Triage training program for a large emergency department

Abstract

Registered nurses (RNs) in an acute care trauma emergency center (TEC) of a regional health system were leaving the department in staggering numbers. Informal leaders in the TEC verbalized frustration working with novice nurses in triage compared to working with experienced emergency nurses. Novice nurses felt unequipped and underprepared to effectively triage more acute patients due to lack of experience and mentoring. Emergency department (ED) triage is instrumental in ensuring high quality, timely care. It is a process through which patients are registered, the chief complaint is obtained, and patients are seen according to the highest nurse-assigned treatment priority. In the TEC, novice nurses with 4 months experience were assigned an online learning module and started shifts in the triage area by 6 months. These nurses do not receive trauma and high acuity training until after 1 year of experience. Experienced TEC nurses complained that patients were sometimes assigned inappropriate triage acuity scores by novice nurses. The Emergency Nurse Association (ENA) recommends a minimum of 1 year of emergency nursing experience, as well as appropriate credentials and education, before assuming responsibility for triage assessment.