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Published on: March 29, 2019

Errors in nurse-led triage: An observational study.

Dietmar Ausserhofer¹, Arian Zaboli², Norbert Pfeifer²

¹College of Health Care-Professions Claudiana, Lorenz-Böhler-Str. 13, 39100 Bolzano-Bozen, Italy; Institute of Nursing Science, University of Basel, Basel, Switzerland.

International Journal of Nursing Studies

|October 29, 2020

Summary

Nurse-led triage errors occurred in 16.3% of patients, impacting emergency department stays. Factors like patient age, chronic conditions, and busy environments increase these errors, highlighting the need for improved triage accuracy.

Keywords:

Emergency medical services Hospitals Nursing care Patient safety Triage

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Area of Science:

Emergency Medicine
Nursing
Healthcare Quality Improvement

Background:

Nurses are vital for emergency department patient prioritization.
The accuracy of nurse-led triage systems, particularly the Manchester Triage System, is not well understood.
This study investigates the frequency and factors associated with triage errors.

Purpose of the Study:

Determine the frequency of nurse-led triage errors using the Manchester Triage System.
Explore patient, work environment, and nurse-specific factors linked to triage errors.
Examine the association between triage errors and patient outcomes, including length of stay, hospitalization, and mortality.

Main Methods:

Retrospective observational study in a Northern Italian emergency department.
Analysis of electronic health records from a random sample of 1,929 patients over 18 months.
Univariate and multivariate logistic regression to identify factors associated with triage errors and patient outcomes.

Main Results:

Triage errors were identified in 16.3% of patients, significantly associated with longer emergency department and hospital stays.
Higher odds of triage errors were linked to busy triage periods (more than one patient every 15 minutes), older patients, those with multiple chronic conditions, and higher priority codes.
Triage nurses with prior experience in different triage systems showed significantly higher odds of errors.

Conclusions:

Primary evidence on the prevalence, nature, and consequences of nurse-led triage errors is provided.
Patient factors like age and polychronicity may improve Manchester Triage System accuracy.
Further prospective, multicenter studies and qualitative research are needed to confirm findings and explore nurse training and work environment influences.