Transforming triage

Horton, Kate; Johns, Nina; Goodwin, Laura; Kenyon, Sara

Abstract

Triage systems are designed to prioritise the provision of care according to clinical need. Prioritisation follows a standardised initial consultation and physiological assessment, and depends on the presenting condition, the severity of physical symptoms and measurement of vital signs. Triage is well established in emergency medicine, but no standardised triage system currently exists within maternity care.

The physiological changes in pregnancy - increased heart rate, lower blood pressure and increased respiratory rate - mean that general parameters of standard triage tools may not be applicable. The underlying good health of the maternity population may also mask the severity of maternal illness if a specific assessment is not undertaken. Existing triage tools also do not allow the assessment of the condition of the unborn baby.

Previously, all women attending maternity units, other than for scheduled antenatal clinic visits, were reviewed on labour wards. Confidential enquires (CMACE, 2011; CEMACH, 2007) have identified high numbers of women attending with problems that were pregnancy-related, but not labour, whose attendance at the delivery suite diverted midwifery staff and clinical care from women in active labour. National recommendations that women attending with unscheduled visits should be seen in areas away from the delivery suite are now accepted throughout the UK. However, maternity units were not designed for this and ‘triage’ departments have evolved in other physical spaces, such as day assessment units and labour induction bays.

• Journal Article Type: Article
• Acceptance Date: Mar 6, 2018
• Online Publication Date: May 25, 2018
• Publication Date: 2018-05
• Deposit Date: Mar 13, 2021
• Journal: Midwives Magasine
• Issue: May 2018
• Public URL: https://uwe-repository.worktribe.com/output/7202724
• Related Public URLs: https://www.rcm.org.uk/news-views/rcm-opinion/transforming-triage/; ; https://www.rcm.org.uk/member-benefits/midwives-magazine/