The emergency nurse responses to triage interruptions and how these responses are perceived by patients: An observational, prospective study

ElsevierVolume 67, March 2023, 101251International Emergency NursingAuthor links open overlay panel, AbstractBackground

Healthcare providers’ responses to triage interruptions in the emergency department affect quality of care. The purposes for this study were to (1) Examine the relationship between nurses’ response to triage interruption and each of, patients’ perceived confidence in nurses’ technical skills, perceived competence of triage nurse, and satisfaction with the triage experience, (2) Examine the relationship between nurses’ response to triage interruption and nurse demographics.

Methods

Using an observational, prospective design, this study was conducted in an adult academic level 1 trauma center. Data collection tools were: The Triage Interruptions Assessment Tool, Triage and Provider Satisfaction and Confidence Survey, and Demographic Questionnaire.

Results

The number of observed triage interviews is 93. Of them, 66 interviews were interrupted. No significant relationships were found between nurses’ response to the interruption and patients’ perceived confidence in nurses’ technical skills, competence of triage nurse, or satisfaction with triage experience. There were no significant relationships between nurses’ response to triage interruptions and nurses’ demographics.

Conclusions

Triage interruptions in the emergency environment are common and most often result in delays in care. In the current study, this has not been shown to affect patients’ satisfaction. Nurses’ individual characteristics did not affect their responses to triage interruptions.

Section snippetsBackground

Triage is the initial assessment of a patient upon entry into the emergency department (ED) and is the process of prioritizing treatment to the patients according to the clinical urgency of their presenting complaints. [1] A nurse’s triage decision depends on patient’s clinical presentation. [2] However, the nurse’s characteristics can play important roles in the triage decision-making process. The results of the studies by Reay et al. and Sharma et al. [2], [3] show that a nurse’s experience

Study design and settings

This study was conducted is an adult 728 bed academic level 1 trauma center in Midwest region of the United States. This trauma center has, a 55 bed ED that provides care for 75,000 patients annually. In this observational, prospective study, informed consent was obtained from the nurses prior to conducting observation of triage interviews. Observations began as the nurse asked the first question to the patient, either in the triage area or at the patient bedside. Triage was deemed complete

Results

Fifty-one nurses conducted triage interviews on 93 patients. Of the nurses, 38 (77.6%) were female, and 11(22.4%) nurses were male. Forty-forty (89.8%) participants were white, three (6.1%) were African American, and two (4.1) were from other races. The age range for the nurses was between 23 and 67 years (Mean = 37.3, SD = 11.6). Thirty-five (71.4%) nurse participants had Bachelor’s degree, eleven (22.4%) had Associate degree, two (4.1%) had Master’s degree, and one (2%) nurse participant had

Discussion

The purposes for this research study were to; (1) Examine the relationship between nurses’ response to interruption to triage assessment and each of; patients’ perceived confidence in nurses’ technical skills, patients’ perceived competence of triage nurse, and patients’ satisfaction with the triage experience, (2) Examine if there is a relationship between nurses’ response to interruption to triage assessment and nurse demographics

The results of this study show that the observed rate of triage

Limitations

There were some limitations of the current study. First, Providers Surveys and Patients Surveys are self-reported questionnaires and participants responses to the questions in these surveys are subjected to the social desirability bias. Second, patient participants completed the surveys before they left the emergency department; therefore, they might try to please their providers by reporting high satisfaction and high perceived providers competence rates. Third, the study was conducted in a

Conclusions

Triage interruptions are pervasive and result in most instances in increasing the time spent during triage. However, in our study, this has not been shown to affect patient satisfaction and patients’ perception of the quality of care. Moreover, we found that nurses demographics do not affect their response to triage interruptions.

The current study has clinical implications for practice; strategies to manage triage tasks should be implemented to decrease the effects of triage interruptions on

CRediT authorship contribution statement

Dania M. Abu-Alhaija: Conceptualization, Formal analysis, Investigation, Methodology, Resources, Validation, Visualization, Writing – review & editing. Kimberly D. Johnson: Conceptualization, Data curation, Formal analysis, Investigation, Methodology, Resources, Supervision, Validation, Visualization, Writing – review & editing.

Declaration of Competing Interest

The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.

Acknowledgement

Disclosure of Funding

This project was funded by a National Institute of Health (NIH) KL2 Mentored Career Development Award through the CCTST at the University of Cincinnati -Grant #5KL2TR001426 awarded to Dr. Kimberly D. Johnson

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