title: Improving Triage Accuracy: A Staff Development Approach.
abstract: OBJECTIVE
  The purpose of the process improvement initiative was to improve the percentage of undertriaged patients to less than 10% (benchmark) using the Emergency Severity Index tool. Undertriaged patients have an increased potential for poor outcomes due to a lengthier waiting room stay, which results in delay of care.
  
  
  METHODS
  An evidence-based project designed for staff development was conducted for a 7-month period. Project procedures consisted of triage chart reviews for a 3-month period during pre- and post-Emergency Severity Index training. Emergency Severity Index refresher training for nurses triaging in the emergency department was conducted for a 1-month period.
  
  
  RESULTS
  Chart reviews revealed that 102 of 388 patients (26.3%) were undertriaged before Emergency Severity Index training. After Emergency Severity Index training, chart reviews depicted that 41 of 440 patients (9.3%) were undertriaged. This difference was statically significant (P < .001), when tested using a 1-sided t test at the 95% confidence level and achieving at least 80% power.
  
  
  CONCLUSIONS
  Regardless of previous training or years of emergency department nursing experience, triage refresher training has been shown to increase accuracy of triage categorization, thus leading to a decreased risk of poor patient outcomes.
authors.affiliation: Author Affiliations: Assistant Department Head (Ms Brosinski) and Clinical Nurse Specialist (Ms Riddell), Naval Medical Center Portsmouth, Virginia; and Clinical Nurse Specialist (Mr Valdez), Naval Medical Center San Diego, California.
authors.forename: Carmen M
authors.initials: CM
authors.lastname: Brosinski
authors.forename: Autumn J
authors.initials: AJ
authors.lastname: Riddell
authors.forename: Sherwin
authors.initials: S
authors.lastname: Valdez
mesh_terms: D016529:Emergency Nursing; D006801:Humans; D015403:Nursing Evaluation Research; D015404:Nursing Methodology Research; D011785:Quality Assurance, Health Care; D013192:Staff Development / Q000379:methods*; D014218:Triage / Q000592:standards*