Emerg Med J. 2010 Jun;27(6):451-5.

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

departments.
Chen SS, Chen JC, Ng CJ, Chen PL, Lee PH, Chang WY.
Nursing Department, Taoyuan Armed Forces General Hospital, Taipei, Taiwan.

Abstract

OBJECTIVES: To gain an understanding of the accuracy of acuity assessment made by

emergency department (ED) triage nurses, to compare the differences between the characteristics
of triage nurses according to hospital variables and the accuracy of acuity ratings, and to explore
the influence of nursing variables on the judgement of triages.

METHODS: A cross-sectional questionnaire survey was conducted at the EDs of hospitals in

northern Taiwan. Ten adult emergency case scenarios and a demographic sheet with high
validity were developed to survey 279 triage nurses. Data were collected from April to October
2006. All data were analysed using percentage, mean, SD, independent t test, one-way ANOVA
and a stepwise logistic regression analysis.

RESULTS: The average score of rating accuracy was 5.62 points (out of a possible total of 10
points), which was considered low. Approximately 24.3% (n=68) of nurses' triage ratings were
under-triaged and 19.7% (n=55) were over-triaged. Factors included years of ED experience,
hours of triage education, level of hospital and triage mode of delivery. These factors were
identified as significantly affecting the accuracy of nurses' judgement (p<0.05; adjusted
R(2)=40.0%).

CONCLUSION: 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.
 Triage comes from the French verb trier, meaning to separate, sort, sift or select. It is a
process of assessing patients to determine management priorities. Triage is important because it
provide care to those patients who are most likely to survive.
The Triage Nurse who works in the hospital setting, most often in the Emergency Room,
has a big role in saving the lives of the patients. It is important that triage nurses should have
limited margin for error, be able to rapidly identify and respond to actual life-threatening states
and can make complex clinical decisions, in conditions of uncertainty with limited or obscure
information, in minimal time.
Thus, this journal that I have choosen about the factors that influence the accuracy of
triage nurses' judgement in emergency departments is very important. According to this the
factors influencing the accuracy of triage nursing are the following: years of ED experience,
hours of triage education, level of hospital and triage mode of delivery. Based on this study the
average score of rating accuracy is very low because of the said factors. Therefore in order to
increase the accuracy of the nurses’ judgment it is important to alter these factors contributing to
its inaccuracy. Thus this study is a good way of improving the judgment skill of triage nurses.
It is the responsibility of these men and women to quickly and accurately assess a
patient's condition and determine that patient's priority for treatment. Strong evaluation ability,
quick and decisive judgment, and the ability to keep a cool head are all necessary skills needed to
be a successful Triage Nurse.