Improving the Assessment and Triage of Patients with Mental Illness ...

Abstract
Since the amalgamation of mental institutions with acute hospitals there has been an increase
in presentations of patients with mental illness to the Emergency Department. The first point
of contact for the patient attending the Emergency Department is typically triage. It is the
point where emergency care begins with the nurse assessing the patient and assigning a triage
category that best suits the patient’s clinical need. Traditionally triage had its origins in
assessing patients presenting with a physical injury or illness and did not consider those with
a psychological illness. Present-day triage has improved but not to the extent that is required
for best practice. Furthermore staff in the Emergency Department may have received no
formal training in the speciality that is Mental Health. Specialised training is necessary to
provide a consistent and high standard of nursing care and assessment. The purpose of this
study was the implementation of a change management project. This was initiated in a large
Emergency Department in Dublin. The project involved the introduction of a mental illness
triage tool, a computerised pop-up screen in triage and nursing assessment documentation
specifically designed to manage the care of the patient attending the emergency department
with a mental illness.
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