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A Systems Analysis of Obstetric Triage

Zocco, Jeanette MSN, RN; Williams, Mary Jane PhD, RN; Longobucco, Diane B. MSN, APRN; Bernstein, Bruce PhD

The Journal of Perinatal & Neonatal Nursing: October-December 2007 - Volume 21 - Issue 4 - p 315–322
doi: 10.1097/01.JPN.0000299789.47161.8a
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Objective The purpose of this study is to examine some of the variables involved in obstetric triage in an effort to develop a more efficient patient care delivery system in a high-volume obstetric unit. An efficient triage system is essential to a busy labor and delivery unit for the evaluation of unscheduled patient visits. In hospitals that lack an efficient obstetric triage system, it is very difficult to regulate patient flow and wait times.

Method The study was designed to determine whether a triage room and/or standing orders decreased length of stay as compared to the existing system of evaluating women in labor rooms. In 2 separate phases, women who met triage criteria were randomly assigned to either the triage room or the standard care labor room. During phase 1, the effect of room assignment was evaluated. During phase 2, the effect of room assignment and the intervention of standing orders in common obstetric problems were utilized. The total sample size was 398 patients. The study took place on a midsize labor and delivery unit, in an academic medical center averaging 3600 births per year.

Results Results showed that using a triage room and/or standing orders did not significantly decrease length of stay.

Conclusion The results of this study suggest that the triage process in this setting is strongly dependent on the provider's availability to assess, triage, and discharge patients.

Saint Francis Hospital and Medical Center (Ms Zocco), Neonatal/Perinatal Nursing (Ms Longobucco), and Pediatrics and Surgery (Dr Bernstein), Yale University School of Nursing, Hartford, CT; and Department of Nursing, University of Hartford, CT (Dr Williams).

Corresponding Author: Jeanette Zocco, MSN, RN, Department of Maternal/Child Nursing, Saint Francis Hospital and Medical Center, Yale University School of Nursing, 114 Woodland Str, Hartford, CT 06105 (Jeanettezocco@hotmail.com).

Submitted for publication: July 27, 2006

Accepted for publication: April 24, 2007

© 2007 Lippincott Williams & Wilkins, Inc.