Strategies to improve the quality of nurse triage in emergency departments: A systematic review

IF 1.8 4区医学 Q2 NURSING

International Emergency Nursing Pub Date : 2025-06-17 DOI:10.1016/j.ienj.2025.101639

Simon Ouellet , Maria Cécilia Gallani , Guillaume Fontaine , Éric Mercier , Alexandra Lapierre , Fabian Severino , Céline Gélinas , Mélanie Bérubé

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引用次数: 0

Abstract

Aim

This systematic review aimed to assess the impact of implementation strategies for nursing triage on quality outcomes and to examine barriers and facilitators to their implementation in the emergency department (ED).

Data sources

Embase, PubMed, CINAHL, Cochrane Library, Web of Science, PsycINFO and ProQuest Dissertations & Theses.

Methods

This systematic review included quantitative and qualitative studies published from January 1990 to April 2024 that evaluated strategies to improve ED triage. Study quality was assessed with the Mixed Methods Appraisal Tool (MMAT). The benefits of the strategies were reported using descriptive statistics (quantitative studies) and themes and subthemes (qualitative studies). Barriers and facilitators were identified using the Behavior Change Wheel framework.

Result

Three main implementation strategy categories to improve the quality of nursing triage were identified: education (64%), technology (30%), and audit and feedback (6%). All strategies demonstrated short-term benefits, including increased triage accuracy and improved triage knowledge and skills. The most frequently reported barriers were workload and overcrowding, while facilitators included nurses’ experience, interprofessional collaboration, and a culture of continuous improvement.

Conclusion

Comprehensive approaches, including education, technology, and regular audits with feedback, are associated with improved triage quality outcomes. Continuous training, active nurse participation in tool development, and the use of validated audit tools are essential. These measures could ensure rigorous nursing triage in EDs and enhance care safety by optimizing patient prioritization as they enter healthcare systems. This review underscores the need for further research on implementation strategies to enhance effective and safe patient prioritization in the ED.

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提高急诊科护士分诊质量的策略：系统回顾

目的：本系统综述旨在评估护理分诊实施策略对质量结果的影响，并研究急诊部（ED）实施护理分诊的障碍和促进因素。数据来源：embase、PubMed、CINAHL、Cochrane Library、Web of Science、PsycINFO、ProQuest；论文。方法本系统综述纳入了1990年1月至2024年4月期间发表的定量和定性研究，评估了改善急诊科分诊的策略。采用混合方法评价工具（MMAT）评价研究质量。使用描述性统计（定量研究）和主题和分主题（定性研究）报告了这些战略的益处。使用行为改变轮框架确定障碍和促进因素。结果提高护理分诊质量的主要实施策略类别为：教育（64%）、技术（30%）和审计与反馈（6%）。所有策略都显示出短期效益，包括增加分诊准确性和改进分诊知识和技能。最常见的障碍是工作量和过度拥挤，而促进因素包括护士的经验、跨专业合作和持续改进的文化。结论综合治疗方法，包括教育、技术和定期审计反馈，可提高分诊质量。持续培训、护士积极参与工具开发和使用经过验证的审核工具是必不可少的。这些措施可以确保急诊科进行严格的护理分诊，并通过优化患者进入医疗保健系统时的优先级来提高护理安全性。本综述强调需要进一步研究实施策略，以提高急诊科有效和安全的患者优先级。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

International Emergency Nursing NURSING-

CiteScore

3.20

自引率

11.10%

发文量

期刊介绍： International Emergency Nursing is a peer-reviewed journal devoted to nurses and other professionals involved in emergency care. It aims to promote excellence through dissemination of high quality research findings, specialist knowledge and discussion of professional issues that reflect the diversity of this field. With an international readership and authorship, it provides a platform for practitioners worldwide to communicate and enhance the evidence-base of emergency care. The journal publishes a broad range of papers, from personal reflection to primary research findings, created by first-time through to reputable authors from a number of disciplines. It brings together research from practice, education, theory, and operational management, relevant to all levels of staff working in emergency care settings worldwide.