[Standing Orders and Quality of Care at Triage in Emergency Services: Integrative Review]

Overcrowding of emergency services is a widespread problem in western countries. This situation results in negative patient outcomes and influences the quality of care. Standing orders are a possible way to improve the quality and performance of the health system. The aim of this article is to identify, based on a review of the literature, the effects of standing orders initiated by triage nurses in emergency services on the quality of care.

The quality of care dimensions of the Institute of Medicine (2001) were used as a frame of reference. The integrative review was performed on a selection of articles from Cochrane, CINALH, EMBASE, Medline, PubMed and Google Scholar. A total of 23 articles were selected and analysed.

The integrative review documented the effects of standing orders initiated by triage nurses on the six dimensions of quality of care: effectiveness, patient-centeredness, efficiency, timeliness, safety and equity. Standing orders are able to improve the efficiency of care by reducing, among other things, the time to treatment and diagnostic tests. They also reduce the length of stay of patients in emergency services.

Standing orders initiated by triage nurses in emergency services can have positive effects on the quality of care provided to the patient. Further research with more robust study designs is needed.