The development and testing of an instrument to measure decision making in emergency department triage nurses
Kelly J. Cone, PhD, MS, BSN, ADN, CNE
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An emergency department may be the initial entry site for health care for the critically ill client; the triage nurse is the frontline provider to prioritize care. Decision-making skills are important in the accurate direction of client care. To date, no published research was available about triage nurses' decision-making skills in the triage setting. The conceptual frameworks for this study were diagnostic reasoning and Benner's theory of novice to expert.
This three-phase study used a nonexperimental, descriptive design to develop and test the Triage Decision-Making Inventory (TDMI), to compare decision making by emergency nurses practicing triage, and to measure differences in decision making between beginner and expert emergency triage nurses. Phase I was completed to identify decision-making characteristics of expert triage emergency nurses and to develop the initial 140 items for the TDMI. Phase II estimated content validity of the TDMI and reduced the number of items through the estimation process. Phase III was completed to estimate reliability (test-retest .77; internal consistency .95), and construct validity of the TDMI. After a maximum likelihood extraction with oblimen rotation was completed to reduce the number of items, a four-factor solution emerged that explained 50% of the variance. The factor analysis yielded four subscales: cognitive behaviors, experience and skill confidence, intuition, and critical thinking. Phase In also examined differences in decision making between beginner and expert triage emergency nurses. The expert nurse scored significantly higher on the TDMI than the beginner (t = −2.180, df = 181, p < .05). </p>
The TDMI was found to be statistically adequate. The TDMI will be a benefit to the nursing profession and society by providing an instrument to evaluate a triage nurses' ability to make accurate decisions, enhance the quality of care, and ultimately reduce healthcare costs.
This dissertation has also been disseminated through the ProQuest Dissertations and Theses database. Dissertation/thesis number: 3000661; ProQuest document ID: 230759761. The author still retains copyright.
This item has not gone through this repository's peer-review process, but has been accepted by the indicated university or college in partial fulfillment of the requirements for the specified degree.
|Review Type||None: Degree-based Submission|
|Research Approach||Qualitative Research|
|Keywords||Emergency Department Nurses;
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