Accuracy of triage nurses in predicting patient disposition

Holdgate, A; Morris, J; Fry, M; Zecevic, M

Accuracy of triage nurses in predicting patient disposition

Holdgate, A Morris, J Fry, M

Zecevic, M

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Publication Type:: Journal Article
Citation:: EMA - Emergency Medicine Australasia, 2007, 19 (4), pp. 341 - 345
Issue Date:: 2007-08-01

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Field	Value	Language
dc.contributor.author	Holdgate, A	en_US
dc.contributor.author	Morris, J	en_US
dc.contributor.author	Fry, M https://orcid.org/0000-0003-1265-7096	en_US
dc.contributor.author	Zecevic, M	en_US
dc.date.issued	2007-08-01	en_US
dc.identifier.citation	EMA - Emergency Medicine Australasia, 2007, 19 (4), pp. 341 - 345	en_US
dc.identifier.issn	1742-6731	en_US
dc.identifier.uri	http://hdl.handle.net/10453/4363
dc.description.abstract	Objective: Increasing demand to reduce patient waiting times and improve patient flow has led to the introduction of a number of strategies such as fast track and patient streaming. The triage nurse is primarily responsible for identifying suitable patients, based on prediction of likely admission or discharge. The aim of the present study was to explore the accuracy with which triage nurses predict patient disposition. Methods: Over two separate 1-week periods, triage nurses at two urban tertiary hospitals electronically recorded in real time whether they thought each patient would be admitted or discharged. The patient's ultimate disposition (admission or discharge), age, sex, diagnostic group, triage category and time of arrival were also recorded. Results: In total, 1342 patients were included in the study, of which 36.0% were subsequently admitted. Overall, the triage nurse correctly predicted the disposition in 75.7% of patients (95% CI: 73.2-78.0). Nurses were more accurate at predicting discharge than admission (83.3% vs 65.1%, P = 0.04). Triage nurses were most accurate at predicting admission in patients with higher triage categories and most accurate at predicting discharge in patients with injuries and febrile illnesses (89.6%, 95% CI: 85.6-92.6). Predicted discharge was least accurate for patients with cardiovascular disease, with 41.1% (95% CI: 26.4-57.8) of predicted discharges in this category subsequently requiring admission. Conclusion: Triage nurses can accurately predict likely discharge in specific subgroups of ED patients. This supports the role of triage nurses in appropriately identifying patients suitable for 'fast track' or streaming. © 2007 The Authors.	en_US
dc.relation.ispartof	EMA - Emergency Medicine Australasia	en_US
dc.relation.isbasedon	10.1111/j.1742-6723.2007.00996.x	en_US
dc.subject.classification	Emergency & Critical Care Medicine	en_US
dc.subject.mesh	Humans	en_US
dc.subject.mesh	Patient Admission	en_US
dc.subject.mesh	Patient Discharge	en_US
dc.subject.mesh	Prospective Studies	en_US
dc.subject.mesh	Time Factors	en_US
dc.subject.mesh	Clinical Competence	en_US
dc.subject.mesh	Adult	en_US
dc.subject.mesh	Child	en_US
dc.subject.mesh	Emergency Service, Hospital	en_US
dc.subject.mesh	Triage	en_US
dc.subject.mesh	Efficiency, Organizational	en_US
dc.subject.mesh	Nursing Assessment	en_US
dc.subject.mesh	New South Wales	en_US
dc.subject.mesh	Female	en_US
dc.subject.mesh	Male	en_US
dc.title	Accuracy of triage nurses in predicting patient disposition	en_US
dc.type	Journal Article
utslib.citation.volume	4	en_US
utslib.citation.volume	19	en_US
utslib.for	1103 Clinical Sciences	en_US
utslib.for	1117 Public Health and Health Services	en_US
pubs.embargo.period	Not known	en_US
pubs.organisational-group	/University of Technology Sydney
pubs.organisational-group	/University of Technology Sydney/Faculty of Health
pubs.organisational-group	/University of Technology Sydney/Faculty of Health/Nursing
pubs.organisational-group	/University of Technology Sydney/Strength - CHSP - Health Services and Practice
utslib.copyright.status	closed_access
pubs.issue	4	en_US
pubs.publication-status	Published	en_US
pubs.volume	19	en_US

Abstract:

Objective: Increasing demand to reduce patient waiting times and improve patient flow has led to the introduction of a number of strategies such as fast track and patient streaming. The triage nurse is primarily responsible for identifying suitable patients, based on prediction of likely admission or discharge. The aim of the present study was to explore the accuracy with which triage nurses predict patient disposition. Methods: Over two separate 1-week periods, triage nurses at two urban tertiary hospitals electronically recorded in real time whether they thought each patient would be admitted or discharged. The patient's ultimate disposition (admission or discharge), age, sex, diagnostic group, triage category and time of arrival were also recorded. Results: In total, 1342 patients were included in the study, of which 36.0% were subsequently admitted. Overall, the triage nurse correctly predicted the disposition in 75.7% of patients (95% CI: 73.2-78.0). Nurses were more accurate at predicting discharge than admission (83.3% vs 65.1%, P = 0.04). Triage nurses were most accurate at predicting admission in patients with higher triage categories and most accurate at predicting discharge in patients with injuries and febrile illnesses (89.6%, 95% CI: 85.6-92.6). Predicted discharge was least accurate for patients with cardiovascular disease, with 41.1% (95% CI: 26.4-57.8) of predicted discharges in this category subsequently requiring admission. Conclusion: Triage nurses can accurately predict likely discharge in specific subgroups of ED patients. This supports the role of triage nurses in appropriately identifying patients suitable for 'fast track' or streaming. © 2007 The Authors.

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http://hdl.handle.net/10453/4363