Nurses’ Evaluation of a New Formalized Triage System in the Emergency Department:A Qualitative Study

Introduction: Formalized triage in the emergency department (ED) is not widely used in Denmark; this study explores the effects of introducing a five-level process triage system in a Danish ED.Material and methods: Semi-structured qualitative interviews were conducted with 15 emergency nurses. The interviews were preceded by observations of the work of the ED nurses in which focus was on the triage process.Results: Formalized triage was experienced to improve the overview of patients and resources at the ED, and the nurses described that they felt more assured when prioritizing between patients. Communication and coordination were also improved by the triage system. But more time spent on documentation and re-evaluation may cause the nurses to feel professionally inadequate if adequate resources are not provided. Furthermore, the triage system has reduced the focus on the humanistic and psychosocial aspects of nursing. Difficulties were occasionally experienced when categorizing patients with diffuse symptoms according to the standardized triage symptoms and signs’ algorithms.Conclusion: Introducing a formalized triage system in the ED was experienced to give a better overview and more overall control of ED patients. Adequate resources are needed to ensure that a stronger focus on documentation and re-evaluation related to triage does not produce a feeling of professional inadequacy among the staff.