PRIORITERING FRÅN LARM TILL SJUKHUS : En retrospektiv registerstudie om bedömningar i den prehospitala vårdkedjan

Sammanfattning: Introduction: When in care, patients are assessed and prioritised throughout the whole process of care, but to perform these assessments is a complex task. The emergency dispatch center performs the assessment and prioritise the patient over the phone, and do not see them in person. Often it is not even the patients themselves that are on the other end of the line. The ambulance nurse meets their patient when the assessment is made and all senses can be utilized. The purpose of the ambulance nurse assessment is that the patient should receive the best care upon arrival in the pre-hospital care and further in the chain of care. It is desirable that there is a connection between the assessments between the assessments that are made in the pre-hospital chain of care, despite that they have different purposes. Today a tendency to contact the emergency dispatch center prevails, and a general increase of ambulance assistance compared to earlier years can be seen in Sweden. However, the number of ambulance resources are limited and can in the long run become a problem for patient safety. Seriously ill patients must not be overlooked, and therefore correct assessments must form the foundation for those assessments that are being made across the whole chain of care. A well functioning pre-hospital chain of care is of significant importance for patient's security and for the following process of care. Aim: The aim of the study was to investigate what differences and associations that exists between the emergency dispatch centers' assessment of the level of care priority and those from the ambulance nurse. Method: A quantitative study with a retrospective design. In total, 638 alarms were analysed via data from an ambulance operation in the south of Sweden. The result was accounted for by statistical analysis. Result: The result showed a weak connection between the prioritisation performed by the emergency dispatch center compared to that performed by the ambulance nurse. In order to strengthen the  validity of the study, the ambulance nurse different assessments (CUPS and RETTS-triage) were also compared which showed a relatively strong association. Conclusion: The comparison between the emergency dispatch center's assessment and the ambulance nurse assessment of the patients can be seen as problematic since they have different preconditions an purposes. The assessments are and should be different and a certain degree over-priorities has to be accepted in order to ensure that acute ill patients not should be overlooked. A stronger connection between these two in order not to endanger patient safety is however desirable.