Abstract：
BACKGROUND: In EDs, triage ensures that patients whose condition requires immediate care are prioritized while reducing overcrowding. Previous studies have described the manifestation of caregivers\' moral judgements of patients in EDs. The equal treatment of patients in clinical practice presents a major issue. Studying the impact of prejudice on clinical practice in the ED setting provides an opportunity to rethink clinical tools, organizations and future training needs. Our study sought to describe the moral judgements expressed by triage nurses during admission interviews in emergency departments and to assess their impact on patient management.
METHODS: An exploratory sequential mixed-method study was performed. The study was conducted between January 1, 2018, and February 18, 2018, in the EDs of three French hospitals. Five hundred and three patients and 79 triage nurses participated in the study. Audio recordings, observations and written handover reports made by nurses during admission triage interviews were analyzed with a view to discerning whether moral judgements were expressed in them. We studied the impact of moral judgements on patient management in the emergency department.
RESULTS: Abstract Moral judgements were made in 70% of the triage situations studied (n=351/503). They could be classified in seven categories. Patients were more likely to be subjected to moral judgements if they were over 75 years old, visibly disabled or if they had visible signs of alcohol intoxication. Being subjected to moral judgement was associated with differential treatment, including assignment of a triage score that differed from the theoretical triage score.
CONCLUSIONS: More than two thirds of patients admitted to EDs were triaged using moral criteria. Patients who were morally judged at the admission interview were more likely to be treated differently.
METHODS: An exploratory sequential mixed-method study was performed. The study was conducted between January 1, 2018, and February 18, 2018, in the EDs of three French hospitals. Five hundred and three patients and 79 triage nurses participated in the study. Audio recordings, observations and written handover reports made by nurses during admission triage interviews were analyzed with a view to discerning whether moral judgements were expressed in them. We studied the impact of moral judgements on patient management in the emergency department.
RESULTS: Abstract Moral judgements were made in 70% of the triage situations studied (n=351/503). They could be classified in seven categories. Patients were more likely to be subjected to moral judgements if they were over 75 years old, visibly disabled or if they had visible signs of alcohol intoxication. Being subjected to moral judgement was associated with differential treatment, including assignment of a triage score that differed from the theoretical triage score.
CONCLUSIONS: More than two thirds of patients admitted to EDs were triaged using moral criteria. Patients who were morally judged at the admission interview were more likely to be treated differently.
摘要：
背景：在ED中，分诊可确保病情需要立即护理的患者优先考虑，同时减少过度拥挤。先前的研究已经描述了护理人员对ED患者的道德判断的表现。在临床实践中，患者的平等待遇是一个主要问题。在ED环境中研究偏见对临床实践的影响提供了重新思考临床工具的机会，组织和未来的培训需求。我们的研究旨在描述分诊护士在急诊科入院访谈中表达的道德判断，并评估其对患者管理的影响。
方法：进行了探索性序贯混合方法研究。该研究于2018年1月1日至2018年2月18日在法国三家医院的ED中进行。500名患者和79名分诊护士参加了这项研究。录音,分析了护士在入院分诊访谈期间的观察和书面交接报告，以辨别其中是否表达了道德判断。我们研究了道德判断对急诊科患者管理的影响。
结果：摘要在所研究的分类情况中，有70％进行了道德判断（n=351/503）。它们可以分为七类。如果患者超过75岁，他们更有可能受到道德判断，明显残疾或有明显的酒精中毒迹象。受到道德判断与差别待遇有关，包括分配与理论分诊分数不同的分诊分数。
结论：超过三分之二的ED患者使用道德标准进行分类。在入院访谈中受到道德判断的患者更有可能受到不同的对待。
方法：进行了探索性序贯混合方法研究。该研究于2018年1月1日至2018年2月18日在法国三家医院的ED中进行。500名患者和79名分诊护士参加了这项研究。录音,分析了护士在入院分诊访谈期间的观察和书面交接报告，以辨别其中是否表达了道德判断。我们研究了道德判断对急诊科患者管理的影响。
结果：摘要在所研究的分类情况中，有70％进行了道德判断（n=351/503）。它们可以分为七类。如果患者超过75岁，他们更有可能受到道德判断，明显残疾或有明显的酒精中毒迹象。受到道德判断与差别待遇有关，包括分配与理论分诊分数不同的分诊分数。
结论：超过三分之二的ED患者使用道德标准进行分类。在入院访谈中受到道德判断的患者更有可能受到不同的对待。
