Factors that influence the accuracy of triage nurses' judgement in emergency departments

Chen, Shu Shin; Chen, Jih Chang; Ng, Chau Yee; Chen, Ping Ling; Lee, Pi Hsia; Chang, Wen Yin

doi:10.1136/emj.2008.059311

Cited by 51 publications

(57 citation statements)

References 11 publications

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“…Studies have also raised issues concerning the validity and reliability of paediatric triage in general 1–6. This may be related to inadequate triage training or insufficient standardisation of triage processes 7. Two review articles have suggested that the use of a valid and reliable five-level triage system can improve ED operations 8 9.…”

Section: Introductionmentioning

confidence: 99%

Effectiveness of a five-level Paediatric Triage System: an analysis of resource utilisation in the emergency department in Taiwan

Chang

et al. 2012

Emerg Med J

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ObjectivesTo examine the effectiveness of a five-level Paediatric Triage and Acuity System (Ped-TTAS) by comparing the reliability of patient prioritisation and resource utilisation with the four-level Paediatric Taiwan Triage System (Ped-TTS) among non-trauma paediatric patients in the emergency department (ED).MethodsThe study design used was a retrospective longitudinal analysis based on medical chart review and a computer database. Except for a shorter list of complaints and some abnormal vital sign criteria modifications, the structure and triage process for applying Ped-TTAS was similar to that of the Paediatric Canadian Emergency Triage and Acuity Scale. Non-trauma paediatric patients presenting to the ED were triaged by well-trained triage nurses using the four-level Ped-TTS in 2008 and five-level Ped-TTAS in 2010. Hospitalisation rates and medical resource utilisation were analysed by acuity levels between the contrasting study groups.ResultsThere was a significant difference in patient prioritisation between the four-level Ped-TTS and five-level Ped-TTAS. Improved differentiation was observed with the five-level Ped-TTAS in predicting hospitalisation rates and medical costs.ConclusionsThe five-level Ped-TTAS is better able to discriminate paediatric patients by triage acuity in the ED and is also more precise in predicting resource utilisation. The introduction of a more accurate acuity and triage system for use in paediatric emergency care should provide greater patient safety and more timely utilisation of appropriate ED resources.

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Section: Introductionmentioning

confidence: 99%

Effectiveness of a five-level Paediatric Triage System: an analysis of resource utilisation in the emergency department in Taiwan

Chang

et al. 2012

Emerg Med J

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“…Since triage scoring is linked to resource utilization (e.g., consultants called or bloodwork performed), the high agreement between actual and PTP triage scores may be interpreted as representing the more accurate and advanced knowledge PTP might have, which parallels patient care orders regularly occurring within the ED [33,34]. …”

Section: Discussionmentioning

confidence: 99%

Traditional nurse triage vs physician telepresence in a pediatric ED

Marconi¹,

Pham²,

Grajower³

et al. 2014

The American Journal of Emergency Medicine

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Objectives To compare traditional nurse triage (TNT) in a Pediatric Emergency Department (PED) to physician tele-presence (PTP). Methods Prospective, 2×2 crossover study with random assignment using a sample of walk-in patients seeking care in a PED at a large, tertiary care children’s hospital, from May 2012 to January 2013. Outcomes of triage times, documentation errors, triage scores, and survey responses were compared between TNT and PTP. Comparison between PTP to actual treating PED physicians regarding the accuracy of ordering blood and urine tests, throat cultures, and radiologic imaging was also studied. Results Paired samples t-tests showed a statistically significant difference in triage time between TNT and PTP (p=0.03), but no significant difference in documentation errors (p=0.10). Triage scores of TNT were 71% accurate, compared to PTP, which were 95% accurate. Both parents and children had favorable scores regarding PTP and the majority indicated they would prefer PTP again at their next PED visit. PTP diagnostic ordering was comparable to the actual PED physician ordering, showing no statistical differences. Conclusions Utilizing physician tele-presence technology to remotely perform triage is a feasible alternative to traditional nurse triage, with no clinically significant differences in time, triage scores, errors and patient and parent satisfaction.

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“…Nursing clinical decision making is a process that begins with the perception of risk within an environment and ends with a clinical decision . Risks must be identified and differentiated from background noise within the patient care…”

Section: Introductionmentioning

confidence: 99%

“…Nursing clinical decision making is a process that begins with the perception of risk within an environment and ends with a clinical decision. [11][12][13][14][15][16][17][18][19] Risks must be identified and differentiated from background noise within the patient care environment, interpreted based on the current situation, and evaluated for potential future risks prior to making a clinical decision. 20,21 Because nursing clinical decision making begins with a perception of risk, it is essential to understand what nurses perceive as a risk to patients in order to design safe systems.…”

Section: Introductionmentioning

confidence: 99%

Nursing perception of risk in common nursing practice situations

Trevino

Green

Middaugh

et al. 2017

J of Healthc Risk Manag

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MPHAs health care organizations seek to be highly reliable, systems that include layers of redundancy have been created to protect patients from harm. Many of these layers of protection are dependent on nurses making a decision to follow or adhere to the human aspects of the process. Because these decisions begin with a perception and identification of risk, understanding what nurses perceive to be a risk to patients is an essential part of designing safer health care systems. The purposes of this qualitative study were to (1)

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Factors that influence the accuracy of triage nurses' judgement in emergency departments

Abstract: The scores of accuracy ratings for triage nurses can be improved if factors contributing to inaccuracy can be altered. The findings of this study can be used to guide improvements.

Cited by 51 publications

References 11 publications

Effectiveness of a five-level Paediatric Triage System: an analysis of resource utilisation in the emergency department in Taiwan

Effectiveness of a five-level Paediatric Triage System: an analysis of resource utilisation in the emergency department in Taiwan

Traditional nurse triage vs physician telepresence in a pediatric ED

Nursing perception of risk in common nursing practice situations

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