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Triage Decision-Making in Interdisciplinary Pediatric Chronic Pain Programs.

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Nurses play a key role in triaging youth with complex chronic pain to interdisciplinary programs. They desire evidence-based clinical decision support tools to improve these crucial triage decisions.

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Area of Science:

  • Pediatric nursing
  • Pain management
  • Healthcare decision support

Background:

  • Interdisciplinary pediatric chronic pain programs offer comprehensive care for youth with complex biopsychosocial needs.
  • Nurses are central to patient triage but lack evidence-based clinical decision support tools.
  • This gap increases the risk of inconsistent and haphazard triage decisions.

Purpose of the Study:

  • To explore and describe nurses' decision-making practices during patient triage to interdisciplinary pediatric chronic pain programs.
  • To identify contextual influences affecting these triage decisions.

Main Methods:

  • Qualitative exploratory descriptive design.
  • 12 nurses from 11 interdisciplinary pediatric chronic pain programs participated.
  • Semi-structured interviews were analyzed using concurrent content analysis, guided by Cognitive Continuum Theory and the Theoretical Domains Framework.

Main Results:

  • Triage for pediatric chronic pain is complex and primarily nurse-led.
  • Key themes identified include nurse-led triage determinants, the triage decision-making process, and external influences.
  • Nurses highlighted the complexity of the patient population and the absence of evidence-based guidance.

Conclusions:

  • Nurse-led triage for interdisciplinary pediatric chronic pain programs is complex.
  • Nurses expressed a strong desire for an evidence-based clinical decision support (CDS) triage tool.
  • Implementing a CDS tool could streamline referrals and prioritize patients most in need of interdisciplinary care.