Triage Nursing During Covid-19

Triage Nursing During Covid-19

by Jeff Love

25 Mar 2020

User Experience

The wife of one of our developers is working as a triage nurse for Kaiser Permanente during Covid-19. She shares her experience with using technology to work with patients remotely and some of the challenges she faces. This is a great insight into how technology in the healthcare industry is helping workers navigate this difficult time.

What is triage nursing?

Helping members via a video visit or on the phone is an exploding industry known as triage nursing. This profession is booming as technology is driving these options. Triage nursing is typically one of the first points of contact for a person and it can be done virtually. A telephonic triage nurse is a nurse that helps people decided the next level of care, whether hospital nursing, MD office appt and how soon, or advice for self-care at home is the appropriate option regarding their symptoms.
However, there are many moving parts that must be instituted for the assessment to take place. Since there are so many rules set up with HIPAA and patient privacy, there needs to be secure ways of logging in to protected information. The hurdle of supporting patient confidentiality but at the same time having the ability to access a patient’s record for health history and medication list is a sizable one.

How does triage nursing use technology?

This balance between security and functionality is where today’s technology allows me to meet my needs as a work-from-home triage nurse and maintain the federal and state requirements for patient confidentiality. My company uses a three-tiered security plan that allows us to connect and VPN from anywhere. The first step is to log in to the VPN network, much like millions of home workers around the world. The second step uses a piece of software called “Ping ID” that is installed on my personal phone to help ensure that it is me that is actually logging in to the VPN. When I connect their servers send a signal the PingID application on my phone that then requires I “slide” an icon to accept the VPN connection. The final step is then I log in to the software used to manage patient information, which in our case is a very large system called Epic EMR.
As a registered nurse for over two decades, nursing and assessment by phone is one of the most challenging positions I’ve held. I don’t have access to the patients heart rate, their blood oxygen levels, or their lungs so I need to listen to their breathing and speaking patterns over the phone, while asking relevant questions so I can accurately give advice to the patient, or forward their concerns to a doctor, an urgent care or emergency room facility.
Much of my current patient load is related to the COVID-19 virus. The patients call to ask about symptoms, testing availability, avoidance, clarifications about government regulations, and pretty much any other question one could imagine about the virus. A critical component of a nurse’s job relies on continuous training, and in this case, we must learn all we can about COVID-19. We have daily online and weekly meetings call in meetings with other staff to ensure we have he latest information and triage techniques. I dial in to a secure corporate switchboard to keep anything we discuss within the company.
Another tool I can use is online education. Websites like CDC.gov, and our own corporate intranet can really be a treasure trove of the latest up to date information regarding current issues, such as COVID-19. Patients expect, and I expect of myself, to be knowledgeable about a great number of health issues as well as anything that is new or emerging, such as COVID-19.

Do I see a future in online nursing?

With the current technology it is very possible for much of non-bedside nursing to move to the home. The concerns of patient confidentiality at the home is valid, and with the use of technology it can be mitigated. The phone triage that I do at home adds a level of convenience and comfort to patients that didn’t exist in previous generations, not to mention a convenience for nurses such as myself. In the future, more apps and technology will become available for nurses and healthcare workers to reach everyone including those in remote areas.