Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2024 Aug 22:10:23779608241274766.
doi: 10.1177/23779608241274766. eCollection 2024 Jan-Dec.

Comparing Emergency Nursing Measures Before and During COVID-19: A Retrospective Study of Assessment, Triage, and Workflow

Nofar Misan  1 , Rachel Wilf-Miron  1   2 , Mor Saban  3
Affiliations

Comparing Emergency Nursing Measures Before and During COVID-19: A Retrospective Study of Assessment, Triage, and Workflow

Nofar Misan et al. SAGE Open Nurs. .

Abstract

Background: The COVID-19 pandemic significantly impacted emergency department (ED) operations and patient care. Understanding its effects on nursing processes, triage accuracy, and wait times is pivotal for optimizing outcomes.

Objectives: This study aimed to analyze the differences in nursing processes, triage accuracy, and wait times before and during the COVID-19 pandemic.

Design: A retrospective cohort study.

Methods: The study analyzed 224 electronic medical records from a single ED, with 120 records from the pre-pandemic period (January 2019-February 2020) and 104 records from the pandemic period (March 2020-March 2021). Dependent variables included missed nursing care per validated scales, triage accuracy per Emergency Severity Index, and wait times for nursing triage and physician examination. Independent factors encompassed sociodemographic, clinical characteristics, and organization dynamics.

Results: Sociodemographic and clinical profiles were comparable between periods. Triage accuracy remained high except for older patients. Nursing triage wait times differed little, yet physician examination and urgent case waits decreased amidst the pandemic. Nursing documentation completeness, such as recording patient status and mental state, augmented during this crisis period.

Conclusion: This evaluation identified differences in triage accuracy, wait times, and documentation completeness before and during the COVID-19 pandemic period at a single institution. Patient age and clinical status influenced some metrics. Lessons from comparing precrisis benchmarks to intra-pandemic nursing performance may guide pandemic preparedness strategies. Further research is warranted to optimize emergency processes and outcomes during public health emergencies, as well as examine strategies through multicenter investigations comparing prepandemic to intra-pandemic performance to provide broader insights into challenges and inform efforts to bolster emergency care through future crises.

Keywords: COVID-19; emergency departments; nursing care management; triage accuracy; waiting times.

PubMed Disclaimer

Conflict of interest statement

The authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Figures

Figure 1.
Figure 1.
Waiting times in the ED (in minutes) according to the urgency score given during triage, before and after the pandemic began (n = 224).
Figure 2.
Figure 2.
Completeness of nurse assessment, by period.
See this image and copyright information in PMC

Similar articles

See all similar articles

References

    1. Aloweni F., Bouchoucha S. L., Hutchinson A., Ang S. Y., Toh H. X., Bte Suhari N. A., Bte Sunari R. N., Lim S. H. (2022). Health care workers’ experience of personal protective equipment use and associated adverse effects during the COVID-19 pandemic response in Singapore. Journal of Advanced Nursing, 78(8), 2383–2396. 10.1111/jan.15164 - DOI - PMC - PubMed
    1. Ataman M. G., Sarıyer G. (2021). Predicting waiting and treatment times in emergency departments using ordinal logistic regression models. American Journal of Emergency Medicine, 46, 45–50. 10.1016/j.ajem.2021.02.061 - DOI - PubMed
    1. Ayalon L., Tesch-Römer C. (Eds.). (2018). Contemporary Perspectives on Ageism (Vol. 19). Springer International Publishing. 10.1007/978-3-319-73820-8 - DOI
    1. Brosinski C. M., Riddell A. J., Valdez S. (2017). Improving triage accuracy. Clinical Nurse Specialist, 31(3), 145–148. 10.1097/NUR.0000000000000291 - DOI - PubMed
    1. Cameron A., Ireland A. J., McKay G. A., Stark A., Lowe D. J. (2017). Predicting admission at triage: Are nurses better than a simple objective score? Emergency Medicine Journal : EMJ, 34(1), 2–7. 10.1136/emermed-2014-204455 - DOI - PubMed

LinkOut - more resources