title: Factors that influence the accuracy of triage nurses' judgement in emergency departments.
abstract: OBJECTIVE
  To gain an understanding of the accuracy of acuity assessment made by emergency department (ED) triage nurses, to compare the differences between the characteristics of triage nurses according to hospital variables and the accuracy of acuity ratings, and to explore the influence of nursing variables on the judgement of triages.
  
  
  METHODS
  A cross-sectional questionnaire survey was conducted at the EDs of hospitals in northern Taiwan. Ten adult emergency case scenarios and a demographic sheet with high validity were developed to survey 279 triage nurses. Data were collected from April to October 2006. All data were analysed using percentage, mean, SD, independent t test, one-way ANOVA and a stepwise logistic regression analysis.
  
  
  RESULTS
  The average score of rating accuracy was 5.62 points (out of a possible total of 10 points), which was considered low. Approximately 24.3% (n=68) of nurses' triage ratings were under-triaged and 19.7% (n=55) were over-triaged. Factors included years of ED experience, hours of triage education, level of hospital and triage mode of delivery. These factors were identified as significantly affecting the accuracy of nurses' judgement (p<0.05; adjusted R(2)=40.0%).
  
  
  CONCLUSIONS
  The scores of accuracy ratings for triage nurses can be improved if factors contributing to inaccuracy can be altered. The findings of this study can be used to guide improvements.
authors.affiliation: Nursing Department, Taoyuan Armed Forces General Hospital, Taipei, Taiwan.
authors.forename: Shu-Shin
authors.initials: SS
authors.lastname: Chen
authors.forename: Jih-Chang
authors.initials: JC
authors.lastname: Chen
authors.forename: Chip-Jin
authors.initials: CJ
authors.lastname: Ng
authors.forename: Ping-Ling
authors.initials: PL
authors.lastname: Chen
authors.forename: Pi-Hsia
authors.initials: PH
authors.lastname: Lee
authors.forename: Wen-Yin
authors.initials: WY
authors.lastname: Chang
mesh_terms: D000328:Adult; D002983:Clinical Competence; D016529:Emergency Nursing; D004636:Emergency Service, Hospital; D019538:Health Care Surveys; D006801:Humans; D007600:Judgment; D009730:Nursing Assessment; D009741:Nursing Staff, Hospital; D012044:Regression Analysis; D011795:Surveys and Questionnaires; D013624:Taiwan; D014218:Triage