Introduction The term triage refers to "the first moment of reception and evaluation of patients according to defined criteria that allow to establish the priority of intervention". Within the U.O. of first aid it is possible to use different organizational models aimed at improving assistance, one of these is definitely the Fast Track.Fast Track is a model of response to minor emergencies of mono-specialized relevance, to which in the phase of Triage was attributed a coding of minor urgency. Also for this route the activation starts from the Triage and is conducted on the basis of specific guidelines and protocols validated locally that, in the presence of a minor pathology with clear mono-relevancespecialist, they allow the patient to be sent directly to the competent specialist.This organizational model shows a clear improvement in terms of care and waiting time. Purpose To verify the effectiveness of the introduction of the various routes added in the first quarter of 2024 by comparing the total number of accesses performed during the same period of 2023, viewing the real impact of fast track on the total number of accesses. Demonstrate that the use of fast track allows a reduction in overcrowding within operating units with a sufficient number of patients enrolled on the route on total access and lower priority codes. General objective of the study: to group data according to age and gender, collect data on nursing management of patients enrolled in the fast-track path in the U.O.C. First Aid of the two Hospital Establishments of Ast di Ascoli Piceno. Specific objective of the study: To detect differences in the application of fast track routes in the two Hospital Establishments "Madonna del Soccorso" of San Benedetto del Tronto and "C. &. G. Mazzoni" di Ascoli Piceno Materials and Methods The longitudinal observational study is conducted through the analysis of data extracted from the medical records of the Operative Unit First Aid Criteria for inclusion - Patients undergoing triage at "Mazzoni" hospital - Patients undergoing triage at "Madonna del Soccorso" hospital Criteria for exclusion - Patients who do not use the "Emergency Room" Operating UnitStudy procedure and data analysis Collection and analysis of data in the computer archive of the S.I.A and processing of variables relevant to the study, using an Excel spreadsheet managed by the Microsoft 365® software. Authorization and Ethical considerations The collection of data will be carried out in compliance with current legislation, following the guidelines provided by the rules of Good Clinical Practice, as well as those for the protection of individuals and other subjects with regard to the processing of personal data. The data collected by this survey will be treated with respect to the confidentiality of personal data and users enrolled in the survey will not be exposed to any risk. Timing The data analysis will be carried out between April 2024 and September 2024. Limitations The research is evaluated exclusively in the only available quadrimestre because the introduction of the organizational model within the U.O. is recent. This means that there is a limited amount of data available, which is sufficient only to show a trend in the effectiveness of the model and not for a whole year. Results and Conclusions The observational study, through data analysis, will show the number of patients enrolled in the Fast Track route with the relative differences between the different specialist branches. This study will also show the change and better care and use of resources within the U.O. of the Ast of A.P. First Aid in the previous year.
Introduzione Con il termine triage si intente "il primo momento di accoglienza e valutazione di pazienti in base a criteri definiti che consentano di stabilire la priorità di intervento”. All’interno delle U.O. di pronto soccorso è possibile utilizzare diversi modelli organizzativi rivolti a migliorare l’assistenza, uno di questi è sicuramente il Fast Track. Il Fast Track è un modello di risposta assistenziale alle urgenze minori di pertinenza mono specialistica , alle quale nella fase di Triage è stata attribuita una codifica di urgenza minore. Anche per questo percorso l’attivazione si avvia dal Triage ed è condotta sulla base di specifiche linee guida e di protocolli validati localmente che, in presenza di un quadro di patologia minore con chiara pertinenza mono-specialistica, consentono di inviare il paziente direttamente allo specialista competente. Scopo Verificare l’efficacia dell’introduzione dei vari percorsi aggiunti nel primo quadrimestre del 2024 con il confronto sul totale degli accessi eseguiti nello stesso periodo del 2023, visionando il reale impatto dei fast track sul totale degli accessi. Dimostrare che l’utilizzo dei fast track permette una riduzione del sovraffollamento all’interno delle unità operative con un sufficiente numero di pazienti arruolati nel percorso sul totale di accessi e sui codici di priorità minore. Obiettivo generale dello studio: raggruppare i dati in base a età e genere, raccogliere dati inerenti alla gestione infermieristica dei pazienti arruolabili nel percorso fast-track nell’U.O.C. Pronto Soccorso dei due Stabilimenti Ospedalieri dell’Ast di Ascoli Piceno. Obiettivo specifico dello studio: Rilevare le differenze di applicazione dei percorsi fast track nei due Stabilimenti Ospedalieri “Madonna del Soccorso” di San Benedetto del Tronto e "Mazzoni” di A. P. Materiali e Metodi Lo studio osservazionale longitudinale viene condotto attraverso l’analisi dei dati estratti dalle cartelle cliniche dell’Unità Operativa Pronto Soccorso Criteri di inclusione Pazienti che si sottopongono a Triage Ospedale “Mazzoni” Pazienti che si sottopongono a Triage Ospedale “Madonna del Soccorso” Criteri di esclusione Pazienti che non usufruiscono dell’Unità Operativa “Pronto Soccorso” Procedura di studio e Analisi dei dati Raccolta ed analisi dei dati presenti nell’archivio informatico del S.I.A ed elaborazione delle variabili pertinenti allo studio, tramite utilizzo di foglio di calcolo Excel gestito dal software Microsoft 365. Autorizzazione e Considerazioni etiche La raccolta dati verrà realizzata in aderenza alla vigente normativa, attenendosi alle indicazioni fornite dalle norme di Buona Pratica Clinica, nonché a quelle per la tutela delle persone e di altri soggetti rispetto al trattamento dei dati personali. I dati raccolti dalla presente indagine, saranno trattati nel rispetto della riservatezza dei dati personali e gli utenti arruolati nella survey non saranno esposti a nessun rischio. Timing L’analisi dei dati verrà effettuata nel periodo compreso tra il mese di aprile 2024 e settembre 2024. Limiti La ricerca viene valutata esclusivamente nell’unico quadrimestre disponibile in quanto l’introduzione del modello organizzativo all’interno del U.O. è recente. Per questo si dispone di un numero di dati limitati sufficiente esclusivamente a delineare un andamento dell’efficacia del suddetto modello e non per un intero anno. Risultati e Conclusioni Lo studio osservazionale, attraverso l’analisi dei dati, oltre a correlare i precedenti studi, mostrerà il numero di pazienti arruolati nel percorso Fast Track con le relative differenze tra le diverse branche specialistiche. Il presente studio mostrerà anche il cambiamento e una migliore assistenza e utilizzo delle risorse all’interno del U.O. del pronto soccorso dell’Ast di A.P. nell'anno precedente.
LA GESTIONE DEL PERCORSO FAST TRACK NELL’AST DI ASCOLI PICENO: STUDIO OSSERVAZIONALE MONOCENTRICO
MARINI, SIMONE
2023/2024
Abstract
Introduction The term triage refers to "the first moment of reception and evaluation of patients according to defined criteria that allow to establish the priority of intervention". Within the U.O. of first aid it is possible to use different organizational models aimed at improving assistance, one of these is definitely the Fast Track.Fast Track is a model of response to minor emergencies of mono-specialized relevance, to which in the phase of Triage was attributed a coding of minor urgency. Also for this route the activation starts from the Triage and is conducted on the basis of specific guidelines and protocols validated locally that, in the presence of a minor pathology with clear mono-relevancespecialist, they allow the patient to be sent directly to the competent specialist.This organizational model shows a clear improvement in terms of care and waiting time. Purpose To verify the effectiveness of the introduction of the various routes added in the first quarter of 2024 by comparing the total number of accesses performed during the same period of 2023, viewing the real impact of fast track on the total number of accesses. Demonstrate that the use of fast track allows a reduction in overcrowding within operating units with a sufficient number of patients enrolled on the route on total access and lower priority codes. General objective of the study: to group data according to age and gender, collect data on nursing management of patients enrolled in the fast-track path in the U.O.C. First Aid of the two Hospital Establishments of Ast di Ascoli Piceno. Specific objective of the study: To detect differences in the application of fast track routes in the two Hospital Establishments "Madonna del Soccorso" of San Benedetto del Tronto and "C. &. G. Mazzoni" di Ascoli Piceno Materials and Methods The longitudinal observational study is conducted through the analysis of data extracted from the medical records of the Operative Unit First Aid Criteria for inclusion - Patients undergoing triage at "Mazzoni" hospital - Patients undergoing triage at "Madonna del Soccorso" hospital Criteria for exclusion - Patients who do not use the "Emergency Room" Operating UnitStudy procedure and data analysis Collection and analysis of data in the computer archive of the S.I.A and processing of variables relevant to the study, using an Excel spreadsheet managed by the Microsoft 365® software. Authorization and Ethical considerations The collection of data will be carried out in compliance with current legislation, following the guidelines provided by the rules of Good Clinical Practice, as well as those for the protection of individuals and other subjects with regard to the processing of personal data. The data collected by this survey will be treated with respect to the confidentiality of personal data and users enrolled in the survey will not be exposed to any risk. Timing The data analysis will be carried out between April 2024 and September 2024. Limitations The research is evaluated exclusively in the only available quadrimestre because the introduction of the organizational model within the U.O. is recent. This means that there is a limited amount of data available, which is sufficient only to show a trend in the effectiveness of the model and not for a whole year. Results and Conclusions The observational study, through data analysis, will show the number of patients enrolled in the Fast Track route with the relative differences between the different specialist branches. This study will also show the change and better care and use of resources within the U.O. of the Ast of A.P. First Aid in the previous year.File | Dimensione | Formato | |
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https://hdl.handle.net/20.500.12075/20066