In Saguenay and Quebec, hospitals have adopted a new emergency pre-triage mode. The first contact with the nurse on the screen is now made real.
News magazine The Daily Chikoutimi recounted this week the surprise of a patient with a head injury when he arrived at the hospital’s emergency room teams. One initiative to reduce wait times, the article describes CIUSSS du Saguenay–Lac-Saint-Jean.
Currently, two emergency rooms at the Quebec University Hospital Center (CHU) are doing the same, and those at three other hospitals in the network will soon follow.
Myleene Ferrand, the emergency critical care coordinator there, is at the forefront of implementing the policy.
Where is the virtual nurse? A little further away, in the office. If someone collapses in front of the screen, she is not the one who rushes to help the patient. The code is immediately triggered to make adjacent personnel responsible.
This is because the nurse placed in pre-triage at the CHU is pregnant or immunocompromised.
One of the benefits of this initiative, Mr.me Ferrand, it is precisely this nurse’s contribution that is “unsupportable”, but she can contribute.
“That makes us one more nurse in the emergency room,” says Mme Ferrand.
This pre-triage nurse asks summary questions, assesses what brings the patient to the hospital and how soon his condition should appear in triage, where a nurse, among other things, takes vital signs and assigns a priority code (from 1 to 5).
As the virtual nurse pre-triages, Mme “During rush hour, it can go up to three or four hours,” says Ferrand, who makes sure the next step, triage, doesn’t exceed an hour.
Ms. said that not everyone is comfortable seeing a nurse first on a screen, and patients are more likely to see a professional in person when they arrive.me Ferrand.
Because it still takes several hours to see a doctor, a nurse must, repeatedly, reassess patients. This task is now also assigned to a virtual nurse who keeps an eye on the waiting room at all times.
Quebec welcomes the project, which has also been implemented in vaccination centers, said Antoine de la Durantaye, press secretary to Health Minister Christian Dubey.
This is a concrete example of what can be achieved with new technologies to ensure greater accessibility based on patient needs, especially as is done with telemedicine.
Antoine de la Durantaye, Press Attache of Health Minister Christian Dubey
In Montreal, no hospital contacted said they had a virtual pre-triage project in the pipeline.
FIQ is compatible
Julie Bouchard, president of the Fédération Interprofessionalelle de la Santé du Québec (FIQ), said her union “keeps an eye open to current experiences. [pour] See if it’s worth exporting the learning to other emergency situations.
dd Judy Morris, of the Association of Emergency Physicians of Quebec, finds the idea “super interesting,” especially if a member of staff’s health condition allows him to contribute even if he is not on the field in time.
However, she emphasized that a virtual nurse must be an “extra help” and that it should never withdraw a person from the field, as all hands are needed when someone appears a little aggressive. the hospital
dd Pre-triage must be done by an experienced nurse familiar with the environment, a task that requires great skills, Morris added.
dR Alain Vadeboncourt, an emergency physician at the Montreal Heart Institute who helped develop the emergency triage scale in the late 1990s, saw no problem with the new practice, even in some institutions.
In the emergency room, people are often expected to “feel alert,” so it’s important to assess whether patients are comfortable with the concept. However, this is the same logic, according to D, that the nurse asked the first basic questions at the screen rather than behind the glass as is currently the case.R Vadeboncoeur.
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