Triage Decisions Involving Pregnancy-Capable Patients: Educational Deficits and Emergency Nurses' Perceptions of Risk

Area of Science:

• Emergency Medicine
• Obstetrics
• Nursing Education

Background:

• Emergency departments (EDs) frequently manage unplanned obstetric care due to limited access to specialized services.
• Emergency nurses often lack universal training in identifying and managing obstetric emergencies.

Purpose of the Study:

• To investigate emergency nurses' perceptions of acuity in triaging high-risk pregnant or postpartum patients.
• To identify factors that facilitate or hinder accurate assessment and treatment of these patients in the ED.

Main Methods:

• A mixed-methods approach combining chart review (N=12,766) and focus groups (N=39).
• Data collected from five emergency departments in the eastern United States.

Main Results:

• Pregnancy status was undocumented in 86.5% of cases.
• 94% of pregnant patients with systolic blood pressure >140 mmHg were under-triaged.
• Qualitative findings revealed 'acuity blindness' due to educational deficits and workflow issues.

Conclusions:

• Significant knowledge gaps exist among healthcare professionals regarding high-risk obstetric conditions.
• Improved training and triage protocols are crucial for enhancing care for pregnant patients in emergency settings.