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Telephone triage: how experienced nurses reach decisions

B Edwards1

  • 1Bournemouth University, Dorset, England.

Journal of Advanced Nursing
|April 1, 1994
PubMed
Summary

Experienced triage nurses use a systematic framework for telephone triage decisions, considering problem cause, caller impact, care access, nurse control, and perceived vulnerability. They balance probable and worst-case outcomes for final dispositions.

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Area of Science:

  • Nursing
  • Healthcare Management
  • Clinical Decision-Making

Background:

  • Telephone triage is a critical component of healthcare access.
  • Understanding nurses' diagnostic reasoning is essential for optimizing telephone triage protocols.

Purpose of the Study:

  • To identify the diagnostic reasoning components used by experienced nurses during telephone triage.
  • To elucidate the decision-making framework employed in telephone-based triage dispositions.

Main Methods:

  • Qualitative study using grounded theory.
  • Five experienced nurses participated, triaging simulated calls.
  • Think-aloud protocol with audio-recorded, transcribed, and analyzed verbalizations.

Main Results:

  • Nurses utilized a systematic reasoning framework despite time constraints.
  • Key considerations included: likely cause, problem impact, care accessibility, nurse's control over caller reactions, and perceived vulnerability.
  • Final dispositions resulted from balancing probable versus worst-case outcomes.

Conclusions:

  • Experienced triage nurses employ a structured diagnostic reasoning process.
  • This framework allows for effective decision-making in telephone triage.
  • Further research can refine training and protocols based on these identified reasoning components.

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