EDTCC#2 – ED Triage Role Management and Decision-making Strategies

3.7 CNE CH

A course series that teaches strategies for preventing and deescalating the anger flow, patient throughput and communication skills, the assessment of personal and professional skills for the role of triage, and critical thinking skills.

Expiration date – 09/15/2022 (Seats purchased will remain open for access. Course updated every two years. )


How This Course Series Works

This series consists of the following courses:

TFED4 – Safety Strategies – 0.8 CNE 

Explores methodologies and behaviors that impact safety in the triage arena

Curriculum  Description & Purpose:

There is a knowledge gap regarding the triage nurse’s perception of patient anger and agitation and the situational awareness and de-escalation techniques needed to recognize indicators of violence and promote a safe work environment.

Due to the escalation of violence and violent acts in our culture, as well as the risks associated with EDs, it is imperative that emergency triage nurses are well informed regarding risk factors for violence.

Law enforcement science explains that violence is part of an observable and therefore preventable cascade of events that occur in predictable patterns and populations.

Emergency department nurses and physicians have long known that their departments are often populated with angry – and even violent – patients and family members, and it is no wonder. Our society is permeated with violence. Our media and entertainment, from children’s video games to prime-time television and the front page of the newspaper, bring violent images and horrific crimes into our everyday lives. Add to this media diet sickness, pain, psychiatric illness, and frustratingly long waits, and the potential for violence is exponential.

The purpose of this activity is to:
1. Practice methodologies to enhance safety as it relates to the physical plant, processes, or personal interactions that may contribute to the potential for violence;
2. Detect behaviors and situations associated with an increased risk for violence;
3. Demonstrate the skills necessary to mitigate the escalation of the anger cascade;
4. Select the appropriate method of restraint required, when necessary, to ensure the safety of patients, staff, and others in the department;
5. Discern circumstances in which retaliatory violence may occur and apply therapeutic interventions to prevent or cease such behavior;
6. Recommend a workplace violence policy that includes prevention, detection, and intervention in violent situations, as well as the appropriate response when deadly force is threatened.

Course Learner Outcomes:
Successful completion of this activity will enable the learner to describe the characteristics of a potentially violent population, recognize agitation, and practice de-escalation techniques. The learner will also be able to give examples of best practice physical plant parameters that promote a safe work environment.

TFED5 – Patient Flow and Communication Strategies – 0.9 CNE

Explores optimizing ED point-of-entry processes by managing patient throughput, wait-time perceptions, and patient communication strategies

Course Description and Purpose

There is an opportunity to improve professional practice at triage regarding the triage nurse’s management of wait times and the complex process of managing patient flow from triage to both acute and minor care areas. Improvement may occur as the knowledge gap is bridged; by triage nurses increasing their knowledge of the input and throughput processes, nursing team member roles, and the value of providing information to patients as they wait.

The purpose of this activity is to:

  1. Evaluate factors that influence patients’ or visitors’ perceptions regarding the psychology of waiting;
  2. Integrate a comprehensive, holistic, and systematic approach to the management of patients and visitors in the lobby;
  3. Recommend methodologies to decrease wait times throughout the triage and registration process;
  4. Determine strategies to enhance customer service and decrease patient wait times;
  5. Compare and contrast communication tools used in the ED.

Course Learner Outcomes

Successful completion of this activity will enable the learner to improve their current nurse and patient relationships and flow strategies – initially by increasing communication with the waiting room, and later by revising current flow processes to reflect best practices in regard to quick registration, any open bed, and dual triage strategies.

TFED6 – “TIGER” – Self Awareness & Professional Health – 1.2 CNE

Gain insight into the triage role stressors and find solutions for the ED triage nurse to enhance personal and professional health

Course Description & Purpose:

There is a gap between the quality of professional service and emergency caregivers’ perceptions regarding their patients. Studies have shown a link between caregiver satisfaction, job stress, work environment, and the delivery of care in an empathetic and highly professional manner. Most patient satisfaction education models focus on techniques and scripting in an attempt to ensure that nurses behave in a “nice” manner. However, analysis shows that results are often temporary and that caregivers return to their previous modes of behavior over time. Culture change in an organization is achieved through a root cause examination of caregiver thought processes, thus eliminating a dysfunctional or even toxic work environment and allowing caregivers to function in a highly empathetic, as well as a clinically expert, arena. 

The purpose of this activity is to:

  1. Examine sources of expectations that relate to inconsistency, as well as obstacles to meeting those expectations;
  2. Detect commonalities interwoven throughout the obstacles in regard to meeting personal, professional, and patient expectations;
  3. Describe the relationship between cynicism and the standard of care provided to patients;
  4. Compare and contrast the general demographics of Disney® and Ritz-Carlton® customers and ED patients;
  5. Identify, through reflection, personal trigger groups;
  6. Detect styles of communication that negatively impact patient care;
  7. Devise a strategy to mitigate an interaction error;
  8. Detect behaviors consistent with empathy burnout in self or colleagues;
  9. Describe interventions that mitigate or eradicate empathy burnout.

Course Learner Outcomes

Successful completion of this activity will enable the learner to choose healthy strategies to promote a healthy work environment. The learner will also be able to justify their choices by examining the obstacles to a healthy work environment and creating a path to improve and transcend customer service standards by practicing mercy.

TFED7 – Triage Critical Thinking Skills – 0.8 CNE

Tools to enhance critical thinking skills and provide a systematic decision-making framework used in the practice of ED triage

Course Description and Purpose

The Triage Critical Thinking Skills module addresses a commonly identified gap in nursing practice. Because many triage nurses have minimal ED nursing experience and triage education, most triage nurses have not been trained to follow a systematic triage process, and therefore can easily fall into dangerous pitfalls that occur from this lack of knowledge.

Using a systematic approach to every assessment, to include both subjective (history) and objective (physical) components, as well as nursing interventions, will ensure a thorough, timely triage assessment that is safe for both the patient and the nurse.

The key to an efficient triage process is systematic data collection and the recording of that data. This course will focus on the nurse-driven interview, the systematic physical assessment of the patient, and documentation of both the interview and the objective findings.

Efficient documentation and process flow largely determine in what manner and how rapidly the data are recorded.

The purpose of this activity is to:

  1. Establish a consistent triage decision-making framework;
  2. Characterize different elements of critical thinking and their relationships to a systematic approach to decision-making;
  3. Use assessment tools in the triage decision-making process.

Course Learner Outcomes

Successful completion of this activity will enable the learner to prioritize incoming patients, in conjunction with individual hospital policies, using a systematic process, thus avoiding common triage pitfalls. The learner will also be able to improve upon their personal critical thinking skills.

To receive continuing nurse education contact hours certificate, the learner must complete all lessons and components of each course, complete the attestation and evaluation forms, and pass the exam with an 75% minimum pass rate.

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