B Edwards

Dr B Edwards, Bournemouth University, Bournemouth, UK; bedwards@bournemouth.ac.uk

QUESTION

How do nurses who perform triage in emergency departments (EDs) initially assess patients?

DESIGN

Qualitative study using the grounded theory approach.

SETTING

2 EDs in the UK.

PARTICIPANTS

Self-selected sample of 14 nurses who regularly did triage in the ED and had 3–20 years of experience in emergency care. Triage encounters involving patients who were confused, acutely ill, or distressed were excluded.

METHODS

Data were collected through 38 video recordings of triage encounters over 9 months. Nurses watched tapes of their own encounters; tapes were stopped after each of their comments or questions and they were asked to describe their thoughts at that time. Their thoughts were recorded, transcribed, and analysed using the constant comparative method.

MAIN FINDINGS

The main intervening condition during triage was nurses’ appraisal of client credibility. (1) Initial visualising and client credibility. Assessment began before the triage encounter, as soon as nurses saw patients, and was intuitive and subjective: “You do sort of make a mental, quick assessment of the patient as they …