Results of an advanced nursing triage protocol in emergency departments.

OBJECTIVES: The increasing number of patients admitted to emergency departments (EDs) and overcrowding of EDs lead to a global problem. Advanced nursing triage is an important solution in facilitating patient and time management, also increasing the efficiency of the ED. This study was conducted to predict the possible effects of applying advanced nursing triage modeling with predetermined protocols during the current nursing triage in the ED. METHODS: This was a descriptive and cross-sectional study. An advanced "triage assessment protocol," which was developed previously, was hypothetically applied for 5 days by triage nurses in the adult ED of a university hospital. The hypothetical application was tested by triage nurses in all shifts. The nurses recorded the examination or treatment options which they thought to apply for the patient on the study form. The data recorded on the advanced triage evaluation protocol form by the triage nurses were compared with the patient outcomes and physician examination/treatment requests in the Hospital Information Management System by the researchers. RESULTS: In the study, it was determined that the rate of examination/treatment that could be requested according to the advanced nursing triage protocol was 46%. There were a good level of agreement on X-ray and a moderate level of agreement on urinary test and urinary beta- Human chorionic gonadotropin (hCG) test between physicians and triage nurses regarding examination/treatment requests. In addition, it was found that there was a 61.2% of agreement on decisions made for patients aged between 18 and 35. The rate of agreement between doctors and nurses regarding a gluco-stick request for patients admitted outside the prime time (92.2%) was found to be significantly higher (87.9%) than for patients admitted during prime time (P = 0.046). CONCLUSION: "Advanced triage" practices recommended for busy EDs were tested "hypothetically" at the national level due to the lack of legal regulations and were found to be compatible with the actual results of physicians' practices at an acceptable level, especially for selected medical conditions. The method used in this study can be useful in planning the transition to "advanced triage" practices. These results can show the readiness of nurses for the transition to this practice.

Emergency nurse triage in the hospital information management system: A quality improvement study.

BACKGROUND: Assessment of nurse triage decision accuracy and triage times is currently carried out through paper-based methods. This quality improvement study aims to develop a method that can assess the accuracy and duration of nurse triage decisions based on a computerized system and to share an example of the application of this method. METHODS: This is a descriptive quality improvement study. The study was carried out in two stages between March and May 2019. The functionality of the developed method was examined using 3835 patients' triage data, which were obtained between June 1 and 14, 2019. RESULTS: With this study, the determination of the accuracy and duration of nurse triage decisions was accomplished with a computerized process based on real patient outputs, and the accuracy and duration of these decisions were continuously measured, monitored, and assessed, which is different from paper-based methods. The functionality of the method was evaluated with data from 3835 real patients. The triage decision accuracy rate was 64.4%, and the average duration of triage was 81.3s. Positive feedback on the method was received from all triage nurses. CONCLUSION: The study result outputs can be integrated into quality processes and can be used internationally as performance assessment criteria and quality indicators for triage nursing.

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

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.

Determination of nursing procedures and competencies in emergency departments: A cross-sectional study.

The aim of this study was to determine the nursing procedures carried out by emergency department nurses. This descriptive study was carried out between April and September 2015 in the emergency departments of two state hospitals and one university hospital in Turkey. The study population comprised 139 emergency nurses working for at least 1 year in the emergency department of one of the three hospitals. Data were gathered by using the Emergency Nursing Procedures Questionnaire, which is composed of three sections to reveal nursing procedures performed in emergency departments. The procedures most frequently performed by the participants were administration of pain medication and assessment of patient responses (3.97 ± .18). Assessment of the patient's nutritional status (1.79 ± 1.16) was among the least frequently performed nursing procedures. Emergency nurses carried out nursing care procedures less frequently and took part most frequently in procedures related to medical diagnosis and treatment. According to results of this study, these procedures and competencies will highlight what knowledge and skills emergency nurses need. They will also guide in the creation of in-service training programs and illuminate competencies that need improvement.