Paper
Thursday, July 22, 2004
The Development and Testing of an Instrument to Measure Decision-Making in Emergency Department Triage Nurses
Kelly Jo Cone, RN, MS, PhD, Saint Francis College of Nursing, Peoria, IL, USA
| Learning Objective #1: Identify the steps in the development of an instrument that is a norm-referenced measure with a Lickert-type scale and the application of the instrument with triage nurses |
| Learning Objective #2: Describe and evaluate the role of the emergency department triage nurse and the effect of experience on the decision-making process |
Objective: An emergency department (ED) may be the initial entry site for health care and the triage nurse must assess the client’s complaints in a timely manner. Assessment requires the triage nurse to critically think and make accurate decisions promptly. The purpose of this study was to evaluate emergency triage nurses’ decision-making skills through the development of the Triage Decision-Making Inventory (TDMI) and to measure the experiential differences in decision making. Design: Quantitative and qualitative data were obtained through a nonexperimental, descriptive design to develop the TDMI, which is a norm-referenced measure with a summated score. Sample: The target population for this study was professional registered nurses who practiced triage in hospital ED’s located in the Midwest. The final phase of the study included a sample of 312 emergency nurses from ten different hospitals. Concepts/Variables: The primary concepts of this study included critical thinking and decision making of triage nurses in the ED. Methods: The researcher-developed TDMI and demographic forms were distributed and a total of 208 questionnaires (66%) were returned. Findings: The final phase was completed to estimate reliability (test-retest .77; internal consistency .95) and construct validity of the TDMI. The factor analysis yielded a final number of 38 items and four subscales: cognitive behaviors, experience and skill confidence, intuition, and critical thinking. A one-way analysis of variance demonstrated a statistically significant difference between the mean scores of each group based on years of experience (F=7.228, df=4,p<.001). Conclusions: The TDMI is a benefit to the nursing profession and society by providing an instrument to evaluate triage nurse’s ability to make accurate decisions, enhance the quality of care, and ultimately reduce healthcare costs. Implications: The TDMI allows the ED clinical nurse educator to evaluate the current triage nurse's as well as the beginner triage nurse’s ability to make life-saving decisions.
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Back to 15th International Nursing Research Congress
Sigma Theta Tau International
July 22-24, 2004