Objectives

Gastrointestinal complications, like blockage, are among the most common oncological emergencies. We investigated whether individuals with cancer presenting at the emergency department (ED) with intestinal obstruction were triaged accurately, and we further evaluated the triage decisions’ effect on their ED treatment outcomes.

Data Sources

A retrospective review was completed on all available records of adult cancer patients who were admitted with intestinal obstruction to a tertiary referral hospital. Over 3 years, 46 cancer patients were admitted from the ED with a provisional diagnosis of intestinal obstruction, confirmed by radiological examination. More than half the patients were undertriaged, which often resulted in these patients experiencing a series of risky time delays in the ED. Patients were significantly delayed in reaching five treatment outcomes: first assessment with a physician, initiation of treatment, decision to admit, length of ED stay, and length of hospital stay.

Conclusion

The application of triage in practice was inconsistent, inaccurate, and had a significant negative impact on patient treatment outcomes.

Implications for Nursing Practice

The study results indicated the need to critically analyze current triage training and policies to increase their effectiveness. Improvement strategies are identified in the literature, and several are discussed. Involving triage nurses in this work is essential.

中文翻译：

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肠梗阻的肿瘤急症：ED 识别和治疗结果

目标

胃肠道并发症，如阻塞，是最常见的肿瘤急症之一。我们调查了因肠梗阻在急诊科 (ED) 就诊的癌症患者是否被准确分类，并进一步评估了分类决策对其 ED 治疗结果的影响。

数据源

对因肠梗阻入院三级转诊医院的成年癌症患者的所有可用记录完成了回顾性审查。3 年多来，46 名癌症患者从急诊部入院，临时诊断为肠梗阻，经放射学检查证实。超过一半的患者未得到充分分类，这往往导致这些患者在急诊室经历一系列危险的时间延迟。患者在达到五个治疗结果方面明显延迟：与医生的首次评估、治疗的开始、入院的决定、ED 住院时间和住院时间。

结论

分流在实践中的应用不一致、不准确，并对患者的治疗结果产生了显着的负面影响。

对护理实践的影响

研究结果表明，需要批判性地分析当前的分类培训和政策，以提高其有效性。文献中确定了改进策略，并讨论了一些改进策略。让分流护士参与这项工作是必不可少的。