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 retrospec...
| Autores: | , , , , , , , , , |
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| Tipo de recurso: | artículo |
| Fecha de publicación: | 2026 |
| País: | España |
| Institución: | Universidad Autónoma de Madrid |
| Repositorio: | Biblos-e Archivo. Repositorio Institucional de la UAM |
| Idioma: | inglés |
| OAI Identifier: | oai:dnet:biblosearchi::e758d94a7bad1e7e677dba92218cfced |
| Acceso en línea: | https://hdl.handle.net/10486/760520 https://dx.doi.org/10.1111/jocn.70320 |
| Access Level: | acceso abierto |
| Palabra clave: | Enfermería |
| Sumario: | 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. Reporting Method: STROBE guidelines. Patient or Public Contribution: This study did not include patient or public involvement in its design, conduct or reporting |
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