Factors affecting triage competence among emergency room nurses: A cross‐sectional study

Abstract

Aims and Objectives:The purpose of this study was to examine work-related stress, nurse-physician collaboration and clinical reasoning competence to identify the factors that affected the triage competence of emergency room nurses.Background: A quick and accurate treatment plan for patients is first determined by a triage nurse. Triage competence is an indispensable requirement for emergency room nurses.Design: A cross-sectional design was adopted. Methods:The participants comprised 156 emergency room nurses in South Korea who had more than 1 year of experience working in an emergency room. The collected data were analysed using SPSS 28.0. Self-reported data were collected via the Korean Nursing Stress, Nurse-Physician Collaboration, Nurse Clinical Reasoning, Emergency Room Nurse Triage Competence assessing work-related stress, nursephysician collaboration, clinical reasoning competence and triage competence. In the analyses, multiple regression analysis using the enter method was conducted. We have followed through the STROBE checklist for the preparation of this manuscript.Results: Triage competence significantly differed according to the age (F = 9.93, p < .001), clinical experience (F = 18.82, p < .001), emergency department experience (F = 12.07, p < .001), triage experience (t = 4.40, p < .001) and if nurses had a triage certificate (t = 4.85, p < .001). The factors that influenced triage competence included clinical reasoning competence (β = .36, p < .001), emergency department experience (β = .21, p = .006), work-related stress (β = .18, p = .007) and nurse-physician collaboration (β = −.17, p = .009); these factors accounted for 38.1% of the variance in triage competence. Conclusion:The results of this study show that efforts to improve triage competence should be based on clinical reasoning. In addition, an effective plan should be devised to improve nurse-physician collaboration and work-related stress.

Sequential Mediation Effects of Organizational Support and Collaboration on Missed Nursing Care

“…45 This effect is further explained by the finding that nurse-physician collaboration is negatively correlated with nursing outcomes, such as triage competence and clinical reasoning competence, among nurses working in the emergency department. 44 Moreover, evidence in the literature supports a serial mediation effect of POS and nurse-nurse collaboration on the relationship between role overload and MNC (H 5 ). 19,[46][47][48] Nurses recognize that the lack of organizational support is an obstacle to successful teamwork in difficult situations with heavy responsibilities.…”

“…43 In addition, these findings of sequential mediation effects are supported by the empirical findings in prior studies, linear associations between organizational support, interprofessional collaboration or teamwork, and nursing outcomes. 25,28,44,45 Higher perceived support in the organizational context, such as authentic leadership and structural empowerment, results in a higher perceived level of interprofessional collaboration. 28 Consequently, interprofessional collaboration has partial indirect effects on the relationships between the nursing work environment and nursing outcomes, quality of care, and adverse events.…”

“…45 This effect is further explained by the finding that nurse-physician collaboration is negatively correlated with nursing outcomes, such as triage competence and clinical reasoning competence, among nurses working in the emergency department. 44…”

The effects of triage applying artificial intelligence on triage in the emergency department: A systematic review of prospective studies

“…When evaluating the performance of an AI model, it is important to compare it with a gold standard. Using the judgments of nurses and doctors as the gold standard for classi cation raises concerns that bias among raters may occur because the subjective opinion of the rater affects the classi cation result [22][23][24]. In this study, only one supplemented the vulnerability of the gold standard by adding the results of specialists, and all others were compared based on the judgment results of nurses and doctors, which may vary depending on the practitioner.…”

“…However, the manual input method for patient triage by nurses can be hindered by factors such as the pressure to deal with many patients, the chaotic environment within the emergency department, and the presence of waiting ambulances, which can disrupt the decision-making process [21]. It has been observed that nurses' capacity for triage, including their training, knowledge, clinical experience, and communication skills, can in uence its effectiveness [22,23]. Moreover, accurate assessment and triage are crucial for ensuring patient safety and saving lives.…”