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Nurse Triage Line Project: Improving Service and Information During a Pandemic

Nurse Triage Lines provide information and reduce surge

Biologic and naturally occurring pandemic events share several commonalities. Whatever the cause of a large biologic event, like any other disaster, people need to know what to do and when to do it. In the case of a pandemic or similar biologic event, we also have to consider how we will manage getting appropriate medication to those who are sick. And no conversation on this topic would be complete without mention of surge capacity; a time when healthcare systems are overwhelmed with the flood of patients presenting with illness from the biologic or pandemic event.

Managing these situations and the many complexities within them requires a strong biologic event plan. There are numerous issues to consider when writing your biologic plan and it may seem like an impossible task. There are pitfalls to avoid in planning and you should consider having your plans reviewed to see if they include what every good plan should.  The bottom line: it all starts with information.

Getting information to the public and having them act on that information is key to successful operations during a pandemic event. Information is vital to getting people to the most appropriate level of care, medication, and in some cases, prophylaxis. The Nurse Triage Line (NTL) Project tackles these issues and more. The NTL Project goals inlcude:
  • Improving access to medications for the sick
  • Providing accurate and actionable information to the public
  • Promoting appropriate alternatives to medical care (to reduce surge)
Read the preliminary report on the role of NTL during 2009 H1N1 event here.

The public needs information they can rely on and take action on. The public needs to have access to this information in a timely manner, in a means that can be understood, and delivered by a medium that can be accessed. Key information points during a pandemic are when and where to seek medical care. Emergency departments, points of distribution (POD) sites, and clinics can quickly be overwhelmed by the surge of patients looking for information as well as those who are ill. The worried well or those looking for "what should I do" information clog the system and cause delays in seeing a medical provider and receiving medications.
From: Background, Purpose and Description of CDC NTL Project

The NTL Project seeks to mitigate these situations by building on existing systems such as 2-1-1 lines and Poison Control Centers (PCC). By implementing a NTL system into a PCC or other existing system, a caller could be triaged based on (a) need for information or (b) symptoms or need for care. The call would be screened based on need an then forwarded for medical advice, given information of where to seek face-to-face care, manage at home, or where to receive prophylaxis or antiviral care.

The systems of a NTL Project are considered for use only during a severe biologic event or pandemic. They mus also be able to meet the needs of at-risk populations including uninsured or underinsured. The benefits of NTL's are clear; improved access to medications, direction of appropriated people to face-to-face care (minimizing surge), and providing accurate and actionable information.

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