Comparing the Accuracy of Triage by Nurses and Physiciansusing Emergency Severity Index and its Related Factors

The correct triage of patients based on the severity of their situation can reduce the crowding ofpatients in the emergency department and reduce complications and mortality among patients. One of the importanttools to check the accuracy of triage by nurses and physicians is the emergency severity index. This study wasconducted with the aim of determining the accuracy of triage by nurses and physicians, using Emergency SeverityIndex and factors related to it, in patients referring to trauma emergency unit in Zanjan, Iran.

Thisdescriptive cross-sectional study was conducted on 378 patients who referred to the emergency department of ateaching hospital in 2019. The data collection tool was a questionnaire that consisted of demographic informationand the Emergency Severity Index triage evaluation form. The data were analyzed using SPSS version 16 statisticalsoftware and chi-square/Fisher’s exact test, and analysis of variance test. A significance level of less than 0.05was considered.

The present study showed that nurses did 84.4% correct triage and physicians did 90.5%correct triage. Most errors were in the form of under-triage, the rate of which was 10.3% and 7.4% among nurses andphysicians, respectively. Nurses had 18.6% triage error cases and physicians had 9.5% triage error cases (P<0.05).There was a statistically significant difference in the accuracy of nurses’ triage based on their work experience,retraining period, and the patient’s waiting time before assignment (P<0.05). However, the accuracy of physicians’triage did not show a statistically significant difference based on the demographic characteristics of physicians andpatients (P>0.05).

In this study, under-triage was the most common triage error made by nurses andphysicians. Health care workers should know that under-triage can have irreparable consequences for patients.Therefore, it is recommended to periodically hold trainings to update the knowledge of health care professionalsregarding triage.