Best Practices of Emergency Department Triage Training: A Systematic Review and Meta-Analysis Protocol

Accurate triage in emergency departments is critical to patient safety and resource management. Despite the widespread use of validated triage tools, decision-making inconsistencies remain, often owing to inadequate or variable training. Previous research suggests that structured training interventions can improve triage performance, but there is no consolidated evidence to guide best practices in training design.

This protocol outlines a systematic review and meta-analysis to synthesize quantitative evidence on the effectiveness of triage training interventions for emergency nurses. The review aims to identify which training modalities are most effective in improving triage accuracy and related outcomes.

The review will follow the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. A comprehensive search will be conducted in PubMed, Cumulative Index to Nursing and Allied Health Literature, Embase, Scopus, and Web of Science using both Medical Subject Headings terms and free-text keywords. Eligible studies will include randomized controlled trials, quasi-experimental, and pre-post intervention studies involving emergency nurses and reporting accurate triage rate performance outcomes. Two independent reviewers will conduct study selection, data extraction, and quality appraisal using the Joanna Briggs Institute critical appraisal tools. A meta-analysis will be performed depending on whether random-effects or fixed effects are used for heterogeneity. Systematic synthesis will be conducted if meta-analysis is not feasible. This protocol is registered in PROSPERO (registration no: CRD42025115681).

Findings from this review will inform evidence-based triage education, supporting ED leaders and nurse educators in implementing effective training programs to improve decision making and patient safety.