Does Using a Standardised Mental Health Triage Assessment Alter Nurses Assessment of Vignettes of People Presenting with Deliberate Self-Harm

Abstract

Background. The Manchester Triage Scale is used in Irish emergency departments. This fails to provide guidance on triaging psychiatric presentations. A Mental Health Triage scale is recommended by the National Institute of Clinical Excellence. Aim. To examine the effectiveness of a Mental Health Triage scale in assessing patients presenting with self-harm. Method. Ten vignettes were created, detailing cases of deliberate self-harm. Nurses (n=49) were given five vignettes and asked to assign each vignette to a triage category, using The Manchester Triage Scale. Each nurse was subsequently asked to reevaluate the same vignettes using the Mental Health Triage Scale. Triage with each method was deemed safe or unsafe, using the benchmark triage categories assigned by a consultant in psychiatry and a consultant in emergency medicine departments. Results. 245 cases were triaged. There was a significant change in the categories assigned when the Mental Health Triage scale was in use, P<0.001. The triage categories assigned using the Mental Health Triage scale were significantly safer than under the Manchester Triage Scale (79% versus 60% safe, respectively, P<0.001).