Skip to main content
PMC home page
The BMJ logoLink to The BMJ
. 1992 Apr 4;304(6831):876–878. doi: 10.1136/bmj.304.6831.876

Evaluation of nurse triage in a British accident and emergency department.

S George 1, S Read 1, L Westlake 1, B Williams 1, A Fraser-Moodie 1, P Pritty 1
PMCID: PMC1882804  PMID: 1472254

Abstract

OBJECTIVE--To compare formal nurse triage with an informal prioritisation process for waiting times and patient satisfaction. SETTING--Accident and emergency department of a district general hospital in the midlands in 1990. DESIGN--Patients attending between 8:00 am and 9:00 pm over six weeks were grouped for analysis according to whether triage was operating at time of presentation and by their degree of urgency as assessed retrospectively by an accident and emergency consultant. PATIENTS--5954 patients presenting over six weeks. MAIN OUTCOME MEASURES--Time waited between first attendance in the department and obtaining medical attention, and patient satisfaction measured by questionnaire. RESULTS--Complete data on waiting time were collected on 5037 patients (85%). Only 1213 of the 2515 (48%) patients presenting during the triage period were seen by a triage nurse. Patients in the triage group waited longer than those in the no triage group in all four retrospective priority categories, though differences were significant for only the two most urgent categories (difference in median waiting time 10.5 (95% confidence interval 3.5 to 14) min for category 1 and 8.5 (3 to 12) min for category 2). Responses to the patient satisfaction questionnaire were similar in the two groups except for the question relating to anxiety relating to pain. CONCLUSIONS--This study fails to show the benefits claimed for formal nurse triage. Nurse triage may impose additional delay for patient treatment, particularly among patients needing the most urgent attention.

Full text

PDF
876

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Bailey A., Hallam K., Hurst K. Nursing practice. Triage on trial. Nurs Times. 1987 Nov 4;83(44):65–66. [PubMed] [Google Scholar]
  2. Buckles E. Evaluation of patient satisfaction in A&E. 1990 Jan 31-Feb 6Nurs Stand. 4(19):33–35. doi: 10.7748/ns.4.19.33.s40. [DOI] [PubMed] [Google Scholar]
  3. De Angelis C., McHugh M. The effectiveness of various health personnel as triage agents. J Community Health. 1977 Summer;2(4):268–277. doi: 10.1007/BF01325148. [DOI] [PubMed] [Google Scholar]
  4. Estrada E. G. Triage systems. Nurs Clin North Am. 1981 Mar;16(1):13–24. [PubMed] [Google Scholar]
  5. Grose A. Triage in accident and emergency. Prof Nurse. 1988 Jul;3(10):400–402. [PubMed] [Google Scholar]
  6. Lebow J. L. Consumer assessments of the quality of medical care. Med Care. 1974 Apr;12(4):328–337. doi: 10.1097/00005650-197404000-00004. [DOI] [PubMed] [Google Scholar]
  7. Locker D., Dunt D. Theoretical and methodological issues in sociological studies of consumer satisfaction with medical care. Soc Sci Med. 1978 Jul;12(4A):283–292. [PubMed] [Google Scholar]
  8. Mallett J., Woolwich C. Triage in accident and emergency departments. J Adv Nurs. 1990 Dec;15(12):1443–1451. doi: 10.1111/j.1365-2648.1990.tb01787.x. [DOI] [PubMed] [Google Scholar]
  9. McMillan J. R., Younger M. S., DeWine L. C. Satisfaction with hospital emergency department as a function of patient triage. Health Care Manage Rev. 1986 Summer;11(3):21–27. doi: 10.1097/00004010-198601130-00006. [DOI] [PubMed] [Google Scholar]
  10. Mills J., Webster A. L., Wofsy C. B., Harding P., D'Acuti D. Effectiveness of nurse triage in the emergency department of an urban county hospital. JACEP. 1976 Nov;5(11):877–882. doi: 10.1016/s0361-1124(76)80034-2. [DOI] [PubMed] [Google Scholar]
  11. Milner P. C., Nicholl J. P., Williams B. T. Variation in demand for accident and emergency departments in England from 1974 to 1985. J Epidemiol Community Health. 1988 Sep;42(3):274–278. doi: 10.1136/jech.42.3.274. [DOI] [PMC free article] [PubMed] [Google Scholar]
  12. Nuttall M. Accident and Emergency. The chaos controller. Nurs Times. 1986 May 14;82(20):66–68. [PubMed] [Google Scholar]
  13. Shields J. E. Making triage work: the experience of an urban emergency department. J Emerg Nurs. 1976 Jul-Aug;2(4):37–41. [PubMed] [Google Scholar]
  14. Slater R. R. Triage nurse in the emergency department. Am J Nurs. 1970 Jan;70(1):127–129. [PubMed] [Google Scholar]
  15. Ware J. E., Jr Effects of acquiescent response set on patient satisfaction ratings. Med Care. 1978 Apr;16(4):327–336. doi: 10.1097/00005650-197804000-00005. [DOI] [PubMed] [Google Scholar]
  16. Wright B. Hostility in accident and emergency departments. Nurs Mirror. 1985 Oct 2;161(14):42–44. [PubMed] [Google Scholar]

Articles from BMJ : British Medical Journal are provided here courtesy of BMJ Publishing Group

RESOURCES