Songül Biskin Çetin1, Oktay Eray2, Sengül Erdal Akiner3, Meral Gözkaya3, Özlem Yigit2

1Department of Surgical Nursing, Akdeniz University, Antalya, Turkey
2Departments of Emergency Medicine, Faculty of Medicine, Akdeniz University Hospital, Antalya, Turkey
3Department of Emergency, Akdeniz University Hospital, Antalya, Turkey

Keywords: Advanced triage, clinical decision-making, emergency departments, emergency nursing


OBJECTIVES: The increasing number of patients admitted to emergency departments (EDs) and overcrowding of EDs lead to a global problem. Advanced nursing triage is an important solution in facilitating patient and time management, also increasing the efficiency of the ED. This study was conducted to predict the possible effects of applying advanced nursing triage modeling with predetermined protocols during the current nursing triage in the ED.

METHODS: This was a descriptive and cross-sectional study. An advanced “triage assessment protocol,” which was developed previously, was hypothetically applied for 5 days by triage nurses in the adult ED of a university hospital. The hypothetical application was tested by triage nurses in all shifts. The nurses recorded the examination or treatment options which they thought to apply for the patient on the study form. The data recorded on the advanced triage evaluation protocol form by the triage nurses were compared with the patient outcomes and physician examination/treatment requests in the Hospital Information Management System by the researchers.

RESULTS: In the study, it was determined that the rate of examination/treatment that could be requested according to the advanced nursing triage protocol was 46%. There were a good level of agreement on X-ray and a moderate level of agreement on urinary test and urinary beta- Human chorionic gonadotropin (hCG) test between physicians and triage nurses regarding examination/ treatment requests. In addition, it was found that there was a 61.2% of agreement on decisions made for patients aged between 18 and 35. The rate of agreement between doctors and nurses regarding a gluco-stick request for patients admitted outside the prime time (92.2%) was found to be significantly higher (87.9%) than for patients admitted during prime time (P = 0.046).

CONCLUSION: “Advanced triage” practices recommended for busy EDs were tested “hypothetically” at the national level due to the lack of legal regulations and were found to be compatible with the actual results of physicians’ practices at an acceptable level, especially for selected medical conditions. The method used in this study can be useful in planning the transition to “advanced triage” practices. These results can show the readiness of nurses for the transition to this practice.

How to cite this article: Çetin SB, Eray O, Akiner SE, Gözkaya M, Yigit Ö. Results of an advanced nursing triage protocol in emergency departments. Turk J Emerg Med 2022;22:200-5.

Ethics Committee Approval

Ethical approval was obtained by the Akdeniz University Faculty of Medicine Ethics Committee for Non-Interventional Clinical Research with the approval number of 2012/KAEK/20/325/2020 on the date of May 13, 2020. In addition, none of the identifying information of the patients was used so that the privacy of patients could be protected.

Author Contributions

OE was responsible for the study conception, design, data analysis, and drafting of the manuscript. SBÇ was responsible for the study design and the drafting of the manuscript. ŞE was responsible for the study design and accessed to data. MG accessed to data. OY was responsible for the drafting of the manuscript and supervised the study.

Conflict of Interest

None declared.

Financial Disclosure



The authors would like to thank the emergency nurses for participating in the study.