title: Emergency department triage performance timing. A regional multicenter descriptive study in Italy.
abstract: OBJECTIVE
  We explored the time employed by nurses to perform the ED triage process in the clinical setting. Moreover, we assessed the influences on triage timing performance exerted by variables related to nurses, local EDs' features, and by interruptions.
  
  
  METHODS
  This is a multicenter prospective descriptive-explorative study performed in 11 EDs of the Tuscany region (Italy), using a 5 tier triage system. The sample was made up of 1/3 of nurses working in each ED. Sampling was performed by a stratified proportional randomization (length of service classes: <5 years; 5-10 years; >10 years). Triage nurses were observed during their triage work-shift.
  
  
  RESULTS
  In 2014, 120 nurses were observed, during 1114 triage processes. The timings of triage phases were: waiting time to triage, median 2.55 min (IQR 1.28-5.03 min; range 0.1-56.25 min); triage duration, median 2.58 min (IQR 1.36-4.35 min; range 0.07-50 min). 400 interruptions were recorded (35.9%). In 9.9% there were 2 interruptions at least. There were significant differences in the medians of triage duration among the years of nurses' triage experience (P < 0.001). The presence of interruption was significantly associated with the increasing of the time intervals in all the triage phases (P < 0.0001). Finally, we recorded significant differences in all the triage time phases between the EDs.
  
  
  CONCLUSIONS
  We found that the nurses triage time performances are similar to other triage systems in the world.
authors.affiliation: Emergency and Trauma Intensive Care Unit, Azienda Ospedaliero Universitaria Careggi, Largo Brambilla 3, 50134 Florence, Italy. Electronic address: stebam@hotmail.it.
authors.forename: Stefano
authors.initials: S
authors.lastname: Bambi
authors.affiliation: Emergency Department, Azienda Ospedaliero Universitaria Careggi, Largo Brambilla 3, 50134 Florence, Italy.
authors.forename: Marco
authors.initials: M
authors.lastname: Ruggeri
authors.affiliation: Intensive Care Unit, Azienda Ospedaliera di Perugia, Piazzale Menghini, 1 - 06156 Sant'Andrea delle Fratte, Perugia, Italy.
authors.forename: Sandra
authors.initials: S
authors.lastname: Sansolino
authors.affiliation: Emergency Department, Ospedale Santa Maria Nuova, ASF, piazza Santa Maria Nuova n.1 50122, Florence, Italy.
authors.forename: Massimo
authors.initials: M
authors.lastname: Gabellieri
authors.affiliation: Emergency Department, Stabilimento Ospedaliero Nottola - AUSL 7 di Siena, piazzale Rosselli, 26 - 53100, Siena, Italy.
authors.forename: Sabrina
authors.initials: S
authors.lastname: Tellini
authors.affiliation: Emergency Department, Ospedale Santa Maria Annunziata, ASF, Ponte a Niccheri, 58, Via dell'Antella, 50012 - Bagno a Ripoli, Florence, Italy.
authors.forename: Monica
authors.initials: M
authors.lastname: Giusti
authors.affiliation: Emergency Department, Ospedale Santa Maria Annunziata, ASF, Ponte a Niccheri, 58, Via dell'Antella, 50012 - Bagno a Ripoli, Florence, Italy.
authors.forename: Elisa
authors.initials: E
authors.lastname: Ciulli
authors.affiliation: Emergency Department, Ospedale Unico della Versilia, USL 12 Viareggio, via Aurelia sud 312 55041 - Lido di Camaiore, Lucca, Italy.
authors.forename: Federica
authors.initials: F
authors.lastname: Franchi
authors.affiliation: Emergency Department, Ospedale della Misericordia, ASL 9 Via Cimabue 152, 58100 Grosseto, Italy.
authors.forename: Laura
authors.initials: L
authors.lastname: Petrocchi
authors.affiliation: Emergency Department, Azienda Universitaria Ospedaliera Senese Le Scotte, viale Bracci 14, 53100 Siena, Italy.
authors.forename: Mauro
authors.initials: M
authors.lastname: Olivi
authors.affiliation: Emergency Department, Presidio Ospedaliero S. Luca, AUSL 2 Lucca, Via Guglielmo Lippi Francesconi, 55100 Lucca, Italy.
authors.forename: Raffaele Carlo
authors.initials: RC
authors.lastname: Gravili
authors.affiliation: Emergency Department, Presidio Ospedaliero S. Luca, AUSL 2 Lucca, Via Guglielmo Lippi Francesconi, 55100 Lucca, Italy.
authors.forename: Paola
authors.initials: P
authors.lastname: Biancalana
authors.affiliation: Emergency Department, Ospedale San Jacopo, AUSL 3 di Pistoia, via Ciliegiole 97, 51100 Pistoia, Italy.
authors.forename: Andrea
authors.initials: A
authors.lastname: Millanti
authors.affiliation: Emergency Department, Alta Valdelsa, AUSL 7 Poggibonsi, Siena, 53036 Siena, Italy.
authors.forename: Luca
authors.initials: L
authors.lastname: Martini
authors.affiliation: Emergency Department, Ospedale Nuovo del Mugello, ASF, Viale Resistenza, 60 - 50032 Borgo San Lorenzo, Florence, Italy.
authors.forename: Paola
authors.initials: P
authors.lastname: Sgrevi
mesh_terms: D000328:Adult; D004636:Emergency Service, Hospital / Q000458:organization & administration / Q000592:standards*; D006801:Humans; D007558:Italy; D007902:Length of Stay / Q000706:statistics & numerical data; D008875:Middle Aged; D009726:Nurses / Q000592:standards; D011446:Prospective Studies; D061665:Time-to-Treatment / Q000592:standards* / Q000706:statistics & numerical data; D014218:Triage / Q000592:standards* / Q000706:statistics & numerical data
keywords: Emergency department; Nurses; Performance; Standard; Timing; Triage