The effects of the Emergency Severity Index triage education via problem-based learning on the triage nurse's performance and the patient's length of stay in the Emergency Department

Problem-based learning (PBL) is an active educational strategy established on two bases, learner and problem. This study aimed to determine the effect of the Emergency Severity Index (ESI) triage education via PBL on the triage nurse's performance and the patients’ length of stay in the Emergency Department. In this interventional, the ESI-triage education was done via PBL for all 12 triage-nurses in the Besat Hospital. The tools were the observational time-recording checklist developed according to the Swailes et al. study and the ESI form. The validity of the tools was confirmed by experts. The observer reliability was defined by the inter-rater reliability. The Length of stay and ESI triage level of 72 patients before and 72 patients two weeks after intervention were recorded. Data was analyzed by t-test, Mann-Whitney and ANOVA with 95% confidence by the software SPSS-20. The majorities of the triage nurses were men (75%), with a bachelor’s degree (91.7%), mean age 31.5±5.51 and work experience 6.72±8.00 years. The ESI-triage education via PBL strategy significantly lead to the decrease in the "triage by the nurses” duration (P<0.001) and the nurses’ performance improvement (P<0.001). Following the intervention, the reduction in the length of the “patient’s entry to the triage starting by nurse” and the "door –to-doctor” duration phase for all patients were noticeable. Considering the positive influence of the ESI triage, PBL strategy is proposed to train other emergency personnel.