Factors that influence the accuracy of triage nurses' judgement in emergency departments.
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.
Chen
Shu-Shin
SS
Nursing Department, Taoyuan Armed Forces General Hospital, Taipei, Taiwan.
Chen
Jih-Chang
JC
Ng
Chip-Jin
CJ
Chen
Ping-Ling
PL
Lee
Pi-Hsia
PH
Chang
Wen-Yin
WY
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