Factors affecting the accuracy of nurse triage in tertiary care emergency departments

Abstract

OBJECTIVES: The accuracy and duration of triage is vital in emergency departments. However, patient density, diversity of cases, and time pressure make triage difficult. Triage performed properly and at the right time prevents patients from experiencing any untoward incidents that may occur because of waiting. Therefore, the study aimed to share the data obtained from the Hospital Information Management System (HIMS) regarding the accuracy and duration of nurse triage in an adult emergency department. METHODS: This descriptive and cross-sectional study evaluated the accuracy and duration of triage decisions made by nurses for patients admitted to an adult emergency department between June 15 and July 15, 2019. Statistical analysis was performed using Statistical analysis was performed using SPSS software version 23.00. RESULTS: The study included the data of 7705 adult patients. The accuracy rate of nurse triage was 59.3% ( n = 4566), and the average duration of triage was 1.52 ± 2.10 min. It was observed that the average duration of accurate triage decisions was longer in patients with triage category 3. A statistically significant relationship was determined between the accuracy of nurse triage and the duration of triage, years of seniority of the nurse, and shifts ( P < 0.05). CONCLUSIONS: The accuracy and duration of nurse triage in the hospital where the study was conducted can be evaluated via the HIMS. In order to increase the accuracy of nurse triage in the emergency department, it is necessary to employ experienced and trained nurses, develop computer-based support systems, and increase the number of nurses working in shifts providing care to a large number of patients.

Factors affecting triage competence among emergency room nurses: A cross‐sectional study

“…The emergency room clinical experience of participants was also identified as a factor that influenced triage competence, which has also been reported in previous studies (Cetin et al, 2020;Cho & Han, 2020;. The KTAS Committee (2021) recommended that triage should be conducted by skilled professionals with a high degree of experience, which is consistent with the results of this study.…”

“…A previous study in which a reasonably equal relationship between colleagues and an open culture was found to influence the development of critical thinking skills in nurses (Lee & Pak, 2014) supports the result of this study. Previous studies on the triage competence of emergency room nurses have typically only examined factors such as nurses' personal characteristics and competence (Cetin et al, 2020; Cho & Han, 2020; Lee & Kim, 2018) and few have examined the effect of interpersonal relationships. Given this study's finding that the collaborative relationship between nurses and doctors influenced triage competence, in order to improve the triage competence of emergency room nurses, differences in the perceived degree of nurse–physician collaboration (Jeong et al, 2018), which can be a barrier to a collaborative relationship, should be reduced.…”

“…tionship between colleagues and an open culture was found to influence the development of critical thinking skills in nurses(Lee & Pak, 2014) supports the result of this study. Previous studies on the triage competence of emergency room nurses have typically only examined factors such as nurses' personal characteristics and competence(Cetin et al, 2020;Cho & Han, 2020; and few have examined the effect of interpersonal relationships.…”

A Computer-Based Decision Support System for Emergency Department Triage

“…[3][4][5] It is difficult to make decisions under high patient intensity and diversity, in a complex and dynamic environment such as an emergency department triage. 6 Decision support systems (DSSs) can provide successful solutions to overcome these difficulties. 7,8 In the literature, it was reported that a DSS supports triage decisions, 9 helps overcome the challenges in emergency settings, 10,11 and increases consistency of triage decisions.…”

“…A triage system to prioritize patients is the most suitable approach for patient safety 3–5 . It is difficult to make decisions under high patient intensity and diversity, in a complex and dynamic environment such as an emergency department triage 6 . Decision support systems (DSSs) can provide successful solutions to overcome these difficulties 7,8 .…”