Amir Mirhaghi, PhD, MSN, RN is an assistant professor at the Mashhad University of Medical Sciences where he teaches in the graduate and post-graduate program. He has more than 10 years of experience as an emergency nurse. Dr. Mirhaghi's research interests include the triage and risk stratification in emergency department and prehospital emergency services to improve the quality and outcomes of care. Most recently her work has focused on culture of care among triage nurses.
Triage in the interactive atmosphere of the emergency department (ED) has been recognized as complex and dynamic. The triage role has also been described demanding for nurses. Prioritization needs solid decision making that creates a unique role requirement that is significantly different than other specialties in nursing. Gatekeeping role is also embedded in triage role as well as prioritization that make the role more challenging for many nurses. In addition, contextual factors such as patients, physicians, managers, facilities, organizational policies and clinical guidelines should be added to the current field. These factors consistently interact with each other and bring diverse experience resulting in belief system formation. The belief system guides clinical practice, so it`s critical to understand nurses` belief system and its relation to quality of care in emergency department. Belief system may influence in all aspects of professional relationship among nurses with patients and physicians especially determining severity of illness and applicability of triage scales. It may also reveal how other important concepts such as dumping patients as an illegal practice may be connected to the belief system of nurses in the emergency department.
Audience take away:
- Contextual factors play a significant role in belief system of nurses regarding triage decision making.
- Isolated triage scales in the emergency department should be redeveloped in order to be a part of clinical pathway in the hospital.
- Critically-ill patients may be victim of patient dumping on the pretext of lack of facilities.