2.50
Hdl Handle:
http://hdl.handle.net/10755/162722
Type:
Presentation
Title:
The Experiences of the Emergency Triage Nurse: A Phenomenological Study
Abstract:
The Experiences of the Emergency Triage Nurse: A Phenomenological Study
Conference Sponsor:Emergency Nurses Association
Conference Year:2007
Author:Dello Stritto, Rita, RN, PhD, CNS, ENP
P.I. Institution Name:Texas Woman's University - College of Nursing
Title:Assistant Professor
Contact Address:6700 Fannin Street, Houston, TX, 77064, USA
Contact Telephone:(713) 794-2803
Purpose: Accurate assessment and rapid decision making comprise two key functions of the emergency department (ED) triage nurse, one of the most vital jobs in the unit. Initial triage decisions influence appropriateness of care and overall ED efficiency, yet few studies have examined the day-to-day functions of this role. The purpose of this study is to describe the phenomenological experiences of emergency triage nurses and the mediating factors they employ to make decisions about patient care.

Design: This study is based on the phenomenological philosophy of Merleau-Ponty.

Setting: Rural, urban, and inner-city hospitals in southeast Texas.

Participants: Ten triage nurses: 3 men and 7 women, ages 28 - 49 years, with 5 - 21 years of nursing experience, and 1.2 - 21 years of triage experience (mean = 8.9 years). Two nurses worked in a rural setting, 2 in an urgent care department, 2 in a suburban setting, and 4 in an urban emergency department.

Methods: Triage nurses gave informed consent before participating in a 1-hour, semi-structured, audio-taped interview. The interview consisted of 12 open-ended and several probative questions to elicit specific information about the triage experience. Interviews were transcribed verbatim, and accuracy ensured by reading the transcript against the audio-tapes numerous times. Transcripts were read and re-read by the investigator, who noted key aspects of the reported experience, comparing each transcript to the others to determine experiential similarities and differences.

Results: Respondents distinguished between "rituals of getting started," such as cleaning and organizing the work space and reviewing and prioritizing the list of patients waiting to be triaged or medically evaluated, from the triage process itself. Nurses uniformly defined the triage function as consisting of two major processes: "patient assessment" and ôdetermination of priority of care." Nurses overwhelming said they triaged patients based on signs and symptoms and potential medical diagnoses, rather than nursing diagnoses, to better communicate evaluations to other health care providers. Negative influences or "stressors" driving the decision-making process were high patient volume/overcrowding and fear of making an error. The greater the patient volume, the greater the fear of sending an acutely ill patient to the waiting room, since there was less time for assessment and decision making. "Intuition," or ôhaving a gut feeling about the patient's acuity," positively affected triage decisions and was identified as an important decision-making tool. All nurses described a situation in which they knew something was wrong with the patient, but could not explain how they knew it. Nurses with the most triage experience were more "in tune" with their intuition and said new triage nurses should develop and listen to their "gut feelings." Other functions described included "serving as gatekeeper," or keeping order and control over the ED, and because of the nurse's high visibility and access, functioning as the patient's "complaint department."

Recommendations: The extent to which triage nurses control the flow of ED patients and information determines the ease with which they make accurate patient assessments and triage decisions. Because this role is stressful, ED management must create environments that facilitate the triage nurse's job and that helps nurses develop decision making skills that result in more efficient patient care.
Repository Posting Date:
27-Oct-2011
Date of Publication:
17-Oct-2011
Sponsors:
Emergency Nurses Association

Full metadata record

DC FieldValue Language
dc.typePresentationen_GB
dc.titleThe Experiences of the Emergency Triage Nurse: A Phenomenological Studyen_GB
dc.identifier.urihttp://hdl.handle.net/10755/162722-
dc.description.abstract<table><tr><td colspan="2" class="item-title">The Experiences of the Emergency Triage Nurse: A Phenomenological Study</td></tr><tr class="item-sponsor"><td class="label">Conference Sponsor:</td><td class="value">Emergency Nurses Association</td></tr><tr class="item-year"><td class="label">Conference Year:</td><td class="value">2007</td></tr><tr class="item-author"><td class="label">Author:</td><td class="value">Dello Stritto, Rita, RN, PhD, CNS, ENP</td></tr><tr class="item-institute"><td class="label">P.I. Institution Name:</td><td class="value">Texas Woman's University - College of Nursing</td></tr><tr class="item-author-title"><td class="label">Title:</td><td class="value">Assistant Professor</td></tr><tr class="item-address"><td class="label">Contact Address:</td><td class="value">6700 Fannin Street, Houston, TX, 77064, USA</td></tr><tr class="item-phone"><td class="label">Contact Telephone:</td><td class="value">(713) 794-2803</td></tr><tr class="item-email"><td class="label">Email:</td><td class="value">rdellostritto@mail.twu.edu</td></tr><tr><td colspan="2" class="item-abstract">Purpose: Accurate assessment and rapid decision making comprise two key functions of the emergency department (ED) triage nurse, one of the most vital jobs in the unit. Initial triage decisions influence appropriateness of care and overall ED efficiency, yet few studies have examined the day-to-day functions of this role. The purpose of this study is to describe the phenomenological experiences of emergency triage nurses and the mediating factors they employ to make decisions about patient care.<br/><br/>Design: This study is based on the phenomenological philosophy of Merleau-Ponty.<br/><br/>Setting: Rural, urban, and inner-city hospitals in southeast Texas. <br/><br/>Participants: Ten triage nurses: 3 men and 7 women, ages 28 - 49 years, with 5 - 21 years of nursing experience, and 1.2 - 21 years of triage experience (mean = 8.9 years). Two nurses worked in a rural setting, 2 in an urgent care department, 2 in a suburban setting, and 4 in an urban emergency department.<br/><br/>Methods: Triage nurses gave informed consent before participating in a 1-hour, semi-structured, audio-taped interview. The interview consisted of 12 open-ended and several probative questions to elicit specific information about the triage experience. Interviews were transcribed verbatim, and accuracy ensured by reading the transcript against the audio-tapes numerous times. Transcripts were read and re-read by the investigator, who noted key aspects of the reported experience, comparing each transcript to the others to determine experiential similarities and differences.<br/><br/>Results: Respondents distinguished between &quot;rituals of getting started,&quot; such as cleaning and organizing the work space and reviewing and prioritizing the list of patients waiting to be triaged or medically evaluated, from the triage process itself. Nurses uniformly defined the triage function as consisting of two major processes: &quot;patient assessment&quot; and &ocirc;determination of priority of care.&quot; Nurses overwhelming said they triaged patients based on signs and symptoms and potential medical diagnoses, rather than nursing diagnoses, to better communicate evaluations to other health care providers. Negative influences or &quot;stressors&quot; driving the decision-making process were high patient volume/overcrowding and fear of making an error. The greater the patient volume, the greater the fear of sending an acutely ill patient to the waiting room, since there was less time for assessment and decision making. &quot;Intuition,&quot; or &ocirc;having a gut feeling about the patient's acuity,&quot; positively affected triage decisions and was identified as an important decision-making tool. All nurses described a situation in which they knew something was wrong with the patient, but could not explain how they knew it. Nurses with the most triage experience were more &quot;in tune&quot; with their intuition and said new triage nurses should develop and listen to their &quot;gut feelings.&quot; Other functions described included &quot;serving as gatekeeper,&quot; or keeping order and control over the ED, and because of the nurse's high visibility and access, functioning as the patient's &quot;complaint department.&quot;<br/><br/>Recommendations: The extent to which triage nurses control the flow of ED patients and information determines the ease with which they make accurate patient assessments and triage decisions. Because this role is stressful, ED management must create environments that facilitate the triage nurse's job and that helps nurses develop decision making skills that result in more efficient patient care.</td></tr></table>en_GB
dc.date.available2011-10-27T10:33:03Z-
dc.date.issued2011-10-17en_GB
dc.date.accessioned2011-10-27T10:33:03Z-
dc.description.sponsorshipEmergency Nurses Associationen_GB
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