Understanding triage assessment of acuity by emergency nurses at initial
adult patient presentation: A qualitative systematic review
Dublin Core
Title
Understanding triage assessment of acuity by emergency nurses at initial
adult patient presentation: A qualitative systematic review
adult patient presentation: A qualitative systematic review
Subject
Keywords:
Triage
Nurses
Emergency service
Hospital
Decision making
Triage
Nurses
Emergency service
Hospital
Decision making
Description
Background: Nurses make complex triage decisions within emergency departments, which significantly affect
patient outcomes. Understanding how nurses make these decisions and why they deviate from triage algorithms
facilitates interventions that work with their decision-making processes, increasing acceptability and
effectiveness.
Aims: This qualitative systematic review aimed to understand decision-making processes emergency nurses use to
make acuity decisions during triage assessment at initial patient presentation.
Methodology: Medline, CINAHL and Academic Search Complete were systematically searched to 15th December
2022. Data were analysed using thematic synthesis. Established themes were reviewed with GRADE-CERQual to
evaluate certainty of evidence.
Results: 28 studies were included in the review. Data analysis uncovered three superordinate themes of holistic
reasoning, situational awareness, and informed decision-making. The findings show nurses value holistic assessments over algorithms and rely on knowledge and experience. They also assess the wider situation in the
emergency department.
Conclusions: This review presents new perspectives on nurses’ decision-making processes about patient’s acuity.
Nurses holistically gather information about patients before translating that information into acuity scores. These
actions are informed by their knowledge and experience; however, the wider situation also impacts their decisions. In turn, the nurses use interpretations of patients’ acuity to control the wider situation.
patient outcomes. Understanding how nurses make these decisions and why they deviate from triage algorithms
facilitates interventions that work with their decision-making processes, increasing acceptability and
effectiveness.
Aims: This qualitative systematic review aimed to understand decision-making processes emergency nurses use to
make acuity decisions during triage assessment at initial patient presentation.
Methodology: Medline, CINAHL and Academic Search Complete were systematically searched to 15th December
2022. Data were analysed using thematic synthesis. Established themes were reviewed with GRADE-CERQual to
evaluate certainty of evidence.
Results: 28 studies were included in the review. Data analysis uncovered three superordinate themes of holistic
reasoning, situational awareness, and informed decision-making. The findings show nurses value holistic assessments over algorithms and rely on knowledge and experience. They also assess the wider situation in the
emergency department.
Conclusions: This review presents new perspectives on nurses’ decision-making processes about patient’s acuity.
Nurses holistically gather information about patients before translating that information into acuity scores. These
actions are informed by their knowledge and experience; however, the wider situation also impacts their decisions. In turn, the nurses use interpretations of patients’ acuity to control the wider situation.
Creator
Hugh Gorick a,b,*
, Marie McGee a
, Gemma Wilson b
, Emma Williams b
, Jaimik Patel b
,
Anna Zonato b
, Wilfred Ayodele b
, Sabina Shams b
, Luca Di Battista b
, Toby O. Smith a,b,c
, Marie McGee a
, Gemma Wilson b
, Emma Williams b
, Jaimik Patel b
,
Anna Zonato b
, Wilfred Ayodele b
, Sabina Shams b
, Luca Di Battista b
, Toby O. Smith a,b,c
Source
https://pdf.sciencedirectassets.com/276922/1-s2.0-S1755599X23X00068/1-s2.0-S1755599X23000733/main.pdf?X-Amz-Security-Token=IQoJb3JpZ2luX2VjEJr%2F%2F%2F%2F%2F%2F%2F%2F%2F%2FwEaCXVzLWVhc3QtMSJIMEYCIQC8Al5rDGsI6PjZFedAzaSWfzmxNo7V%2F2doVfUzCuxgSgIhAKI2a7CUtAVjK6rw7Kar6RbWQGj%2BmXVipn%2FiUvAp2iPYKrsFCIP%2F%2F%2F%2F%2F%2F%2F%2F%2F%2FwEQBRoMMDU5MDAzNTQ2ODY1IgwZaddThwrx9kUvkdEqjwUZXoWtEJQILjhFY2zvpevgoFPOeXbBVbYl1aOOSY5RQwdWxtmlYyrDGm5W7TRXDc47oGURT6DZuoZAIRqPnbHrQS7UlmDhb4e%2FAArOU38Ub7GnqLUD2qP%2FdwlnWMcuK1t9AEZNLPE0aiM3YehXVaLsnVvhkUd%2BS0ucm8sb2wsbTlRbgfywRAk8Pb1QmBOyoTd9bO%2Ff4T7JLKTEQOThFPzGRXvp4kE0H8VvcgIpfAR4G1K8Igf88Q1cC4FHD4Wrbp71H67DIUFjbcekHq3eHxe4FnZBnLc2gfgvAbx5TytE5634GwY1AgupXcVFWeNv2thgX1vG%2BjIk8m4EVJu%2BXwRNWLMd1oNHJf3RT0hq6e7v0GMjCzS2Th9sNvaewTCtdCxZBD2Hk%2BEWGuiKRgxOBDJqU9ntohcEygSexxJ4AyUv4ZanKBKPDcxJm12FxxGmvODv%2FMX0oQfknQCraDtPBco25JapJcfFNHoTHQUcUk7hZP5533uRKpfSXGY4OkdpiCGw4g73o%2BtyjZPiszNzCpNYRhc3jDXySqjEVpqHPio7u5MoaeKYHExpyeSXeP2w9%2FiAfc9mLqU5rSHuQHNbuUnk87pbw%2FjeGck3Kz2Ytj4eBFZVXVv0UN%2FR8UgPrmxbEXqr9bdZgQ9ZeJUdJEr3%2FPNCA6li5VtnsHSk%2B2BGpOsMXgYAqazpFaxCzJIb1Sj7rhcoRlY8eGR32B5pwA8Cv6BEI27FOj5UmPFIvEitMFo8uVBUNfi5VNydYU9T7nvu%2Fs1pbWVnnv63xMkPcFGm45lHXyHZUQ8kRLxzFD4NbXEC%2BBU2ODLOuL%2FtB7SFg%2BWrXnQkJ0EZoK5H2bHjb88Z4AhRr0x8Qc681SsUJSJ9NPIWMKuyyMIGOrABdGhE1IXnxhgABz9BpzHVcXX5IydpKnwDMukFNdNE4Hr4iACqXeZVGu0Zs%2BLGkOZzV6JIMMn0HzZB5U9YpQP7arJ1S4A50HGDPdIDSc1bR%2Bib%2BSoICTzMnhsHglJOyZs7rlUJjSZ71zwPL0%2FyvPHAIQ%2BY8afi2XSdeXM9lnq%2Bl742RDUvmDJnLD3u2pUnBiRvBV%2FIDiQYILoXlb1h%2FTHEq%2B2dDVEig%2BNplHR7dodxQMg%3D&X-Amz-Algorithm=AWS4-HMAC-SHA256&X-Amz-Date=20250618T022915Z&X-Amz-SignedHeaders=host&X-Amz-Expires=300&X-Amz-Credential=ASIAQ3PHCVTY4F6IUNJN%2F20250618%2Fus-east-1%2Fs3%2Faws4_request&X-Amz-Signature=86b59dde1316c7f9d846c7f68cfbb668f7ef02cdfe387e103996af1d1d54621e&hash=feb740f7b781ad111f0837c3385557143069e43dc327529d4fc55b4978412baa&host=68042c943591013ac2b2430a89b270f6af2c76d8dfd086a07176afe7c76c2c61&pii=S1755599X23000733&tid=spdf-2a2abd5f-9f69-4d39-b8b8-588290561d93&sid=14b8a1eb7498d34787591540b87a02ee8336gxrqb&type=client&tsoh=d3d3LnNjaWVuY2VkaXJlY3QuY29t&rh=d3d3LnNjaWVuY2VkaXJlY3QuY29t&ua=13025d5355575206035106&rr=95175ba1ee930557&cc=id
Publisher
a University of East Anglia, Norwich Research Park, Norwich NR4 7TJ, United Kingdom b Norfolk and Norwich University Hospitals, Colney Lane, Norwich NR4 7UY, United Kingdom c University of Warwick, Coventry CV4 7AL, United Kingdom
Date
12 juli 2023
Contributor
Fajar Bagus W
Format
PDF
Language
English
Type
Text
Citation
Hugh Gorick a,b,*
, Marie McGee a
, Gemma Wilson b
, Emma Williams b
, Jaimik Patel b
,
Anna Zonato b
, Wilfred Ayodele b
, Sabina Shams b
, Luca Di Battista b
, Toby O. Smith a,b,c, “Understanding triage assessment of acuity by emergency nurses at initial
adult patient presentation: A qualitative systematic review,” Repository Horizon University Indonesia, accessed June 18, 2025, https://repository.horizon.ac.id/items/show/9537.
adult patient presentation: A qualitative systematic review,” Repository Horizon University Indonesia, accessed June 18, 2025, https://repository.horizon.ac.id/items/show/9537.