patients who accord with the research object into excel form for data collation.The accuracy rate of triage,the average waiting time of patients,the incidence of the patients' disease change,and the incidence of medical disputes were taken as evaluation indicators.SPSS21.0 software was used for data analysis,the count data was expressed by the rate,using the X~2 test,the measurement data was expressed by the((?)±s),The comparison of two independent samples were put to use the t test.When the variance was not equal,the t' test was used.The difference was statistically significant(P < 0.05).Results:Compare the accuracy rate of triage between the group A in 2016 which used "department of disease" triage method and the group B in 2017 which used the "threedistrict and four-level" triage method.analyze the results,the accuracy rate of the group B was 95.4%,it was higher than the group A which was 90.2%,the statistical chi-square test showed that the difference was statistically significant(X~2=10.117,P<0.05),Compare the patients' average waiting time between the group A and the group B,the average waiting time of the group B was 10.57±6.89 min,it was shorter than the average waiting time of the group A which was 11.54±7.62 min.The difference between the two groups was statistically significant(t'=-2.1103,P<0.05).The patients' average waiting time of I lever patients was 1.33±0.62min;The patients' average waiting time of ? lever patients was 2.67±1.46min;The patients' average waiting time of ? lever patients was 8.27±4.33min;The patients' average waiting time of ? lever patients was 13.11±7.26 min.Compare the patients' average waiting time respectively between four levels of patients in group B and group A.Statistical results show that I lever patients and II lever patients were analyzed by oneway ANOVA,no difference in statistics(P > 0.05).The patients' average waiting time of the group B increased with the increase of four grades of patients.The patients' average waiting time of I lever,II lever and III lever patients was shorter than that of the group A.The average waiting time of the patients in grade IV was longer than that of the A group,and the differences were statistically different(P<0.05).Compare the incidence of disease change between the group A and the group B,the results showed that the incidence of disease change for B was0.4%,it was less than the incidence of disease change of the group A which was 2.8%.the difference was statistically significant(X~2=9.146,P<0.05).Compare the incidence of medical disputes between the group A and the group B,Because of the 500 subjects in the previous study,the sample size was small.this evaluation index was used to compare the incidence of medical disputes between the patients who registered in the emergency room in 2016 and 2017 for the whole year.the incidence of medical disputes was 0.094% in group B it was obviously less than the incidence of medical disputes which was 0.206% in group A,the difference was statistically significant(X~2= 4.766,P < 0.05).Conclusion:The clinical application effect of "three-district and four-level" triage method in emergency triage is good in emergency diagnosis.It can improve the accuracy rate of triage,shorten the average waiting time of patients,reduce the incidence of the patient's disease change,and reduce the incidence of medical disputes.It has positive significance for shunting the patient in the emergency department,improving the crowding in the emergency room and improving the quality of medical care service.It is applicable to the emergency department of our hospital,which advocates the promotion and use.