Accuracy of nurses’ performance in triage using the emergency severity index and its relationship with clinical outcome measures

Submitted: 24 May 2022
Accepted: 2 December 2022
Published: 20 December 2022
Abstract Views: 1116
PDF: 387
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Emergency department (ED) triage in hospitals is part of their emergency structure carried out by nurses in emergency units. There have not been many studies available on nurses' performance in triage based on the emergency severity index (ESI). This present study aimed to investigate the nurses’ performance in triage with regard to the emergency severity index and its relation to clinical outcome measures in the emergency department. This was a cross-sectional study. The hospitalization record of 600 patients who arrived at the emergency department of Sanandaj Social Security Hospital was randomly assessed based on the accuracy of triage performed by nurses. The data analysis procedure was done by employing STATA software version 12, as well as Fisher's exact test, independent t-test, and one-way ANOVA. Findings of the study revealed that nurses’ overall performance in triage showed that 82.67% of nurses had perfect triage accuracy, 12.17% had low-level triage accuracy and 5.17% had high-level triage accuracy. There was an association between nurses' performance in triage with the disposition of patients (p=0.029) and length of stay (p=0.009). Results of the study highlighted the importance of theoretical and practical triage training courses for nurses and provided a foundation for identifying effective factors for decreasing the length of stay and disposition of patients in emergency care units.

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Esmailian M, Zamani M, Azadi F, Ghasemi F. Inter-rater agreement of emergency nurses and physicians in Emergency Severity Index (ESI) Triage. Emergency 2014;2:158.
Ghafarypour-Jahrom M, Taghizadeh M, Heidari K, Derakhshanfar H. Validity and reliability of the emergency severity index and Australasian triage system in pediatric emergency care of Mofid Children's Hospital in Iran. Bull Emerg Trauma 2018;6:329. DOI: https://doi.org/10.29252/beat-060410
Daemi A. The role of electronic triage system in management of hospital emergency department. Bull Emerg Trauma 2016;4:62.
Trinder MW, Wellman SW, Nasim S, Weber DG. Evaluation of the trauma triage accuracy in a Level 1 Australian trauma centre. Emerg Med Australasia 2018;30:699-704. DOI: https://doi.org/10.1111/1742-6723.13117
Hinson JS, Martinez DA, Cabral S, et al. Triage performance in emergency medicine: a systematic review. Ann Emerg Med 2019;74:140-52. DOI: https://doi.org/10.1016/j.annemergmed.2018.09.022
Barzanji A, Abdi K, Yaghobi M, et al. Triage room principles and recommendations for 2019 novel coronavirus. Adv Biomed Res 2021;10:24. DOI: https://doi.org/10.4103/abr.abr_127_20
Bazyar J, Farrokhi M, Khankeh H. Triage systems in mass casualty incidents and disasters: a review study with a worldwide approach. Open Access Macedonian J Med Sci 2019;7:482. DOI: https://doi.org/10.3889/oamjms.2019.119
Zachariasse JM, van der Hagen V, Seiger N, et al. Performance of triage systems in emergency care: a systematic review and meta-analysis. BMJ Open 2019;9:e026471. DOI: https://doi.org/10.1136/bmjopen-2018-026471
Safari S, Rahmati F, Baratloo A, et al. Hospital and pre-hospital triage systems in disaster and normal conditions; a review article. Iranian J Emerg Med 2015;2:2-10.
Zakeri H, Saleh LA, Niroumand S, Ziadi-Lotfabadi M. Comparison the emergency severity index and manchester triage system in trauma patients. Bull Emerg Trauma 2022;10:65.
Soni KD, Kaushik G, Gupta A, et al. From emergency department to intensive care unit, does the delay matter to trauma patients? J Emerg Trauma Shock 2018;11:189. DOI: https://doi.org/10.4103/JETS.JETS_132_17
Stohl S, Sprung CL, Lippert A, et al. Impact of triage-to-admission time on patient outcome in European intensive care units: a prospective, multi-national study. J Critical Care 2019;53:11-7. DOI: https://doi.org/10.1016/j.jcrc.2019.05.013
Moon S-H, Shim JL, Park K-S, Park C-S. Triage accuracy and causes of mistriage using the Korean Triage and Acuity Scale. PLoS One 2019;14:e0216972. DOI: https://doi.org/10.1371/journal.pone.0216972
Najafi Z, Abbaszadeh A, Zakeri H, Mirhaghi A. Determination of mis-triage in trauma patients: a systematic review. Eur J Trauma Emergency Surg 2019;45:821-39. DOI: https://doi.org/10.1007/s00068-019-01097-2
Ausserhofer D, Zaboli A, Pfeifer N, et al. Errors in nurse-led triage: An observational study. Int J Nursing Stud 2021;113:103788. DOI: https://doi.org/10.1016/j.ijnurstu.2020.103788
Lentz BA, Jenson A, Hinson JS, et al. Validity of ED: addressing heterogeneous definitions of over-triage and under-triage. Am Of Emerg Med 2017;35:1023-5. DOI: https://doi.org/10.1016/j.ajem.2017.02.012
Ebrahimi M, Mirhaghi A, Mazlom R, et al. The role descriptions of triage nurse in emergency department: a Delphi study. Scientifica. 2016;2016:5269815. DOI: https://doi.org/10.1155/2016/5269815
Javadi N, Rostamnia L, Raznahan R, Ghanbari V. Triage training in iran from 2010 to 2020: A systematic review on educational intervention studies. Iranian J Nursing Midwifery Res 2021;26:189. DOI: https://doi.org/10.4103/ijnmr.IJNMR_155_20
Mirhaghi A, Roudbari M. A survey of emergency department nurses on hospital triage. Iran J Crit Care Nurs 2010;3:165-70.
Javadi S, Salimi T, Sareban MT, Dehghani MA. Knowledge and Practice of Nurses Regarding Patients’ Triage in Emergency Department. Iranian J Emerg Med 2016;3:15-22.
Cherry RA, Bradburn E, Nichols PA, et al. Outcome assessment of blunt trauma patients who are undertriaged. Surgery 2010;148:239-45. DOI: https://doi.org/10.1016/j.surg.2010.05.004
Hinson JS, Martinez DA, Schmitz PS, et al. Accuracy of emergency department triage using the Emergency Severity Index and independent predictors of under-triage and over-triage in Brazil: a retrospective cohort analysis. Int J Emerg Med 2018;11:1-10. DOI: https://doi.org/10.1186/s12245-017-0161-8
Rehn M, Eken T, Krüger AJ, et al. Precision of field triage in patients brought to a trauma centre after introducing trauma team activation guidelines. Scandinavian J Trauma Resuscit Emerg Med 2009;17:1-10. DOI: https://doi.org/10.1186/1757-7241-17-1
Lehmann R, Brounts L, Lesperance K, et al. A simplified set of trauma triage criteria to safely reduce overtriage: a prospective study. Arch Surg 2009;144:853-8. DOI: https://doi.org/10.1001/archsurg.2009.153
Chen S-S, Chen J-C, Ng C-J, et al. Factors that influence the accuracy of triage nurses' judgement in emergency departments. Emerg Med J 2010;27:451-5. DOI: https://doi.org/10.1136/emj.2008.059311
Dadashzade A, Abdolahzade F, Lotfi M, Ghujazade M. The necessory experiences and educational activies for the role of triage in Tabriz emergency departments. J Caring Sci 2008;10:31-7.
Khatiban M, Khazaei A, Karampourian A, et al. The effects of the emergency severity index triage education via problem-based learning on the triage nurses ‘performance and the patients ‘length of stay in the emergency department. J Clin Res Paramed Sci 2014;3:63-74.
Rahmati F, Gholamalipoor H, Hashemi B, et al. The reasons of emergency department patients’ dissatisfaction. Iran J Emerg Med 2015;2:59-63.
Afshinjoo M, Moghadam M, Tourabi Ahmadi M. The relationship between causes and demographics of patients admitted to emergency departments of Zanjan University of Medical Sciences in the Zanjan city. Iranian J Emerg Care 2017;1:52-60.
Kamrani F, Ghaemipour F, Nikravan M, Alavi Majd H. Prevalence of miss triage and outcomes under triage of patients in emergency department. J Health Promot Manag 2013;2:17-23. DOI: https://doi.org/10.1016/j.aenj.2013.11.002
Tabibi SJ, Najafi B, Shoaie S. Waiting time in the emergency department in selected hospitals of Iran University of Medical Sciences in 2007. Pejouhesh dar Pezeshki (Research in Medicine) 2009;33:117-22.

How to Cite

Shabrandi, N., Bagheri-Saweh, M. I., Nouri, B., & Valiee, S. (2022). Accuracy of nurses’ performance in triage using the emergency severity index and its relationship with clinical outcome measures. Emergency Care Journal, 18(4). https://doi.org/10.4081/ecj.2022.10638