Evaluation of Nurse-Led Triage in the Emergency Department: A Retrospective Observational Study
Aim: To assess the quality of the Spanish Triage System performed by nurses according to the triage code assigned to each patient and to examine factors associated with the need for re-evaluation after completion of triage.Design: Retrospective longitudinal observational study.Methods: A retrospecti...
| Autores: | , , , , , , |
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| Formato: | artículo |
| Fecha de publicación: | 2026 |
| País: | España |
| Recursos: | Universidad de Castilla-La Mancha |
| Repositorio: | RUIdeRA. Repositorio Institucional de la UCLM |
| OAI Identifier: | oai:dnet:ruidera_____::d0fbd787dc6c082edfe4af007f40af8b |
| Acesso em linha: | https://doi.org/10.1111/jocn.70320Digital Object Identifier (DOI) https://onlinelibrary.wiley.com/doi/10.1111/jocn.70320 https://hdl.handle.net/10578/48305 |
| Access Level: | acceso abierto |
| Palavra-chave: | Emergency Nursing Triage |
| Resumo: | Aim: To assess the quality of the Spanish Triage System performed by nurses according to the triage code assigned to each patient and to examine factors associated with the need for re-evaluation after completion of triage.Design: Retrospective longitudinal observational study.Methods: A retrospective analysis was conducted of patients triaged in the emergency department between 2018 and 2023. Patients triaged by other healthcare professionals and those who did not receive a triage priority level were excluded.Results: 493,211 episodes were analysed. Most were low/intermediate acuity (Level IV 65.4%, Level III 23.9%; Level I 0.1%). Mean time-to-first physician record entry increased as acuity decreased (38 min Level I vs. 81 min Level V), yet recorded time-target compliance was lowest in Levels I–II (23.8% and 14.7%). Re-evaluation occurred more often in high-acuity levels and was independently associated with older age, male sex, lower oxygen saturation and longer emergency department length of stay; compared with Level I, Levels II–III and lower adjusted odds of re-evaluation.Conclusion: Nurse-led triage demonstrated coherent clinical and operational stratification; however, the lowest recorded time-target compliance in the sickest patients suggests a gap between immediate care and electronic documentation.Implications for the Profession and/or Patient Care: Streamline documentation workflows for high-acuity cases and use re-evaluation risk profiles to prioritize monitoring and escalation.Impact: Evidence on nurse-led Spanish Triage System performance and time-documentation quality is limited. Acuity and flow metrics showed expected gradients, but target-time compliance was lowest in Levels I–II; predictors of re-evaluation were also identified. Findings support emergency department nursing, quality improvement and potential benefits for patients attending emergency departments. |
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