Development and implementation of a structured emergency nursing triage training program

Introduction

In most Emergency Departments (EDs) around the world, triage is performed by nurses with appropriate training and extensive experience. In Greece, organized Triage in EDs began being implemented in 2018 by ED attendings. Nurses' privileges for ED Triage were legislated only in 2022. Having a long ground to cover, a systematic training program in triage for nurses was implemented at Nikaia’s Hospital in Greece.

Implementation in Nikaia’s ED

Based on specific requirements, regional regulations, and globally recognized best practices, a standardized triage procedure was developed. The main objective was to create a training program that would enable the triage nurses to classify patients' acuity accurately and safely. The training program was designed with a six-month theoretical component and a one-month on-the-job training component. After completing the training, nurses managed triage under the supervision of ED attendings before continuing on their own. In order to analyze specific triage cases and provide educational interventions to address prevalent areas of under-or over-triage, monthly meetings with triage nurses and ED attendings were held.

Results

The training program's evaluation was in line with findings from the global literature that highlight the improvement in patient satisfaction ratings and the decrease in conflicts between triage and on-call clinic staff. Nikaia’s Hospital ED is one of the first hospitals in Greece to introduce a systematic triage training program. The effectiveness and depth of experience acquired by the staff of Nikaia’s Hospital have been recognized nationally. The Hellenic Society for Emergency Medicine (HESEM) has chosen Nikaia’s triage staff to teach the first triage course. The first academic program of specialized training in triage of the Medical School of the University of Patras is developed and delivered, among others, by Nikaia’s triage staff.