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Incident reporting in nurse-led national telephone triage in Sweden: The reported errors reveal a pattern that needs to be broken
University of Gävle, Faculty of Health and Occupational Studies, Department of Health and Caring Sciences, Nursing science. Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden.ORCID iD: 0000-0001-9513-3102
University of Gävle, Faculty of Health and Occupational Studies, Department of Health and Caring Sciences, Nursing science. Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden.ORCID iD: 0000-0002-9912-5350
Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden.
Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden.
2010 (English)In: Journal of Telemedicine and Telecare, ISSN 1357-633X, E-ISSN 1758-1109, Vol. 16, no 5, p. 243-247Article in journal (Refereed) Published
Abstract [en]

We conducted a retrospective study of incident reports concerning the national, nurse-led telephone triage system in Sweden. The Swedish Health Care Direct organization (SHD) is staffed by registered nurses who act as telenurses and triage the callers' need for care, using a computerized decision support system. Data were collected during 2007 from all county councils that participated in the SHD and were analysed using content analysis. Incident reports were then compared concerning differences in reported categories and who reported the errors. The 426 incident reports included 452 errors. Of the analysed incident reports, 41% concerned accessibility problems, 25% incorrect assessment, 15% routines/guidelines, 13% technical problems and 6% information and communication. The most frequent outgoing incident reports (i.e. sent from SHD to other health-care providers) concerned accessibility problems and the most frequently incoming reports (i.e. sent to SHD from other health-care providers) concerned incorrect assessment. There was a significant difference (P < 0.001) between outgoing and incoming reports regarding the main category. Telenurses have limited possibilities for referring the caller to their primary health-care provider or specialist, which may cause them to over-triage or under-triage the callers' need for care. This over-triage or under-triage may in turn cause other health-care providers to report incorrect assessment to SHD. The implications for practice are that poor accessibility is a matter that should be addressed and that the reasons for incorrect assessment should be explored.

Place, publisher, year, edition, pages
2010. Vol. 16, no 5, p. 243-247
Keywords [sv]
Swedish Health Care Direct organization (SHD), registered nurses, national telephone triage, telenurses
National Category
Nursing
Identifiers
URN: urn:nbn:se:hig:diva-7557DOI: 10.1258/jtt.2009.090813ISI: 000280360000004PubMedID: 20457800Scopus ID: 2-s2.0-77954882765OAI: oai:DiVA.org:hig-7557DiVA, id: diva2:350812
Projects
Nationellt samordnad telefonrådgivning utifrån ett patientsäkerhetsperspektivAvailable from: 2010-09-11 Created: 2010-09-11 Last updated: 2018-03-13Bibliographically approved
In thesis
1. National telephone advice nursing in Sweden: patient safety and communication
Open this publication in new window or tab >>National telephone advice nursing in Sweden: patient safety and communication
2012 (English)Doctoral thesis, comprehensive summary (Other academic)
Place, publisher, year, edition, pages
Uppsala: Uppsala universitet, 2012
Series
Acta Universitatis Upsaliensis, ISSN 1651-6206
National Category
Public Health, Global Health, Social Medicine and Epidemiology
Identifiers
urn:nbn:se:hig:diva-13108 (URN)978-91-554-8404-0 (ISBN)
Public defence
Universitetshuset, Biskopsgatan 3, Uppsala (Swedish)
Opponent
Supervisors
Projects
Nationellt samordnad telefonrådgivning utifrån ett patientsäkerhetsperspektiv
Available from: 2012-10-01 Created: 2012-09-26 Last updated: 2018-03-13Bibliographically approved

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Ernesäter, AnnicaEngström, Maria

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