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Ambulant Triage Streaming of COVID Positive – SCOVID and Low-Risk COVID to SHED waiting areas

This document provides a summary of best practice in relation to streaming of ambulant patients to SHED waiting rooms based on COVID assessment. The summary has been created to support staff during the Sunshine Hospital Emergency Department Redevelopment transition and early post-move period, and has been endorsed by the ED Leadership Team.

Overview

This QRG provides an overview of patient streaming at point of triage to the SHED waiting rooms based on COVID assessment.

 

Applicability

This QRG is applicable to all SHED staff

 

Responsibility

It is the responsibility of the SHED Nurse Unit Managers and Directors to ensuring that all relevant staff are appropriately trained and orientated to the content detailed in this QRG.

All SHED staff are to ensure this guideline is adhered to, to support effective management of patients in the waiting rooms.

 

Guideline/Process Details

Triage

Pre-Triage

  1. Patient presents to ambulatory triage
  2. Patient is greeted by concierge staff and directed to security check in if physically able, or to a seat in front of triage if unable to ambulate to security
  3. Patient provided with surgical mask by security check in
  4. Security check in directs patient to appropriate triage nurse for triaging

Triage

  • Triage nurse assesses patient and ascertains if they are – COVID PositiveHigh Risk suspected COVID or Low Risk suspected COVID against the ED screening, triaging and co-horting tool. COVID positive patients will be provided with an N95 by the triage nurse.
  • High Risk suspected COVID patients will be provided with an N95 by the triage nurse
  • Low Risk suspected COVID patients will be provided with a surgical mask
  • Paediatric low and high risk suspected COVID patients will be directed to the Paediatric Wait Room

 

  1. Triage Nurse to document type of PPE provided to patient in ‘Triage Notes’. If patient is non-compliant with mask wearing, this should also be documented.

 

  1. Patients following triage then directed to clerical staff for further details and data collection

Streaming of patients to waiting areas

  1. COVID positive patients should be immediately transferred to the COVID positive zone of the department. If all beds are full they are to be allocated to the sub-wait

 

  1. High Risk suspected COVID patients who are triaged as category 3, 4 or 5 will be directed to take a seat in the High Risk Waiting Room outside the front of triage.

 

  1. High Risk patients triaged as a category 1 or 2 should go immediately into an appropriate treatment space in the department. Notify the NIC to facilitate this.

 

Important: If unable to facilitate immediate transfer into a cubicle the patient may be managed in an appropriate TAR space. The TAR should have an isolation clean after patient is decanted from this room.

 

4. Low Risk COVID are to be directed to the internal Low Risk adult wait room.

 

Any COVID positive confirmed cases at ambulatory triage to be immediately escalated to Nurse In Charge

Maintain physical separation from patients unless absolutely necessary

 

High Risk Waiting Room - How Does it Work?

Roles and Responsibilities

COVID High Risk Waiting Room Nurse role and responsibility here

 

Visitors

No visitors present in High Risk Wait Room

Patient Movement

High Risk patients only to move out of wait room space once an appropriate cubicle available in main department and should be collected by the bedside nurse

High Risk patients to be directed to use toilet closest to triage doors only. This toilet will be designated as the “High Risk” Bathroom.

Emergency and Security Response

Ensure a staff member is present at all times in this area and the DECT phone and 2 way radio are charged and in working order

For all emergencies in the High Risk wait room use door bell to alert triage staff to enact the emergency buzzer response

Triage staff to direct responding staff to the High Risk Wait Room and to don Tier 3 PPE before entering

Security to respond as per normal Code Grey protocol for duress activation or security guard call for help

Cohorting to High Risk vs Low Risk COVID Zone

Screening against the ED screening, triaging and co-horting tool Post COVID screening and triaging – patients are allocated to the High Risk Waiting Room (outside marquee)

Aim is to reduce patient to health care worker or patient to patient transition

 

Supporting Documentation

 

Document Governance

 

Ambulant Triage Streaming of COVID Positive – SCOVID and Low-Risk COVID to SHED waiting areas
Version: 1.0
Date Published: September, 2021
Date of scheduled review: 01/02/2022
Author: Approver:
Chris Poropat SHED Leadership Team