The consequences of not using the Manchester protocol correctly in Urgent and Emergency services

Authors

DOI:

https://doi.org/10.33448/rsd-v11i13.35476

Keywords:

Emergency; Urgency; Triage.

Abstract

Introduction: The Manchester Risk Classification System (MCHR) was developed in the United Kingdom by physicians and nurses with the purpose of prioritizing emergency care according to higher-risk clinical criteria in order to minimize harm to the patient's health. Objectives: To identify the main difficulties and clinical outcomes during the use of SMCR. Methodology: Integrative literature review by searching the PUBMED and SciELO databases, using the descriptors "Manchester triage" and "emergency" and their variations in English. Articles published between 2017 to 2022, which answered the research question and free full texts were included. In the end, a sample of 16 articles was obtained. Results And Discussion: Three thematic categories were listed. The first one corresponded to the clinical profile of patients screened by the RRMS, which indicated the prevalence of male patients in the white and red categories, and the most prevalent comorbidities in the red category were associated with diabetes mellitus and hypertension. Another category highlighted the main difficulties associated, which were the lack of standardization, nursing staff with no previous training, and lower performance of the triage as the patient's level of complexity increased. The last category pointed out that the RMCMS is a good predictor of mortality. CONCLUSION: There are several factors that hinder the screening process, and it is necessary that institutions promote training of healthcare professionals to improve screening standardization protocols, in order to generate a lower error rate and reduce morbidity and mortality.

References

Amaral, S. F. (2017). O uso do protocolo de Manchester pode auxiliar no atendimento humanizado em uma emergência? [Trabalho para a aprovação no Curso Técnico em Registros e Informações em Saúde].

Anziliero, F., Dal Soler, B. E., Silva, B. A. da, Tanccini, T., & Beghetto, M. G. (2017). Sistema Manchester: tempo empregado na classificação de risco e prioridade para atendimento em uma emergência. Revista Gaúcha de Enfermagem, 37. https://doi.org/10.1590/1983-1447.2016.04.64753

Brouns, S. H. A., Mignot-Evers, L., Derkx, F., Lambooij, S. L., Dieleman, J. P., & Haak, H. R. (2019). Performance of the Manchester triage system in older emergency department patients: a retrospective cohort study. BMC Emergency Medicine, 19(1). https://doi.org/10.1186/s12873-018-0217-y

Costa, F. F., Prudente, G. M., Borba, A. C. G., Deus, S. D. de, Castilho, T. C., & Sampaio, R. A. (2021). A eficácia da aplicação do protocolo de Manchester na classificação de risco em unidades de pronto atendimento: uma revisão sistemática. Revista Saúde Multidisciplinar, 9(1). http://revistas.famp.edu.br/revistasaudemultidisciplinar/article/view/211

Costa, J. P. da, Nicolaidis, R., Gonçalves, A. V. F., Souza, E. N. de, & Blatt, C. R. (2020). The accuracy of the Manchester Triage System in an emergency service. Revista Gaúcha de Enfermagem, 41. https://doi.org/10.1590/1983-1447.2020.20190327

Gräff, I., Latzel, B., Glien, P., Fimmers, R., & Dolscheid‐Pommerich, R. C. (2018). Validity of the Manchester Triage System in emergency patients receiving life‐saving intervention or acute medical treatment—A prospective observational study in the emergency department. Journal of Evaluation in Clinical Practice, 25(3), 398–403. https://doi.org/10.1111/jep.13030

Guedes, H. M., Araújo, F. A., Pinto Júnior, D., Martins, J. C. A., & Chianca, T. C. M. (2017). Outcome assessment of patients classified through the Manchester Triage System in emergency units in Brazil and Portugal. Investigación Y Educación En Enfermería, 35(2), 174–181. https://doi.org/10.17533/udea.iee.v35n2a06

Guedes, H. M., Souza, C. C. de, Pinto Júnior, D., Morais, S. S., & Chianca, T. C. M. (2017). Avaliação de sinais vitais segundo o sistema de triagem de Manchester: concordância de especialistas [Evaluation of vital signs by the Manchester triage system: expert agreement]. Revista Enfermagem UERJ, 25(0). https://doi.org/10.12957/reuerj.2017.7506

Jesus, A. P. S. de, Batista, R. E. A., Campanharo, C. R. V., Lopes, M. C. B. T., & Okuno, M. F. P. (2021). Evaluation of the Manchester Triage System quality indicator: service time. Revista Gaucha de Enfermagem, 42, e20200371. https://doi.org/10.1590/1983-1447.2021.20200371

McCabe, C., O’Brien, M., & Quirke, M. B. (2019). The introduction of the Early Warning Score in the Emergency Department: A retrospective cohort study. International Emergency Nursing, 45, 31–35. https://doi.org/10.1016/j.ienj.2019.03.002

Moura, B. R. S., & Nogueira, L. de S. (2020). Performance of the rapid triage conducted by nurses at the emergency entrance. Revista Latino-Americana de Enfermagem, 28. https://doi.org/10.1590/1518-8345.3467.3378

Sacoman, T. M., Beltrammi, D. G. M., Andrezza, R., Cecílio, L. C. de O., & Reis, A. A. C. dos. (2019). Implantação do Sistema de Classificação de Risco Manchester em uma rede municipal de urgência. Saúde Em Debate, 43(121), 354–367. https://doi.org/10.1590/0103-1104201912105

Santos De Jesus, A., Fernanda, M., Okuno, P., Barbosa, M., Lopes, T., Ester, R., Batista, A., & Fernandes, A. (2021). Cassia Regina Vancini Campanharo II. Revista Brasileira de Enfermagem, 74(3). https://doi.org/10.1590/0034-7167-2020-1361

Silva, A. D. C., Chianca, T. C. M., Pádua, D. R., Guimarães, G. de L., Manzo, B. F., & Correa, A. dos R. (2019). CHARACTERISTICS OF CARE OF A PUBLIC EMERGENCY ROOM ACCORDING TO THE MANCHESTER TRIAGE SYSTEM. Reme Revista Mineira de Enfermagem, 23(e-1178). https://doi.org/10.5935/1415-2762.20190026

Silva, S. K. de A., Lima, B. L. de, Barbosa, D. A. M., Lima, M. A. M. de, Bandeira, T. D., Santos, I. H. O. L., Silva, A. S. R. da, & Simoneti, R. A. A. de O. (2021). Óbitos por causas externas no Brasil: um estudo ecológico temporal de 2014 a 2018 / Deaths from external causes in Brazil: a temporal ecological study from 2014 to 2018. Brazilian Journal of Development, 7(7), 67049–67059. https://doi.org/10.34117/bjdv7n7-128

Soler‐Sanchis, A., Martínez‐Arnau, F. M., Sánchez‐Frutos, J., & Pérez‐Ros, P. (2022). Identification through the Manchester Triage System of the older population at risk of delirium: A case–control study. Journal of Clinical Nursing, Online version. https://doi.org/10.1111/jocn.16349

Souza, C. C. de, Chianca, T. C. M., Cordeiro Júnior, W., Rausch, M. do C. P., & Nascimento, G. F. L. (2018). Reliability analysis of the Manchester Triage System: inter-observer and intra-observer agreement. Revista Latino-Americana de Enfermagem, 26(0). https://doi.org/10.1590/1518-8345.2205.3005

Vredebregt, S. J., Moll, H. A., Smit, F. J., & Verhoeven, J. J. (2018). Recognizing critically ill children with a modified pediatric early warning score at the emergency department, a feasibility study. European Journal of Pediatrics, 178(2), 229–234. https://doi.org/10.1007/s00431-018-3285-9

Zachariasse, J. M., Seiger, N., Rood, P. P. M., Alves, C. F., Freitas, P., Smit, F. J., Roukema, G. R., & Moll, H. A. (2017). Validity of the Manchester Triage System in emergency care: A prospective observational study. PLOS ONE, 12(2), e0170811. https://doi.org/10.1371/journal.pone.0170811

Published

08/10/2022

How to Cite

SILVA, J. R.; ALENCAR, L. M. de S.; SÁ, L. C.; SANTOS, M. V. F. dos. The consequences of not using the Manchester protocol correctly in Urgent and Emergency services. Research, Society and Development, [S. l.], v. 11, n. 13, p. e324111335476, 2022. DOI: 10.33448/rsd-v11i13.35476. Disponível em: https://rsdjournal.org/index.php/rsd/article/view/35476. Acesso em: 25 apr. 2024.

Issue

Section

Review Article