The Triage Role Experience: An Interpretive Description Approach

Abstract

Background: The demands for specialized cardiac diagnostic and interventional procedures exceed available resources. Long wait times pose difficulties for patients, families, and the triage nurses who work to optimize the process. Referral intake teams operate independently to book hospitalized inpatients and outpatients for the same cardiac procedure timeslots within the Cardiac Catheterization Laboratory. The role of the triage nurse is to optimize patient placement based on acuity. Understanding the meaning and inherent complexity that triage nurses attach to this process is necessary to inform optimization of resource utilization and improve the assessment capabilities of the triage nurse. Aim: The aim of this study was to address the question: What are the experiences and perspectives of triage nurses when implementing referral processes for cardiac procedures? Methods: A qualitative interpretive description (ID) methodology was used to understand the critical factors influencing triage decision-making and processes. Six semi-structured interviews were conducted with five nurses responsible for triaging inpatients and outpatients for specialized cardiac procedures. Thereafter, constant comparative analysis was used to analyze the data and support the iterative ID process. Findings: The human touch, the advocate, and the art of triage illustrate that the triage nurse role necessitates clinical and interpersonal skills and expertise to develop rapport with multiple stakeholders to optimize patient flow and ensure timely access to care for all cardiac patients regardless of inpatient or outpatient status. Discussion: Collegial relationships, transparency regarding wait times, standardizing education, and applying a streamlined, evidence-based approach to triage and waitlist management are essential in reducing inconsistencies and improving the art of triage. The addition of a Clinical Nurse Specialist can support clinical excellence in this area through ongoing research, quality improvement initiatives, education, collaboration between both triage roles and coordination of patient care with referring and procedural sites.