Effects of Experience Level of the Nurse on Triage Accuracy

Saturday, 7 November 2015

April H. Ganz, MSN-Ed, RN, CEN
Department of Education, Memorial Hermann Southeast Hospital, Houston, TX, USA


Aims and objectives.  To explore the relationship between the length of clinical nursing experience and the accuracy of assigning triage acuity levels to provide a model for triage nurse preparation.

Background.  As many emergency centers across the nation struggle to fill staffing vacancies with experienced emergency nurses, professional dialogue is emerging about the length of clinical experience necessary to perform triage, a core competency of the emergency nursing professional.   Different belief systems about the development of competency have led to much disagreement in the professional nursing community.

Research methodology.  A retrospective, descriptive, quantitative design was employed in this research.  The setting was a level three trauma center with approximately 65,000 patient visits per year.  Twenty nurses were included in the participant sample and divided evenly into an experienced and an inexperienced group based on Benner’s Model of Clinical Competence.  The first strata of participants had six months to less than three years emergency nursing experience (Advanced Beginner-Competent) and the second strata had greater than three years emergency nursing experience (Proficient-Expert) on Benner’s model. The results from 200 chart reviews were included in the study.

Results.  Overall, a shorter clinical experience was not shown to inhibit a nurse’s ability to accurately assign triage levels. The inexperienced nurses (mean 1.8 years with SD=0.67) assigned the correct triage level 83% of the time; the experienced nurses (mean 10.9 years with SD=9.6) assigned the correct triage level 75% of the time. 

Conclusions.  Study findings indicated that experience level did not influence the nurse’s ability to triage accurately.  Data indicated that nurses with less experience (inexperienced group) who have received formal triage training, obtained emergency specific certifications, and demonstrated baseline competency in the clinical setting accurately assigned triage acuity levels 83% of the time.

Implications for clinical practice. The findings of the study offer valuable insights to nursing leaders.  Data suggested emergency centers may develop policies that allow newer nurses to triage without jeopardizing the quality of triage assessments.  Additionally, data indicated emergency center nursing leaders may shift emphasis from length of clinical experience to completion of appropriate training and preparation for the triage role in emergency nursing care.