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Can You Catch It? Lessons Learned and Modification of ED Triage Symptom- and Travel-Screening Strategy.
J Emerg Nurs ; 46(6): 932-940, 2020 Nov.
Article in English | MEDLINE | ID: covidwho-831171
ABSTRACT

INTRODUCTION:

Efficient identification and isolation of patients with communicable diseases limits exposure to health care workers, other patients, and visitors. In August 2014, our team developed and implemented an algorithm to triage suspected cases of Ebola virus disease in a midwestern United States emergency department and outpatient clinics based on patient travel history and symptoms. Here, we present the lessons learned and modifications to update the tool.

METHODS:

Two strategies were developed and utilized to properly identify, isolate, and inform on patients with suspected highly hazardous communicable diseases 1) a robust electronic symptom and travel screen with decision support tools in the electronic medical record, and 2) the availability of workflow protocols for Ebola virus disease, Middle East Respiratory Syndrome (MERS), and coronavirus 2019 (COVID-19) once a person under investigation is identified. After action reports provided opportunities to modify the algorithm and improve the identification and isolation processes.

RESULTS:

Since our screening and travel electronic medical record inception 5 years ago, modifications changed iteratively to further enhance the screening process. Since 2018, staff have identified 5 patients at risk for MERS; in all cases, identification occurred during the check-in process. Exposure investigations in the emergency department decreased significantly after algorithm implementation in January 2019, from 30 in 2018 to 0 in 2019.

DISCUSSION:

Although highly hazardous communicable diseases like Ebola virus disease and MERS are of concern due to their mortality rates and limited treatment options, these same concepts may be applied to the early identification and isolation of patients suspected of having more common communicable diseases like measles and influenza, emphasizing the importance of protocol-based screening in the healthcare environment.
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Full text: Available Collection: International databases Database: MEDLINE Main subject: Pneumonia, Viral / Travel / Triage / Emergency Nursing / Coronavirus Infections / Hemorrhagic Fever, Ebola / Electronic Health Records / Pandemics Type of study: Observational study / Prognostic study Limits: Humans Country/Region as subject: North America Language: English Journal: J Emerg Nurs Year: 2020 Document Type: Article

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Pneumonia, Viral / Travel / Triage / Emergency Nursing / Coronavirus Infections / Hemorrhagic Fever, Ebola / Electronic Health Records / Pandemics Type of study: Observational study / Prognostic study Limits: Humans Country/Region as subject: North America Language: English Journal: J Emerg Nurs Year: 2020 Document Type: Article