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Setting Up a Stroke Team Algorithm and Conducting Simulation-based Training in the Emergency Department - A Practical Guide

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Emergency Department Triage Nurses' Scope of Practice: An Observational Study.

Julie Considine^1,2,3, Elizabeth Oldland¹, Judy Currey^1,2

¹School of Nursing and Midwifery, Deakin University, Geelong, Victoria, Australia.

Journal of Clinical Nursing

|May 27, 2026

Summary

Emergency department triage nurses perform complex tasks beyond initial assessment, including ongoing patient care in waiting areas. Their multifaceted role is crucial for safety and timely emergency care.

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Area of Science:

Emergency nursing
Healthcare delivery
Patient flow management

Background:

The traditional view of emergency department (ED) triage nurses' roles is limited to initial patient assessment and categorization.
Contemporary ED environments present complex challenges, necessitating a broader understanding of triage nurses' responsibilities.
The scope of practice for triage nurses, particularly in managing patients in waiting areas, requires further exploration.

Purpose of the Study:

To investigate the scope of practice and specific activities undertaken by ED triage nurses.
To examine how triage nurses manage patients situated in ED waiting areas.
To understand the full spectrum of triage nursing activities beyond initial triage category allocation.

Main Methods:

An exploratory, descriptive, observational study employing naturalistic decision-making principles.
Semi-structured, non-participant observations of 15 triage nurses across three Melbourne EDs.
Data collection via audio recordings and transcription, analyzed using deductive content analysis with the HIRAID framework.

Main Results:

Triage nurses possessed extensive experience (median 10 years nursing, 5 years triage).
Over 33 observation hours, 303 interactions and 1183 tasks were recorded, with history taking, post-triage communication, and patient assessment being most frequent.
While history taking and assessment were prominent during initial triage, interventions, diagnostics, and communication occurred throughout both triage and post-triage phases.

Conclusions:

Triage nursing practice is complex and extends significantly beyond assigning a triage category.
The linear division between triage and post-triage care is inadequate for current ED practice.
Models of care and education for triage nurses should reflect their comprehensive role, encompassing waiting area management and a wide range of clinical skills.