Why we do the things we do: applying clinical decision-making frameworks to triage practice

Area of Science:

• Nursing Science
• Clinical Decision Making
• Health Services Research

Background:

• Clinical decision making is complex, particularly in emergency departments.
• Nurse triage involves critical judgments under pressure and uncertainty.
• Existing literature provides varied perspectives on decision-making frameworks.

Purpose of the Study:

• To review and synthesize major themes in clinical decision-making literature.
• To connect these themes to the practice of emergency department nurse triage.
• To identify research needs for improving triage processes and outcomes.

Main Methods:

• Literature review of published research on clinical decision making.
• Exploration of decision research approaches in nursing and medicine.
• Analysis of triage scales, algorithms, and intuitive decision processes.

Main Results:

• Key themes include decision autonomy and decision making under uncertainty.
• Strengths and limitations of various decision-making approaches are outlined.
• Current frameworks often do not fully capture the chaotic triage environment.

Conclusions:

• Naturalistic research methods are essential for understanding the triage environment.
• Improved understanding can lead to better evaluation and outcomes of triage decisions.
• Further research is needed to optimize emergency department nurse triage practices.