TRIAGE GUIDELINES

Effective Date: 
Fri, 02/01/2002
Reviewed: 
Fri, 08/19/2011
Revised: 
Wed, 05/06/2015
Policy: 

The triage nurse is the point of entry for  Same Day Clinic at the Student Health Center. A consultation with the triage nurse is available to any registered student, regardless of insurance status.  All students presenting to the Student Health Center with symptoms of alarm are seen by the triage nurse.  The job of the triage nurse is to determine appointment priority and to assist students to make a plan of care appropriate to their complaint.  This may include assisting a student to identify a provider who accepts their insurance, teaching student’s about simple self-care, or initiating emergency response.  Under standardized procedures  the triage nurse may provide a number of additional services including emergency contraceptive refills, ordering ankle x-rays according to the Ottawa guidelines, and providing expedited antibiotic treatment for uncomplicated UTIs for selected patients who meet criteria for uncomplicated UTI and who decline clinician appointment.   The policy of the Student Health Center is to see all students who present for care in as timely a manner as possible.  The triage nurse works to optimize clinician schedules and student access.

Procedure: 

1. The triage nurse is an RN who has completed her orientation at the Student Health Center including at least 10 sessions observing in triage.

2. Patients registered are seen in the triage office in the order in which they register unless there is evidence of obvious urgent distress/alarm such as active vomiting, bleeding, respiratory difficulty, altered mental status, fainting, severe pain, or medical emergency. 

3. The triage nurse determines the best plan of care for students with options including immediate appointment, same day appointment, scheduled f/up appointment, emergency expedited care, referral to off-campus provider, or treatment under Standardized Procedures.  

4. It is the policy of the Health Center not to turn away students requesting same day medical care without an interview by a licensed health professional.  The triage nurse works in collaboration with the charge nurse to coordinate schedules within the building to maximize efficiency and flow.  Low acuity students may be offered next day appointments in the event that clinicians are fully scheduled for that day.  All true emergencies will be evaluated by a registered nurse and in collaboration with a clinician provided a disposition that includes transport off campus after stabilization at the SHC.

5. Using standardized procedures the triage nurse may manage a variety of common presenting issues including: emergency contraceptive refills, asymptomatic STI testing,  ordering ankle x-ray per Ottowa guidelines prior to clinician appointment and treatment of uncomplicated UTIs. 

6. Each patient encounter is documented in the patient's EMR, including assessment and disposition.

7.  Any student evaluated  by the Triage Nurse and sent away without a clinician evaluation, even if returning for an appointment later that same day, will have vital signs performed including Temperature,Pulse,Respiratory rate, Blood pressure  and oxygen saturation by oximetry as indicated.

 7. The triage nurse acts as a second RN for the Same Day Clinic should a situation arise in which nursing care is required in the Same Day Clinic .

Key Points: 

All students presenting to the Student Health Center with alarm symptoms are seen by the triage nurse

The job of the triage nurse is to work with the student to develop the most appropriate plan of care for the student.

The triage nurse assesses the priority of the student's presenting complaint and arranges care as indicated. 

The policy of the Student Health Center is not to turn students away without an interview by a licensed health professional.  In collaboration with the charge nurse the triage nurse manages the flow of patients to assure that all students are seen in a timely manner.

Under Standardized Procedures, the triage nurse can handle common issues including emergency contraceptive refills, ordering asymptomatic STI testing, treating simple UTIs, ordering urine pregnancy or dipstick analysis and ordering an ankle x-ray in advance of an appointment with a clinician.