title: Use routine chart reviews, training, and careful staffing decisions to root out under-triage in the ED.
abstract: Experts say under-triage is a serious problem in EDs across the country, and the issue has serious implications for patient outcomes. For example, patients who are deemed urgent but stable can deteriorate quickly if they are more ill than the triage nurse initially determined.This can lead to delays in needed care and worse outcomes or even death. One small study found that patients who were designated as Emergency Severity Index (ESI) level 3 were often under-triaged. Routine chart reviews can help ED nursing leaders determine whether under-triage is a problem, and which nurses may need added training in triage to improve their skills. Rather than rotating all emergency nurses through the triage role, ED leaders should carefully evaluate which nurses have the high-level skills needed to make accurate triage decisions.
mesh_terms: D004636:Emergency Service, Hospital / Q000592:standards*; D006801:Humans; D008485:Medical Audit; D010561:Personnel Staffing and Scheduling; D010564:Personnel, Hospital / Q000193:education*; D014218:Triage / Q000592:standards