University of Oulu

Roivainen, P, Hoikka, MJ, Raatiniemi, L, Silfvast, T, Ala‐Kokko, T, Kääriäinen, M. Telephone triage performed by nurses reduces non‐urgent ambulance missions: A prospective observational pilot study in Finland. Acta Anaesthesiol Scand. 2020; 64: 556– 563. https://doi.org/10.1111/aas.13542

Telephone triage performed by nurses reduces non‐urgent ambulance missions : a prospective observational pilot study in Finland

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Author: Roivainen, Petri1; Hoikka, Marko J.2; Raatiniemi, Lasse3,4;
Organizations: 1Research Unit of Nursing Science and Health Management, University of Oulu, Oulu, Finland
2Emergency Medical Services, Kainuu Central Hospital, Kajaani, Finland
3Centre for Pre‐Hospital Emergency Care, Oulu University Hospital, Oulu, Finland
4Anaesthesia Research group, MRC, Oulu University Hospital and University of Oulu, Oulu, Finland
5Department of Anaesthesiology and Intensive Care, University of Helsinki, Helsinki University Central Hospital, Helsinki, Finland
6Research Group of Surgery, Anaesthesia and Intensive Care Medicine, University of Oulu, Medical Research Center, Division of Intensive Care, Oulu University Hospital, Oulu, Finland
7Faculty of Medicine, Research Unit of Nursing Science and Health Management, University of Oulu, Medical Research Centre, University Hospital of Oulu, Oulu, Finland
Format: article
Version: accepted version
Access: embargoed
Persistent link: http://urn.fi/urn:nbn:fi-fe2020060139936
Language: English
Published: John Wiley & Sons, 2020
Publish Date: 2021-01-02
Description:

Abstract

Background: The increased workload in emergency medical services (EMS) is a global phenomenon in welfare states. It has been suggested that telephone triage by nurses may reduce the increasing use of EMS services, by directing patient flow to appropriate care. This study aimed to investigate whether, after an emergency medical communication centre (EMCC) provider assessed risk, a telephone nurse could assess the patient’s needs and guide patients to social and health care services in non‐urgent cases.

Methods: This prospective observational study was performed in the Kainuu Hospital District in northern Finland from March to April 2018. All EMS requests classified as non‐urgent by the EMCC were transferred to a telephone triage nurse. Subsequent patient guidance was recorded. The International Classifications of Primary Care categories were recorded.

Results: We studied phone calls of 700 patients with non‐urgent needs. Of these, the nurse transferred 63.7% to EMS and 17.3% were guided to other social and health care services. Nineteen per cent of the calls were handled over the phone by the nurse, who provided health advice and instructions. The most common needs for care were general and unspecified symptoms, musculoskeletal symptoms, mental health problems and substance abuse.

Conclusion: By providing telephone counseling, care instructions and patient guidance to other social and health services than EMS, the telephone triage reduced non‐urgent EMS missions by one third. The results imply that telephone triage could be a viable model for managing non‐urgent missions. Patient safety issues should be monitored when developing new service concepts.

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Series: Acta anaesthesiologica Scandinavica
ISSN: 0001-5172
ISSN-E: 1399-6576
ISSN-L: 0001-5172
Volume: 64
Issue: 4
Pages: 556 - 563
DOI: 10.1111/aas.13542
OADOI: https://oadoi.org/10.1111/aas.13542
Type of Publication: A1 Journal article – refereed
Field of Science: 316 Nursing
Subjects:
Copyright information: © 2020 The Acta Anaesthesiologica Scandinavica Foundation. Published by John Wiley & Sons Ltd. This is the peer reviewed version of the following article: Roivainen, P, Hoikka, MJ, Raatiniemi, L, Silfvast, T, Ala‐Kokko, T, Kääriäinen, M. Telephone triage performed by nurses reduces non‐urgent ambulance missions: A prospective observational pilot study in Finland. Acta Anaesthesiol Scand. 2020; 64: 556– 563, which has been published in final form at [https://doi.org/10.1111/aas.13542. This article may be used for non-commercial purposes in accordance with Wiley Terms and Conditions for Self-Archiving.