Implementing best practice into the emergency department triage process.

Area of Science:

• Emergency Medicine
• Nursing Practice
• Healthcare Quality Improvement

Background:

• Emergency departments (EDs) use triage to prioritize patients based on urgency.
• The Australasian Triage Scale guides medical assessment timeliness.
• Timely treatment is critical for conditions like stroke, sepsis, and myocardial infarction, impacting patient safety.

Purpose of the Study:

• To compare current ED triage practices with evidence-based guidelines.
• To identify barriers to adherence to triage best practices.
• To plan and implement interventions for improved triage adherence.

Main Methods:

• A clinical audit of 200 triage episodes (100 pre- and 100 post-implementation) in a metropolitan ED.
• Assessment against 12 criteria across five key areas: arrival, documentation, policy compliance, communication, and staff.
• Comparison of current practice with Australasian College for Emergency Medicine and College of Emergency Nurses Australasia guidelines.

Main Results:

• Five triage criteria showed improvement, notably patient reassessment and triage time.
• Four criteria showed no improvement or a decline.
• Two criteria achieved 100% adherence in both audit phases.

Conclusions:

• Clinical audit supports adherence to evidence-based triage guidelines.
• A formal nursing role for waiting room patients and a second triage nurse are recommended.
• Physical environment and communication strategies impact adherence and patient experience.