SortED’s treatment and procedure (Rx) recommendations

Rapid Assessment and Treatment (RAT) involves the early identification of treatments at initial patient assessment.

 

SortED displays treatments and procedures in a combined Rx list. These lists contain 1-15 Rx (median 6 Rx) depending on presentation.

 

One important procedure recommended for any presentation where IV treatment is likely is obtaining IV access.

 

Identifying patients who should be ‘nil by mouth’, or who need cardiac monitoring or isolation, are also procedure options.

 

Taking three examples of treatments, the median time for ICHT clinicians to order analgesia in the control patients was 88 minutes after arrival (interquartile range IQR 50-136 minutes), whereas the nurses using SortED ‘ordered’ analgesia at triage at 1.42 minutes (IQR 1.17-2.07) after first seing the patient.

 

IV antibiotics were odered by ED clinicians at a median interval of 112 minutes after arrival (IQR 74.5-156.5) and ‘ordered’ on SortED at a median 1.45 minutes (IQR 1.18-2.15) after the patient wes first seen. Such time savings could prove life-saving in patients developing sepsis.

 

For antiemetics the median times were 85 minutes (IQR 31.5-132.3) and with SortED 1.51 minutes (IQR 1.32-2.57 minutes). Prompt antiemetic and analgesia are important for improving the patients’ experience of their ED stay.

 

Comparison of the % patients selected for each Rx by ICHT clinicians and nurses using SortED was performed (as we did for for Ix mentioned in the 21 October 2017 post). There was a correlation coefficient r=0.840, confidence interval 0.590-0.943, p<0.001, n=16). However, several Rx were ‘ordered’ more frequently on SortED than by ICHT clinicians. Having the results back for early investigations and a more detailed examination of the patient is presumably responsible for the difference, but flagging up treatements likely to be needed at initial assessment may be useful.

 

Gillie Francis – Nov 2017