Triage
Once people have checked-in they wait to be seen by a triage nurse, who will start their diagnosis and treatment process.
But patients will not necessarily understand what triage means, and consequently what the triage nurse will do. Staff should always give a personal introduction, explain their role and what they will do and explain the next steps in the patient care pathway. [Reference: Center for Health Design, Ulrich, Roger, Martinez, C.A. et al (2004) The Role of the Physical Environment in the Hospital of the 21st Century: A Once-in-a-Lifetime Opportunity
They may be in a distressed and vulnerable state so can very easily feel threatened or agitated by the need to share personal information. This could lead to them responding aggressively.
The triage spaces and the service and information delivered by staff should be designed to feel non-threatening and comfortable.
Patients have to give personal details at triage, and in addition, may be embarrassed to talk about their illness / injury. Triage rooms need to be located off the main waiting area, but they should be located away from vending machines and other areas of congregation. Rooms should provide full auditory and visual privacy for the patient.
Triage or assessment rooms should be visible directly from the main waiting area. This ensures that when patients are discharged from these rooms, they cannot go into the controlled access sensitive treatment areas. [Reference: Department of Health: Intelligent Space Partnership (2002) ISBN : 0113224877 The impact of the built environment on care within A&E departments ]
Members of staff can spend extended periods of time in hot and uncomfortable triage rooms. Adequate provisions should be made in terms of light, sound and air quality, to put the patient at ease, and to create a comfortable place of work for the triage nurse to ensure they deliver the best quality of care.
Staff can be vulnerable when treating patients in a closed room on their own. Triage rooms should have two exits to enable staff to escape any violent patients.
Triage staff are the nearest members of staff to the waiting area. The triage nurse should be able to maintain a view of the waiting area so that they can intervene if a patient’s condition rapidly deteriorates or a situation develops. Patient privacy needs to be balanced with safety of staff. [Reference: Effective management of security in A&E, NHS executive]