The authors of a new triage training program for Australian hospital emergency departments have found low levels of agreement among nurses on how to assess risk in pregnant women, children and people with mental illness.

In response to these findings Dr Marie Gerdtz, from the University of Melbourne’s School of Nursing, and the Australian Commonwealth Department of Health and Ageing have led the development of the new training kit which is now being rolled out through Australian emergency departments.

“Triage is an incredibly challenging role for nurses, who need to possess a great deal of skill and sound decision making ability,” Dr Gerdtz says. “However, our research shows us that we need to provide nurses with more structured and detailed advice about how to perform assessments on particular patient groups.”

As part of her research to develop the kit, Dr Gerdtz surveyed a panel of 42 expert triage nurses working in different emergency departments around Australia.

The nurses were required to make urgency assessments on more than 200 patient presentations commonly encountered in Australian emergency departments including pregnant women, children and people with mental health related problems.

She found:

• Almost half of the nurses (47.6 per cent) did not agree on the level of urgency for scenarios involving pregnant women;
• Almost half (47.5 per cent) did not agree on the level of urgency for scenarios involving mental illness;
• Almost a third (32 per cent) did not agree on the level of urgency for children presenting in emergency departments.

“Our analysis showed a less consistent approach among nurses when assessing urgency for people who are pregnant, under the age of 18 or have a mental health problem, when compared to other common emergency department presentations.” Dr Gerdtz says.

As a result of the research, more than 1500 copies of the Emergency Triage Education Kit, funded by the Australian Commonwealth Department of Health and Ageing, are currently being distributed to hospitals across Australia.

Dr Gerdtz says the Emergency Triage Education Kit is an important step in providing more consistent advice for all triage nurses working in emergency departments.

“The kit will help nurses take a more consistent approach to assessing risk in patients.

“A consistent approach will ensure that all people who come to an Australian emergency department will receive a level of care that is commensurate with their clinical condition.”