Achoo achoo: Have you got the flu? How well do triage nurses identify potential influenza patients?

Jo-anne Mcshane1, Dr Andrew Maclean1,2, Leanne Houston4, Helen  Marquand4, Madeleine Smith1, A/Prof Mary O’Reilly2,3

1Emergency Department, Box Hill Hospital, Eastern Health, Box Hill, Australia, 2Eastern Health Clinical School, Monash University Faculty of Medicine, Nursing and Health Sciences, Box Hill, Australia, 3Department of Infectious Diseases, Eastern Health, Box Hill, Australia, 4Infection Prevention and Control, Eastern Health, Box Hill, Australia

Aim

The aim of the study was to see if triage and primary care Emergency Department (ED) nurses identified potentially infectious influenza patients in the Emergency Department and if correct isolation practices were being implemented.

Background

The identification and management of patients with potentially infectious diseases is a challenging aspect of triage. The triage clinician has minutes to decide what may be potentially wrong with a patient and what immediate actions are needed. In addition, post triage often patients spend a significant amount of time in the waiting room of ED’s , potentially infecting other patients and staff.

Methods

A retrospective e-audit (using Symphony, the electronic Emergency Department Information System) with filters set to capture patients with influenza like illness (ILI) and an e-audit of influenza  Polymerase Chain Reaction (PCR) ordered from Box Hill ED was undertaken from July- September 2016, during peak influenza season. Data collected:  presenting complaint, observations, time to isolation and if Transmission Based Precautions (TBP) were implemented during their ED visit. Data was entered into Excel and analysed using IBM SPSS v22.

Results

Detailed data analysis will be presented including follow-up action taken to address the gaps between current performance and best practice.

Conclusion

Triage and primary care nurses in the ED have an opportunity to improve their practise of identifying potential infectious patients by understanding the case definitions for ILI, applying surgical masks at triage, and isolating the patient until results of PCR testing are available. Identifying these patients early will help prevent transmission to other, sick vulnerable patients and staff both in ED and the inpatient setting.

Funding

The lead author is a recipient of an Medtronic Infection Control Scholarship


Biography:

Jo-Anne is an enthusiastic Emergency Nurse with 20 yrs experience in Australian and overseas Emergency Departments. Jo-Anne is currently a research nurse at Box Hill Emergency Department and is particularly enthusiatic about Infection Prevention and Control practice and research.